title: Clinical practice variation in the management of diminutive colorectal polyps: results of a national survey of gastroenterologists.
abstract: OBJECTIVE
  We investigated physician beliefs and behaviors regarding diminutive colorectal polyps and the contribution of these beliefs to variable detection rates.
  
  
  METHODS
  One hundred sixty-seven members of the American College of Gastroenterology took a Web-based survey. We compared respondents and nonrespondents using demographic and practice information from the American Medical Association Physician Masterfile.
  
  
  RESULTS
  Respondents varied in their definition of diminutive polyps. Respondents acknowledged leaving diminutive polyps in place during colonoscopy in various scenarios. Years in practice, confidence in endoscopic histologic diagnosis, and never having seen advanced histology in a diminutive polyp were predictive of leaving polyps in place. The majority of respondents were at least somewhat agreeable to leaving diminutive polyps in place if guidelines endorsed this practice.
  
  
  CONCLUSIONS
  Gastroenterologists vary in their removal of diminutive polyps. The results have implications for the interpretation and management of variable polyp detection rates.
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA. ziad.gellad@duke.edu
authors.forename: Ziad F
authors.initials: ZF
authors.lastname: Gellad
authors.forename: Corrine I
authors.initials: CI
authors.lastname: Voils
authors.forename: Li
authors.initials: L
authors.lastname: Lin
authors.forename: Dawn
authors.initials: D
authors.lastname: Provenzale
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D005762:Gastroenterology / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007417:Intestinal Polyps / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*