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Management of subcentimetric polyps detected by CT colonography

Nature Reviews Gastroenterology & Hepatology volume 10, pages 119–124 (2013)Cite this article

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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.

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Figure 1: A 6 mm tubular adenoma detected at CT colonography (CTC) screening and confirmed endoscopically in a 52-year-old woman.

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Author information

Authors and Affiliations

  1. Digestive Endoscopy Unit, “Nuovo Regina Margherita” Hospital, Via Morosini 30, Rome, 00153, Italy

    Cesare Hassan

  2. Department of Radiology, University of Wisconsin School of Medicine & Public Health, Madison, E3/311 Clinical Science Center, 600 Highland Avenue, Madison, 53792-3252, WI, USA

    Perry J. Pickhardt

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  1. Cesare Hassan
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Contributions

C. Hassan contributed to researching the data, discussion of content and writing of the manuscript. P. J. Pickhardt contributed to the discussion of content, writing and reviewing/editing of the manuscript.

Corresponding author

Correspondence to Cesare Hassan.

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Competing interests

P. J. Pickhardt declares that he is a consultant for Bracco, Check-Cap, iCAD and Viatronix. He is co-founder of VirtuoCTC. C. Hassan declares no competing interests.

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Hassan, C., Pickhardt, P. Management of subcentimetric polyps detected by CT colonography. Nat Rev Gastroenterol Hepatol 10, 119–124 (2013). https://doi.org/10.1038/nrgastro.2012.222

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