Table 5. People With Positive Pre-Malignant Polyps or
Other Abnormal Screening Results
Basic/
Limited Enhanced Maximal
3.9 Evaluation of
morpholog y (Strong
Recommendation; Ins)
N/A Endoscopic assessment of lesion using enhanced
endoscopy methods (if available may include
chromoendoscopy); clinicians should follow the BSG
guideline.
3.10 Mucosal
tattooing (Weak
Recommendation; Ins)
N/A If lesion cannot be removed (in BSG guidelines);
if large lesion has a high likelihood of malignancy
should be performed. For patients with polyps that are
completely removed, clinicians may perform tattooing
for surveillance purposes.
3.11 Histolog y/
patholog y (Strong
Recommendation; Ins)
N/A Removed lesions should be retrieved for histologic
exam; confirm negative borders of resection.
3.12 Referral to
surgery (Strong
Recommendation; Ins)
N/A Only patients with lesions that cannot be removed
endoscopically should be referred to surgery.
1
BSG = British Society of Gastroenterolog y/Association of Coloproctologists of Great Britain and
Ireland guidelines for the management of large non-pedunculated colorectal polyps.
Source: Rutter MD, et al. Gut 2015;0:1–27. doi:10.1136/gutjnl-2015-309576
Availabe at: https://www.bsg.org.uk/asset/14074495-3BF4-4EA8-BED8E740BA1E6177
Table 6. Optimal Strategy For Workup/Diagnosis for
Those With Symptoms
Basic Limited Enhanced Maximal
4.1 DRE (IC-Ins) DRE may be performed
(standard part of physical).
N/A physical exam
4.2 Double contrast
barium enema
(IC-Ins)
Double contrast barium
enema may be performed.
N/A
4.3 For those
without
contraindications
to colonoscopy
Colonoscopy with
biopsy for those without
contraindications should be
performed, if colonoscopy
is available, including by
referral.
Colonoscopy with biopsy for those
without contraindications should be
performed.
(cont'd)
Treatment
