Determine the prevalence of advanced histological features in diminutive and small colon polyps.
Retrospective analysis of data from 3 prospective clinical trials.
Two tertiary-care referral centers.
This study involved patients undergoing screening or surveillance colonoscopy.
The location, size, and morphology of each polyp detected was documented. Each polyp was then resected, placed in a unique specimen jar, and sent for histopathological evaluation.
Rates of advanced histological features (villous histology, high-grade dysplasia, and cancer).
A total of 2361 polyps were detected, removed, and retrieved. Both diminutive and small polyps had a lower frequency of any advanced histological features compared with large polyps (0.5 % and 1.5 % , respectively vs 15.0 % ; P < .001 for both comparisons). Polyps <10 mm in size had a lower frequency of advanced histology compared with polyps ?0 mm (0.8 % vs 15.0 % ; P < .001). During sensitivity analysis, the frequency of advanced histological features varied from 0.2 % to 0.7 % within diminutive polyps, 1.5 % to 3.6 % within small polyps, and 0.8 % to 1.2 % within polyps <10 mm.
Retrospective analysis from tertiary-care referral centers; predominantly white, male, veteran patient population resulting in limited generalizability of results.
The prevalence of advanced histological features in colon polyps ? mm is very low (0.5 % ). This has important implications for the potential practice of ¡°predicting, resecting, and discarding?diminutive colon polyps.