Evidence-based clinical practice guidelines for management of colorectal polyps
JSGE · 2021 · Japan
Source and licence
- Authors
- Shinji Tanaka, Yusuke Saitoh, Takahisa Matsuda et al.
- Title
- Evidence-based clinical practice guidelines for management of colorectal polyps
- Journal
- Journal of Gastroenterology, 2021
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC8005396
Licence statement of the original publication
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Open the original publication →Full text on Europe PMC
Recommendations
Verbatim, with grade of recommendation or strength of consensus where given.
CQ. How should non-neoplastic polyps be managed?
- We recommend classifying non-neoplastic colorectal polyps as hamartomatous, inflammatory, or hyperplastic (recommendation strong [agreement rate 100%], level of evidence D).
CQ. Who are candidates and what are appropriate methods for cancer surveillance in ulcerative colitis?
- We recommend that initial surveillance colonoscopy be performed in patients with extensive left-sided colitis that is present 8–10 years after onset of the disease(recommendation strong [agreement rate 100%], level of evidence B).
- We suggest starting surveillance earlier for patients in whom remission is not confirmed endoscopically (recommendation weak [agreement rate 100%], level of evidence B).
- We recommend total colonoscopy using chromoendoscopy and/or NBI with targeted biopsy. Attention should be paid to elevated lesions and any change in mucosal structure or color that is different from that in the surrounding area (recommendation strong [agreement rate 100%], level of evidence B).
- We recommend stepped biopsies from each segment of the colon (recommendation weak [agreement rate 100%], level of evidence B).
Abstract
Background: The Japanese Society of Gastroenterology (JSGE) published ‘‘Daicho Polyp Shinryo Guideline 2014′’ in Japanese and a part of this guideline was published in English as “Evidence-based clinical practice guidelines for management of colorectal polyps” in the Journal of Gastroenterology in 2015. A revised version of the Japanese-language guideline was published in 2020, and here we introduce a part of the contents of revised version.
Methods: The guideline committee discussed and drew up a series of clinical questions (CQs). Recommendation statements for the CQs were limited to items with multiple therapeutic options. Items with established conclusions that had 100% agreement with previous guidelines (background questions) and items with no (or old) evidence that are topics for future research (future research questions: FRQs) were given descriptions only. To address the CQs and FRQs, PubMed, ICHUSHI, and other sources were searched for relevant articles published in English from 1983 to October 2018 and articles published in Japanese from 1983 to November 2018. The Japan Medical Library Association was also commissioned to search for relevant materials. Manual searches were performed for questions with insufficient online references.
Results: The professional committee created 18 CQs and statements concerning the current concept and diagnosis/treatment of various colorectal polyps, including their epidemiology, screening, pathophysiology, definition and classification, diagnosis, management, practical treatment, complications, and surveillance after treatment, and other colorectal lesions (submucosal tumors, nonneoplastic polyps, polyposis, hereditary tumors, ulcerative colitis-associated tumors/carcinomas).
Conclusions: After evaluation by the moderators, evidence-based clinical practice guidelines for management of colorectal polyps were proposed for 2020. This report addresses the therapeutic related CQs introduced when formulating these guidelines.
Contents of the original publication
The section headings of the original.
- Introduction
- Clinical questions and statements
- CQ. What are the indications for endoscopic resection with respect to the size and shape of adenomas?
- CQ. How should hyperplastic polyps be managed?
- CQ. What are the indications for cold snare polypectomy?
- CQ. How should serrated colorectal lesions be diagnosed and treated?
- CQ. What therapy is indicated for laterally spreading tumors?
- CQ. In which colorectal tumors is it acceptable to perform piecemeal EMR?
- CQ. How should surveillance colonoscopy be planned after endoscopic removal of colorectal adenoma?
- CQ. How should surveillance be planned after endoscopic resection of T1 (SM) colorectal cancer?
- CQ. What is the diagnosis and management of neuroendocrine tumors of the colorectum?
- Diagnosis of colorectal NET
- Treatment of colorectal NET
- Follow-up after resection of rectal NET
- CQ. How should non-neoplastic polyps be managed?
- CQ. Are there differences in management between FAP and attenuated FAP?
- CQ. Who are candidates and what are appropriate methods for cancer surveillance in ulcerative colitis?
- CQ. If dysplasia or cancer is detected in ulcerative colitis, should be all lesions be surgical removed? Is low-grade dysplasia an indication for surgery?
- Appendix
- Executive Committee
- Evaluation Committee
- The Japanese Society of Gastroenterology
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