title: Management of subcentimetric polyps detected by CT colonography.
abstract: The advent of CT colonography (CTC) has generated conservative policies for the management of diminutive (<5 mm) and small (6-9 mm) polyps to prevent inefficient duplication of screening tests. The effect of not referring subcentimetric polyps for polypectomy on the efficacy of colorectal cancer screening is still uncertain but depends on the natural history of diminutive and small polyps, as well as on the distribution of advanced neoplasia within these lesions. Simulation modelling enables the efficacy and cost-effectiveness of conservative strategies for the management of subcentimetric lesions to be tested (such as nonreferral to polypectomy for diminutive polyps and early CTC surveillance for small polyps). These policies might be further refined by the inclusion of patient and polyp-related predictive factors for advanced neoplasia, enabling a patient-tailored approach for the management of these lesions.
authors.affiliation: Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Via Morosini 30, 00153 Rome, Italy. cesareh@hotmail.com
authors.forename: Cesare
authors.initials: C
authors.lastname: Hassan
authors.forename: Perry J
authors.initials: PJ
authors.lastname: Pickhardt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D023881:Colonography, Computed Tomographic / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D019468:Disease Management; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors