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Diagnosis and Treatment of Diminutive Polyps in the Colon

  • Endoscopy (P Siersema, Section Editor)
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Abstract

Purpose of review

Colonoscopy and polypectomy reduce the incidence and mortality of colorectal cancer (CRC) by detecting and removing colorectal adenomas. Diminutive polyps (1–5 mm) account for 75% of all polyps found but rarely contain or progress to CRC. Although a high adenoma detection rate (ADR) is associated with improved cancer prevention, the increase in detection of diminutive polyps also increases costs associated with CRC prevention programs. This review provides an update on endoscopic management and considerations related to diminutive colorectal polyps.

Recent findings

Recent studies show that only 0–4.3% of diminutive polyps show advanced features and progression into CRC is extremely rare. Advances in endoscopic imaging have improved the ADR for screening colonoscopy, mostly as a result of greater detection of diminutive and hyperplastic polyps. A resect and discard strategy for these low-risk diminutive polyps could reduce the need for pathologic assessment and is included in society guidelines with recommendations on imaging modalities, classification, and endoscopist benchmarks. To ensure complete resection, cold snare polypectomy is emerging as the most efficient and safest method of removal. A recent guideline review showed that fecal immunochemical testing is generally the preferred first-line screening test in average-risk adults. Post-polypectomy surveillance intervals may increase in the future as evidence on the management and outcomes of diminutive polyps which is assimilated.

Summary

High detection rates of diminutive polyps result in more surveillance colonoscopies and higher healthcare costs, with unclear benefit for CRC prevention. Optical diagnosis and strategies such as resect and discard may help to reduce costs. The performance of high-quality colonoscopies and strict adherence to recommended surveillance intervals will also optimize the effectiveness of screening programs.

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Abbreviations

ADR:

Adenoma detection rate

AI:

Artificial intelligence

ASGE:

American Society for Gastrointestinal Endoscopy

CRC:

Colorectal cancer

CSP:

Cold snare polypectomy

CTC:

Computed tomography colonoscopy

ESGE:

European Society of Gastrointestinal Endoscopy

FICE:

Flexible spectral imaging color enhancement

FIT:

Fecal immunochemical test

HGD:

High-grade dysplasia

NBI:

Narrow-band imaging

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. World Health Organization. Cancer. Key facts. 2019. https://www.who.int/news-room/fact-sheets/detail/cancer. Accessed 5 Dec 2019

  2. •• Lieberman D, Gupta S. Does colon polyp surveillance improve patient outcomes? Gastroenterology. 2019. https://doi.org/10.1053/j.gastro.2019.10.008. High-quality initial colonoscopy with appropriate polypectomy reduces CRC mortality. There is almost no evidence supporting effectiveness of post-polypectomy surveillance on reducing CRC incidence and mortality. Modern high-definition endoscopy increases ADR to the extent it is hypothesized that patients with 3–4 small adenomas might be categorized as low-risk patients.

  3. Neugut AI, Jacobson JS, Rella VA. Prevalence and incidence of colorectal adenomas and cancer in asymptomatic persons. Gastrointest Endosc Clin N Am. 1997;7:387–99.

    Article  CAS  PubMed  Google Scholar 

  4. •• Rex DK, Sullivan AW, Perkins AJ, Vemulapalli KC. Colorectal polyp prevalence and aspirational detection targets determined using high definition colonoscopy and a high level detector in 2017. Dig Liver Dis. 2019; Prevalence of adenoma reaches up to 48.5% in the screening population. Diminutive polyps represent the majority of these lesions. This study highlights the significant economic burden diminutive polyps represent.

  5. Repici A, Wallace MB, East JE, et al. Efficacy of per-oral methylene blue formulation for screening colonoscopy. Gastroenterology. 2019;156:2198–207.

    Article  CAS  PubMed  Google Scholar 

  6. Wong JCT, Chiu HM, Kim HS, et al. Asia-Pacific Working Group on Colorectal Cancer. Adenoma detection rates in colonoscopies for positive fecal immunochemical tests versus direct screening colonoscopies. Gastrointest Endosc. 2019;89:607–13.

    Article  PubMed  Google Scholar 

  7. Kligman E, Li W, Eckert GJ, et al. Adenoma detection rate in asymptomatic patients with positive fecal immunochemical tests. Dig Dis Sci. 2018;63:1167–72.

