Approaching polyps in the time of discrimination

Colorectal cancer (CRC) is one of the leading causes of cancer related death in the western countries. Up to 80% of CRC develops from adenomatous polyps, which can be detected and removed during colonoscopy, thus reducing the incidence of colorectal cancer. Screening colonoscopy is indeed the most efficient method of CRC prevention. However, “polyp” is an umbrella term including different type of lesions, which in turn are associated with different risks of developing or already harbouring neoplastic tissue. Several characteristics of a polyp can be assessed during an endoscopy examination such as gross morphology, superficial glandular pattern, vascular pattern and appearance under chromoendoscopy, which can reflect the nature of the polyp whether benign or with malignant potential. Nowadays, the umbrella term “polyectomy” has become obsolete as endoscopist should be able to tailor the management of colonic polyps according to their endoscopic features.