Debate: diminutive polyps noted at CT colonography need not be reported

Colorectal polyps less than 6 mm in size pose a negligible risk to the development of colorectal carcinoma. The sensitivity and specificity for detection of diminutive lesions on all available examinations including CT colonography (CTC) and optical colonoscopy (OC) is relatively low. In the context of regular screening, the low clinical significance and slow to negligible growth of diminutive polyps, as well as the low detection performance of CTC and OC for these lesions, would contribute to wasted health care resource and excess morbidity if each diminutive polyp were referred for potential resection. Respect for patient safety, attention to proper use of resources, and appropriate focus on larger, clinically significant polyps lead the authors to the conclusion that colonic polyps of less than 6 mm should not be separately reported.