    Article  PubMed  Google Scholar 

  8. • Bénard F, von Renteln D. Adenoma detection – the more the merrier? Endoscopy. 2018;50:835–6 Surveillance colonoscopies lead to high ADR of mostly non-advanced lesions. There might be overdiagnosis and overtreatment of lesions that would not likely progress into colorectal cancer. This article highlights that targeting resources toward unscreened individuals are more beneficial on reducing colorectal cancer.

    Article  PubMed  Google Scholar 

  9. •• Ponugoti PL, Cummings OW, Rex DK. Risk of cancer in small and diminutive colorectal polyps. Dig Liver Dis. 2017;49:34–7. This large retrospective study on 42,630 small polyps shows high-grade dysplasia and advanced features are found in 0.3% and 2.1% of diminutive polyps, respectively. There were no cancers. This large study shows that the risk of malignancy in diminutive polyps is extremely low.

    Article  PubMed  Google Scholar 

  10. Rex DK. Serrated polyps in the colon. Gastroenterol Hepatol (N Y). 2014;10:671–4.

    Google Scholar 

  11. Myers DJ, Arora K. Villous adenoma. Treasure Island: StatPearls Publishing; 2019. http://www.ncbi.nlm.nih.gov/books/NBK470272/. Accessed 1 November 2019

    Google Scholar 

  12. IJspeert JE, Bastiaansen BA, van Leerdam ME, et al. Dutch Workgroup serrAted polypS & Polyposis (WASP). Development and validation of the WASP classification system for optical diagnosis of adenomas, hyperplastic polyps and sessile serrated adenomas/polyps. Gut. 2016;65:963–70.

    Article  PubMed  Google Scholar 

  13. Radaelli F. The resect-and-discard strategy for management of small and diminutive colonic polyps. Gastroenterol Hepatol (N Y). 2013;9:305–8.

    Google Scholar 

  14. •• Vleugels J, Hazewinkel Y, Fockens P, et al. Natural history of diminutive and small colorectal polyps: a systematic literature review. Gastrointest Endosc. 2017;85:1169–76.e1 This systematic literature review showed no colorectal cancer in diminutive polyps during follow-up of 1.2–12.6 years. Advanced adenomas during follow-up ranged from 0 to 1%. This review proves the relatively benign natural history of diminutive polyps.

    Article  PubMed  Google Scholar 

  15. • Mizuno K, Suzuki Y, Takeuchi M, et al. Natural history of diminutive colorectal polyps: long-term prospective observation by colonoscopy. Dig Endosc. 2014;26(Suppl. 2):84–9. This prospective observational study has the longest follow-up of diminutive polyps. It confirms the benign natural history of these lesions with no incident cases of invasive carcinomas during 7.8 years of surveillance.

    Article  PubMed  Google Scholar 

  16. Brenner H, Hoffmeister M, Stegmaier C, et al. Risk of progression of advanced adenomas to colorectal cancer by age and sex: estimates based on 840,149 screening colonoscopies. Gut. 2007;56:1585–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. • Vleugels JLA, Hassan C, Senore C, et al. Diminutive polyps with advanced histologic features do not increase risk for metachronous advanced colon neoplasia. Gastroenterology. 2019;156:623–34. This pooled analysis of 12 international cohorts of patients undergoing screening for colorectal cancer proves no increased risk for metachronous advanced colon neoplasia in diminutive polyps with advanced histologic features.

    Article  PubMed  Google Scholar 

  18. • Pickhardt PJ, Hassan C, Laghi A, et al. Cost-effectiveness of colorectal cancer screening with computed tomography colonography. Cancer. 2007;109:2213–21. Reporting diminutive polyps found during computed tomography colonography leads to high cost whereas the incidence of colorectal cancer is reduced by only 1.3%. Therefore, not reporting those lesions appears to be the most cost-effective and safest approach.

    Article  PubMed  Google Scholar 

  19. Eide TJ. Risk of colorectal cancer in adenoma-bearing individuals within a defined population. Int J Cancer. 1986;38:173–6.

    Article  CAS  PubMed  Google Scholar 

  20. van Rijn JC, Reitsma JB, Stoker J, et al. Polyp miss rate determined by tandem colonoscopy: a systematic review. Am J Gastroenterol. 2006;101:343–50.

