AGA: Experts Release New Management Strategies for Malignant Colorectal Polyps

November 4, 2020

AGA: Early identification and removal of cancerous colorectal polyps is critical to preventing the progression of colorectal cancer and improving survival rates.

AGA reports The U.S. Multisociety Task Force on Colorectal Cancer has released new guidance for endoscopists on how to assess colorectal lesions for features associated with cancer, discuss how these factors guide management and outline when to advise surgery after malignant polyp removal.

Key recommendations from the U.S. Multisociety Task Force on Colorectal Cancer, which is comprised of 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 knowledgeable endoscopic assessment designed to identify features of deep submucosal invasion.
2. In nonpedunculated lesions with features of deep submucosal invasion, endoscopic biopsy and tattooing should be followed by surgical resection.
3. Nonpedunculated lesions with high risk of superficial submucosal invasion should be considered for en bloc resection and proper specimen handling.
4. When pathology reports cancer in a lesion that was completely resected endoscopically, the decision to recommend surgery is based on polyp shape, whether there was en bloc resection and adequate histologic assessment, the presence or absence of unfavorable histologic features, the patient’s risk for surgical mortality and morbidity, and patient preferences.

For more information, review the full publication: Endoscopic Recognition and Management Strategies for Malignant Colorectal Polyps: Recommendations of the US Multi-Society Task Force on Colorectal Cancer.

ABOUT COLORECTAL CANCER

Colorectal cancer, the second leading cause of cancer death in the U.S., is preventable when precancerous polyps are found and removed before they turn into cancer. With routine colorectal cancer screening, more than one-third of colorectal cancer deaths can be avoided. Screening for average-risk patients is recommended to begin at age 50, and earlier for patients with risk factors or family history. To learn more, visit colorectal cancer patient information from ACG, ASGE

TASK FORCE MEMBERS

• Aasma Shaukat, MD, MPH, Minneapolis VA Health Care System, Minnesota
• Tonya R. Kaltenbach, MD, MS, University of California San Francisco
• Jason A. Dominitz, MD, MHS, University of Washington Medicine, Seattle
• Douglas J. Robertson, MD, MPH, Dartmouth Geisel School of Medicine, Hanover, New Hampshire
• Joseph C. Anderson, MD, MHCDS, Dartmouth Geisel School of Medicine, Hanover, New Hampshire
• Michael Cruise, MD Cleveland Clinic, Cleveland Ohio
• Carol A. Burke, MD, Cleveland Clinic, Ohio
• Samir Gupta, MD, MSc, University of California San Diego
• David A. Lieberman, MD, Oregon Health and Science University, Portland
• Sapna Syngal, MD, MPH, Dana-Farber Cancer Institute, Boston, Massachusetts
• Douglas K. Rex, MD, Indiana University School of Medicine, Indianapolis

The U.S. MSTF recommendations are published jointly in Gastroenterology, The American Journal of Gastroenterology, and Gastrointestinal Endoscopy.