Endoscopic overestimation of colorectal polyp size

A comparison of endoscopy versus pathology sizing of colorectal adenomas and potential implications for surveillance colonoscopy

“…[45][46][47] One very recent, large, study which included 1528 polyps (931 adenomas) reported significant endoscopy over-sizing. 52 Forty-six percent of 222 polyps estimated as ≥1cm on endoscopy, were <1 cm on pathology, in contrast to only 3.9% of 1306 polyps estimated as <1 cm on endoscopy, proving to be ≥1 cm on pathology. Occasional studies have described smaller endoscopy sizing compared with pathology.…”

“…This has been reported previously. 47,52 Several guidelines specifically state that adenoma measurements should be accurate to the nearest millimeter and not rounded to the nearest 5 or 10 mm. 42,43 Pathology sizing is perhaps more objective and some endoscopists may have a tendency to round up in size to err on the side of caution with respect to the surveillance colonoscopy interval.…”

“…A similar conclusion was reached in a recent, large study which estimated potentially inappropriate surveillance recommendation in up to 10% of individuals with adenomas detected at colonoscopy, if endoscopy sizing was applied. 52 This study however considered only adenoma size in this analysis and did not consider adenoma multiplicity, villousness, and dysplasia grade.…”

Variation between Pathological Measurement and Endoscopically Estimated Size of Colonic Polyps

“…Determination of polyp size is vital to the assessment of CRC risk and surveillance [5]. Inaccurate size estimation may lead to the performance of unnecessary procedures [6] or misdirect patients to less aggressive followup [5].…”

“…Inaccurate size estimation may lead to the performance of unnecessary procedures [6] or misdirect patients to less aggressive followup [5]. There are several studies showing significant inaccuracy of endoscopically estimated polyp size when compared with pathological size [6][7][8].…”