    Article  PubMed  Google Scholar 

  21. ASGE/ACG Task Force on Quality in Endoscopy, Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2015;81:31–53.

    Article  Google Scholar 

  22. Corley DA, Jensen CD, Marks AR, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014;370:1298–306.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Penz D, Ferlitsch A, Waldmann E, Irina G, Daniel P, Asaturi A, et al. Impact of adenoma detection rate on detection of advanced adenomas and endoscopic adverse events in a study of over 200,000 screening colonoscopies. Gastrointest Endosc. 2019.

  24. Kaminski MF, Thomas-Gibson S, Bugajski M, et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative. United European Gastroenterol J. 2017;5:309–34.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Castaneda D, Popov VB, Verheyen E, et al. New technologies improve adenoma detection rate, adenoma miss rate, and polyp detection rate: a systematic review and meta-analysis. Gastrointest Endosc. 2018;88:209–22.

    Article  PubMed  Google Scholar 

  26. Mori Y, Kudo SE, Misawa M, et al. Simultaneous detection and characterization of diminutive polyps with the use of artificial intelligence during colonoscopy. VideoGIE. 2019;4:7–10.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Karkanis SA, Iakovidis DK, Maroulis DE, et al. Computer-aided tumor detection in endoscopic video using color wavelet features. IEEE Trans Inf Technol Biomed. 2003;7:141–52.

    Article  PubMed  Google Scholar 

  28. Wang P, Berzin TM, Glissen Brown JR, et al. Real-time automatic detection system increases colonoscopic polyp and adenoma detection rates: a prospective randomised controlled study. Gut. 2019. https://doi.org/10.1136/gutjnl-2018-317500.

  29. Rex DK, Kahi C, O’Brien M, et al. The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc. 2011;73:419–22.

    Article  PubMed  Google Scholar 

  30. Hassan C, Pickhardt PJ, Rex DK. A resect and discard strategy would improve cost-effectiveness of colorectal cancer screening. Clin Gastroenterol Hepatol. 2010;8:865–869.e1–3.

    Article  PubMed  Google Scholar 

  31. Ponugoti P, Rastogi A, Kaltenbac T, et al. Disagreement between high confidence endoscopic adenoma prediction and histopathological diagnosis in colonic lesions ≤ 3 mm in size. Endoscopy. 2019;51:221–6.

    Article  PubMed  Google Scholar 

  32. Lasisi F, Mouchli A, Riddell R, et al. Agreement in interpreting villous elements and dysplasia in adenomas less than one centimetre in size. Dig Liver Dis. 2013;45:1049–55.

    Article  PubMed  Google Scholar 

  33. Djinbachian R, Dubé AJ, von Renteln D. Optical diagnosis of colorectal polyps: recent developments. Curr Treat Options Gastroenterol. 2019;17:99–114.

    Article  PubMed  Google Scholar 

  34. Bisschops R, East JE, Hassan C, et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline- Update 2019. Endoscopy. 2019;51:1155–79.

    Article  PubMed  Google Scholar 

  35. Buchner AM. The role of chromoendoscopy in evaluating colorectal dysplasia. Gastroenterol Hepatol. 2017;13:336–47.

    Google Scholar 

  36. National Institute for Health and Care Excellence. Virtual chromoendoscopy to assess colorectal polyps during colonoscopy. 2017. https://www.nice.org.uk/guidance/dg28/chapter/1-Recommendation.2017. Accessed 1 November 2019.

  37. Kandel P, Wallace MB. Should we resect and discard low risk diminutive colon polyps. Clin Endosc. 2019;52:239–46.

    Article  PubMed  PubMed Central  Google Scholar 

  38. ASGE Technology Committee, Abu Dayyeh BK, Thosani N, et al. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc. 2015;81:502.e1–502.e16.

    Article  Google Scholar 

  39. Qumseya BJ, Coe S, Wallace MB. The effect of polyp location and patient gender on the presence of dysplasia in colonic polyps. Clin Transl Gastroenterol. 2012;3:e20.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Atkinson NS, East JE. Optical biopsy and sessile serrated polyps: is DISCARD dead? Long live DISCARD-lite! Gastrointest Endosc. 2015;82:118–21.

    Article  PubMed  Google Scholar 

  41. von Renteln D, Kaltenbach T, Rastogi A, et al. Simplifying resect and discard strategies for real-time assessment of diminutive colorectal polyps. Clin Gastroenterol Hepatol. 2018;16:706–14.

