Introduction
Screening endoscopy (sigmoidoscopy and colonoscopy) with polypectomy reduces the incidence of and mortality from colorectal cancer.1-4 Most colorectal polyps are removed with routine endoscopic resection, although polyps considered to be complex because of size, location or morphology are commonly resected surgically.5-7 An estimated 1% of all patients with a non-malignant colorectal polyp will be sent for surgical resection.8-10 In the United States, 73,000 elective colectomies for colorectal cancer and non-malignant colorectal polyps are performed annually. Of these, 32% are performed on patients with non-malignant disease.9 Surgery for a non-malignant colorectal polyp is associated with significant morbidity, mortality and cost.9 …show more content…
There is emerging evidence that complex non-malignant colorectal polyps can be effectively and safely managed with advanced endoscopic resection. Advanced endoscopic resection has been shown to prevent the need for surgery in 92% of cases (6442 patients).11 Advanced endoscopic resection is associated with a reduced risk of adverse events and is more cost effective compared with surgical resection. Despite this paradigm shift in the management of non-malignant colorectal polyps, little is known about temporal trends in clinical practice. Understanding national, regional and hospital-level practice patterns has the potential to inform discussions regarding the relative merits of management strategies and to inform the impact on the health care