Routine Polypectomy Practices Vary Widely Among US Endoscopists and Commonly Deviate From Guidelines: An Analysis of...

Area of Science:

• Gastroenterology
• Endoscopy
• Quality Improvement

Background:

• Established best practices exist for removing colon polyps less than 1 cm.
• Uncertainty remains regarding adherence to these established guidelines.

Purpose of the Study:

• To analyze polypectomy techniques used for colon polyps smaller than 1 cm.
• To identify variations in technique based on patient, procedure, and provider characteristics.

Main Methods:

• Analysis of colonoscopy data from the Gastroenterology Quality Improvement Consortium Registry (GIQuIC).
• Inclusion of over 1.8 million colonoscopies involving polyps less than 1 cm.

Main Results:

• Cold forceps, cold snare, and hot snare techniques were used in 35%, 58%, and 11% of cases, respectively.
• Polypectomy technique varied significantly by polyp type, geographic region, and provider specialty.
• Gastroenterologists demonstrated greater adherence to guidelines compared to non-GI endoscopists.

Conclusions:

• Wide variation exists in polypectomy techniques employed by US endoscopists for small colon polyps.
• Current practices may not consistently align with recommended best practices for colon polyp removal.