A large-scale study in the United States on the practice of cold snare polypectomy for the removal of small polyps (less than 1 cm in size) during colonoscopies. This technique has been recommended for over three years, based on the 2020 guidelines from the U.S. Multi-Society Task Force on Colorectal Cancer. Key points include:
Cold Snare Polypectomy Usage: Despite the recommendation, only about half of colonoscopists in the U.S. are following it. The study found that the overall use of cold snare polypectomy for small polyps was lower than expected.
Variations in Practice: There were significant regional and specialty-related variations in the adoption of this technique. Factors such as the region and the gastroenterologist’s specialty influenced the likelihood of using cold snare polypectomy.
Benefits of Cold Snare Technique: The 2020 guidelines recommended cold snare polypectomy based on studies showing its advantages, such as lower rates of bleeding, mucosal injury, and incomplete resection, especially when compared to hot snare polypectomy and forceps.
Study Data and Quality Measures: The study, reported by Dr. Seth D. Crockett and co-investigators, utilized data from the GI Quality Improvement Consortium registry. This registry includes data on over 1.5 million colonoscopies performed between 2019 and 2022, where small polyps were removed. The study also found that colonoscopists who adhere to the cold snare polypectomy guideline tend to perform better on other colonoscopy quality measures.
In conclusion, while the adoption of cold snare polypectomy for small polyps is recommended and linked to better outcomes and quality measures in colonoscopy, its usage in the U.S. is not as widespread as expected, with variations based on regional and specialty factors.