    Article  Google Scholar 

  42. East JE, Vleugels JL, Roelandt P, et al. Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review. Endoscopy. 2016;48:1029–45.

    Article  PubMed  Google Scholar 

  43. •• Mori Y, Kudo SE, Misawa M, et al. Real-time use of artificial intelligence in identification of diminutive polyps during colonoscopy: a prospective study. Ann Intern Med. 2018;169:357–66. Artificial intelligence reaches required performance level to detect and predict the pathology of diminutive polyps found during colonoscopy. It allows good performance that is independent of the endoscopist’s expertise.

    Article  PubMed  Google Scholar 

  44. Byrne MF, Chapados N, Soudan F, et al. Real-time differentiation of adenomatous and hyperplastic diminutive colorectal polyps during analysis of unaltered videos of standard colonoscopy using a deep learning model. Gut. 2019;68:94–100.

    Article  PubMed  Google Scholar 

  45. Tamai N, Saito Y, Sakamoto T, et al. Effectiveness of computer-aided diagnosis of colorectal lesions using novel software for magnifying narrow-band imaging: a pilot study. Endosc Int Open. 2017;5:E690–4.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Djinbachian R, Iratni R, Durand M, et al. Incomplete resection of 1–20 mm colorectal polyps: a systematic review and meta-analysis. DDW 2020 conference presentation.

  47. Fyock CJ, Draganov PV. Colonoscopic polypectomy and associated techniques. World J Gastroenterol. 2010;16:3630–7.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Komeda Y, Kashida H, Sakurai T, et al. Removal of diminutive colorectal polyps: a prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy. World J Gastroenterol. 2017;23:328–35.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Ferlitsch M, Moss A, Hassan C, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2017;49:270–97.

    Article  PubMed  Google Scholar 

  50. Chang LC, Shun CT, Hsu WF, et al. Risk of delayed bleeding before and after implementation of cold snare polypectomy in a screening colonoscopy setting. Endosc Int Open. 2019;7:E232–8.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Park SK, Ko BM, Han JP, et al. A prospective randomized comparative study of cold forceps polypectomy by using narrow-band imaging endoscopy versus cold snare polypectomy in patients with diminutive colorectal polyps. Gastrointest Endosc. 2016;83:527–32.e1.

    Article  PubMed  Google Scholar 

  52. Lee CK, Shim JJ, Jang JY. Cold snare polypectomy vs. cold forceps polypectomy using double-biopsy technique for removal of diminutive colorectal polyps: a prospective randomized study. Am J Gastroenterol. 2013;108:1593–600.

    Article  PubMed  Google Scholar 

  53. Jung YS, Park CH, Nam E, et al. Comparative efficacy of cold polypectomy techniques for diminutive colorectal polyps: a systematic review and network meta-analysis. Surg Endosc. 2018;32:1149–59.

    Article  PubMed  Google Scholar 

  54. Maruoka D, Kishimoto T, Matsumura T, Arai M, Akizue N, Ishikawa K, et al. Underwater cold snare polypectomy for colorectal adenomas. Dig Endosc. 2019;31:662–71.

    Article  PubMed  Google Scholar 

  55. American Cancer Society. Colorectal cancer screening tests. American Cancer Society. 2018. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html. Accessed 6 Sep 2019.

  56. Yee J, Chang KJ, Johnstone C, et al. ACR–SAR–SCBT-MR practice parameter for the performance of computed tomography (CT) colonography in adults. The American College of Radiology. 2019. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/ct-colonog.pdf. Accessed 9 Sep 2019.

  57. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, et al. Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA. 2016;315:2564–75.

    Article  CAS  Google Scholar 

  58. Pooler BD, Kim DH, Lam VP, et al. CT colonography reporting and data system (C-RADS): benchmark values from a clinical screening program. AJR Am J Roentgenol. 2014;202:1232–7.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Bénard F, Barkun AN, Martel M, et al. Systematic review of colorectal cancer screening guidelines for average-risk adults: summarizing the current global recommendations. World J Gastroenterol. 2018;24:124–38.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Lee JK, Liles EG, Bent S, et al. Accuracy of fecal immunochemical tests for colorectal cancer: systematic review and meta-analysis. Ann Intern Med. 2014;160:171–81.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Levin B, Lieberman DA, McFarland B, et al. American Cancer Society Colorectal Cancer Advisory Group; US Multi-Society Task Force; American College of Radiology Colon Cancer Committee. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570–95.

