Management Strategies for Malignant Colorectal Polyps: U.S. MSTF guidelines

According to new guidelines, early identification and removal of cancerous colorectal polyps is critical to preventing the progression of colorectal cancer and improving survival rates.

Key recommendations 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.