Experts release new guidelines for endoscopists on how to evaluate colorectal lesions

Reviewed by Emily Henderson, B.Sc.November 4, 2020

Early identification and removal of colorectal cancerous polyps is critical for preventing colorectal cancer progression and improving survival rates. The US Multisociety Task Force on Colorectal Cancer has released new guidelines for endoscopists on how to evaluate colorectal lesions for cancer-associated features, discuss how these factors drive management, and outline when to recommend surgery after polyp removal. malignant.

Key recommendations from the US Multisociety Task Force on Colorectal Cancer, which includes leading experts representing the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), and the American Society for Gastrointestinal Endoscopy (ASGE), include :

1. Management of malignant polyps must begin with a thorough and conscious endoscopic evaluation designed to identify the characteristics of deep submucosal invasion.
2. In non-punctured lesions with features of deep submucosal invasion, endoscopic biopsy and tattooing should be followed by surgical resection.
3. Non-punctuated lesions at high risk of superficial submucosal invasion should be considered for en bloc resection and proper specimen handling.
4. When disease signals cancer in a lesion that has been completely resected endoscopically, the decision to recommend surgery is based on the shape of the polyp, whether there was en bloc resection and adequate histological assessment, presence or absence of unfavorable histological features, risk of the patient’s surgical mortality morbidity and patient preferences.