    Article  CAS  PubMed  Google Scholar 

  62. Imperiale TF, Ransohoff SH, Levin TR, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370:1287–97.

    Article  CAS  PubMed  Google Scholar 

  63. Mulhall BP, Veerappan GR, Jackson JL. Meta-analysis: computed tomographic colonography. Ann Intern Med. 2005;142:635–50.

    Article  PubMed  Google Scholar 

  64. Sakamoto T, Mitsuzaki K, Utsunomiya D, et al. Detection of flat colorectal polyps at screening CT colonography in comparison with conventional polypoid lesions. Acta Radiol. 2012;53:714–9.

    Article  PubMed  Google Scholar 

  65. Plumb AA, Eason D, Goldstein M, et al. Computed tomographic colonography for diagnosis of early cancer and polyps? Color Dis. 2019;21(S1):23–8.

    Article  Google Scholar 

  66. Kim DH, Pooler BD, Weiss JM, et al. Five year colorectal cancer outcomes in a large negative CT colonography screening cohort. Eur Radiol. 2012;22:1488–94.

    Article  PubMed  Google Scholar 

  67. Neri E, Halligan S, Hellström M, et al. ESGAR CT Colonography Working Group. The second ESGAR consensus statement on CT colonography. Eur Radiol. 2013;23:720–9.

    Article  PubMed  Google Scholar 

  68. Rex DK, Boland RC, Dominitz J, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2017;112:1016–30.

    Article  PubMed  Google Scholar 

  69. von Renteln D, Bouin M, Barkun AN, et al. Patients’ willingness to defer resection of diminutive polyps: results of a multicenter survey. Endoscopy. 2018;50:221–9.

    Article  Google Scholar 

  70. Sakata S, Lee AHS, Kheir AO, et al. Patient acceptance of the optical diagnosis and misdiagnosis of diminutive colorectal polyps. Gastrointest Endosc. 2017;86:372–5.e2.

    Article  PubMed  Google Scholar 

  71. Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–57.

    Article  PubMed  Google Scholar 

  72. British Society of Gastroenterology. 2019. BSG/ACPGBI/PHE Post-polypectomy and post-colorectal cancer resection surveillance guidelines. 2019. https://www.bsg.org.uk/resource/bsg-acpgbi-phe-post-polypectomy-and-post-colorectal-cancer-resection-surveillance-guidelines.html. Accessed 2 Dec 2019.

  73. Cross AJ, Wooldrage K, Robbins EC, et al. Faecal immunochemical tests (FIT) versus colonoscopy for surveillance after screening and polypectomy: a diagnostic accuracy and cost-effectiveness study. Gut. 2019;68:1642–52.

    Article  PubMed  Google Scholar 

  74. Djinbachian R, Dubé AJ, Durand M, et al. Adherence to post-polypectomy surveillance guidelines: a systematic review and meta-analysis. Endoscopy. 2019;51:673–83.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Internal Medicine, Montreal University Hospital Center (CHUM), Montreal, Canada

    Iness Soltani MD

  2. Montreal University Hospital Research Center (CRCHUM), Montreal, Canada

    Iness Soltani MD & Daniel von Renteln MD

  3. Department of Medicine, Division of Gastroenterology, Montreal University Hospital Center (CHUM) and Montreal University Hospital Research Center (CRCHUM), 900 Rue Saint-Denis, Montreal, QC, H2X 0A9, Canada

    Daniel von Renteln MD

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Contributions

Iness Soltani: acquisition of data, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content. Daniel von Renteln: analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.

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Correspondence to Daniel von Renteln MD.

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Conflict of Interest

Daniel von Renteln is supported by a “Fonds de Recherche du Québec Santé” career development award. He has also received research funding from ERBE, Ventage, Pendopharm, and Pentax, and is a consultant for Boston Scientific and Pendopharm. Iness Soltani has no conflict of interest to declare.

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Soltani, I., von Renteln, D. Diagnosis and Treatment of Diminutive Polyps in the Colon. Curr Treat Options Gastro 18, 175–187 (2020). https://doi.org/10.1007/s11938-020-00281-3

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