Table 5. People With Positive Pre-Malignant Polyps or
Other Abnormal Screening Results
Basic/
Limited Enhanced Maximal
Pedunculated
3.1 Colonoscopy N/A Colonoscopy should be performed always with
therapeutic intent. (Strong Recommendation; Ins);
Performed by endoscopist with training in
polypectomy. (Strong Recommendation; L)
3.2 Polypectomy
(Strong
Recommendation; I)
Refer to guidelines for
special considerations
including anti
coagulants and
coronary stents
N/A Lesions should be removed with polypectomy.
3.3 Evaluation of
morpholog y (Strong
Recommendation; Ins)
N/A Large pre-malignant lesions not suitable for endoscopic
resection should be referred for surgical resection.
3.4 Mucosal
tattooing (Weak
Recommendation; Ins)
N/A If lesion cannot be removed (in BSG guidelines);
if large lesion has a high likelihood of malignancy
(informal consensus) may be performed.
3.5 Histolog y/
patholog y (Strong
Recommendation; Ins)
N/A Removed lesions should be retrieved for histologic
exam; confirm negative borders of resection.
3.6 Referral to
surgery (Strong
Recommendation; Ins)
N/A Only patients with lesions that cannot be removed
endoscopically should be referred to surgery.
Non-Pedunculated
3.7 Colonoscopy N/A Yes always with therapeutic intent; endoscopic
resection first line therapy for LNPCP with
no suspicion of malignancy. (Intent: Strong
Recommendation; Ins; Resection: Strong
Recommendation; I)
Should be performed by endoscopists with training in
large complex polyps. (Weak Recommendation; L)
Multidisciplinary team may perform colonoscopies.
(Weak Recommendation; Ins)
3.8 Polypectomy (Strong
Recommendation; I)
Refer to guidelines for
special considerations
including anti-
coagulants and coronary
stents
N/A Lesions should be removed with polypectomy; removal
of lesions is dependent on the low likelihood of
malignancy. (Strong Recommendation; I)
Possibility of complete resection, refer to BSG/ACGB
guidelines. (Strong Recommendation; L)