title: Current management of diminutive colorectal polyps in Taiwan.
abstract: The majority of polyps detected during colonoscopy are diminutive polyps, for which the cost of pathological analysis is substantial. In our analysis of a screening cohort of 10737 subjects undergoing screening colonoscopy, a total of 15877 neoplastic lesions were detected, of which 10816 (68.1%) were diminutive lesions. Of those diminutive lesions, 90 (0.83%) had a villous component, 14 (0.1%) had high-grade dysplasia, and none had invasive cancer. Only 1.3% of patients were advised to decrease their surveillance interval because of unfavorable histology. Laws regulating medical practice, uncertainty regarding the accuracy of endoscopic diagnosis of diminutive polyps outside of academic centers, and the relatively low cost of pathological analysis are among the barriers to adopting a 'resect and discard' practice in Taiwan.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Colonoscopy Quality Assurance Working Group, The Digestive Endoscopy, Society of Taiwan, Taipei, Taiwan.
authors.forename: Han-Mo
authors.initials: HM
authors.lastname: Chiu
authors.forename: Li-Chun
authors.initials: LC
authors.lastname: Chang
authors.forename: Chia-Tung
authors.initials: CT
authors.lastname: Shun
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
authors.forename: Hsiu-Po
authors.initials: HP
authors.lastname: Wang
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D003111:Colonic Polyps / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology
keywords: advanced neoplasm; colon polyp; colonoscopy; colorectal cancer; image-enhanced endoscopy