New paradigms in polypectomy: resect and discard, diagnose and disregard

Polypectomy at colonoscopy has been shown to reduce the subsequent risk of colorectal cancer. With the advent of national screening programs, the number of colonoscopies performed has increased worldwide. In addition, the recent drive for quality improvement combined with advances in colonoscopic technology has resulted in increased numbers of polyps detected, resected, and sent for histopathology leading to spiraling costs associated with the procedure. Being able to diagnose small polyps in vivo (optical diagnosis) would allow for adenomas to be resected and discarded without the need to retrieve them or send them for formal histopathology.