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Assessment and management of the malignant colorectal polyp
  1. Laura J Neilson1,2,
  2. Matthew D Rutter2,3,4,
  3. Brian P Saunders5,
  4. Andrew Plumb6,
  5. Colin J Rees1,2,4
  1. 1Department of Gastroenterology, South Tyneside District Hospital, South Shields, UK
  2. 2Northern Region Endoscopy Group, Northern England, UK
  3. 3University Hospital of North Tees, Stockton-on-Tees, UK
  4. 4School of Medicine, Pharmacy and Health, Durham University, UK
  5. 5Wolfson Unit for Endoscopy, St Marks Hospital, Imperial College, London
  6. 6Centre for Medical Imaging, University College London, London, UK
  1. Correspondence to Professor Colin Rees, South Tyneside District Hospital, Harton Lane, South Shields, NE34 0PL, UK; colin.rees{at}


Colorectal cancer is the second most common cancer affecting men and women in England. The introduction of National Bowel Cancer Screening in 2006 has led to a rise in the proportion of colorectal cancers detected at an early stage. Many screen-detected cancers are malignant colorectal polyps and may potentially be cured with endoscopic resection, without recourse to the risk of major surgery or prolonged adjuvant therapies. Endoscopic decision making is crucial to select those early lesions that may be suitable for local endoscopic excision as well as identifying lesions for surgical resection, thus avoiding unnecessary surgical intervention in some and ensuring potentially curative surgery in others. This paper uses the current evidence base to provide a structured approach to the assessment of potentially malignant polyps and their management.

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