Small and diminutive polyps: implications for colorectal cancer screening with computed tomography colonography.

摘要

In this issue of Clinical Gastroenterology and Hepa-tology, Butterly et al reported on the prevalence of advanced histology (high-grade dysplasia or villous histology) in small (5-10 mm) and diminutive (<=4 mm) adenomas. In their retrospective study of more than 3000 colonoscopies, the pathology reports from almost 2000 small and diminutive adenomas were reviewed. Advanced histology was identified in only 1.7% of diminutive adenomas and actual carcinoma was not found in any diminutive adenomas. Given these results, Butterly et al suggested that diminutive adenomas are clinically unimportant because of the low risk for transformation to carcinoma.