{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:39:45Z","timestamp":1747183185238,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Computed tomographic colonography (CTC) is sensitive to polyp detection but is considered inaccurate for measuring diminutive polyps (&lt;6\u2009mm), with divergence between CTC and either colonoscopic or histopathological polyp measurements. Reporting diminutive polyps remains debatable. This study aims to compare outcomes of symptomatic patients with diminutive versus borderline polyps on CTC and to thereby examine the potential implication of reporting diminutive polyps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010centre retrospective study of symptomatic patients who underwent CTC from October 2016 through September 2018 was performed. After excluding CTC demonstrating cancer, no polyps, or polyps &gt;6\u2009mm, cases were categorized as either \u2018diminutive\u2019 (largest polyp &lt;6\u2009mm), or \u2018borderline\u2019 (largest polyp\u00a0=\u00a06\u2009mm). The outcome measures were progression to endoscopy, surgery, procedure\u2010related morbidity, dysplasia and malignancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 308 cases (211 diminutive and 97 borderline) were analysed. The groups were similar (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05) in mean age (73 vs. 74\u2009years), female proportion (57% vs<jats:italic>.<\/jats:italic> 49%), endoscopy\u2010related morbidity (6% vs<jats:italic>.<\/jats:italic> 7%) and CTC\u2010related morbidity (0 vs<jats:italic>.<\/jats:italic> 1%). Most patients (64%) underwent endoscopy, which was more common in the borderline vs<jats:italic>.<\/jats:italic> the diminutive group (76% vs<jats:italic>.<\/jats:italic> 59%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). Dysplasia was more common in the borderline vs<jats:italic>.<\/jats:italic> the diminutive group (69% vs<jats:italic>.<\/jats:italic> 48%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). No malignancies were diagnosed, and no patients proceeded to surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reporting diminutive polyps on CTC for symptomatic patients frequently leads to endoscopy, which often reveals dysplasia but rarely malignancy. This raises the question of how referring clinicians can best counsel and manage symptomatic patients with diminutive polyps on CTC, by considering the balance between utilitarianism and deontology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18152","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T12:34:58Z","timestamp":1667997298000},"page":"939-944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computed tomographic colonography for symptomatic patients: the diminutive polyp dilemma"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8872-8757","authenticated-orcid":false,"given":"Christopher","family":"Hadjittofi","sequence":"first","affiliation":[{"name":"Department of General Surgery Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of General Surgery University Hospitals Leicester  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhaara","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of General Surgery Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamam","family":"Rifai","sequence":"additional","affiliation":[{"name":"Department of General Surgery Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of General Surgery Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irshad","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Department of General Surgery Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"89","article-title":"Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors","volume":"14","author":"Rawla P","year":"2019","journal-title":"Przegla\u031cd Gastroenterol."},{"key":"e_1_2_8_3_1","unstructured":"RCR Guidance on the use of CT colonography for suspected colorectal cancer. The Royal College of Radiologists and the British Society of Gastrointestinal & Abdominal Radiology. [Cited 11 Feb 2020.] Available from URL:https:\/\/www.rcr.ac.uk\/publication\/guidance-use-ct-colonography-suspected-colorectal-cancer.2020."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v8.i5.472"},{"key":"e_1_2_8_5_1","unstructured":"Guidance on the use of CT colonography for suspected colorectal cancer. British Society of Gastrointestinal and Abdominal Radiology (BSGAR) and The Royal College of Radiologists. [Cited 12 Oct 2021.] Available from URL:https:\/\/www.rcr.ac.uk\/system\/files\/publication\/field_publication_files\/BFCR%2814%299_COLON.pdf."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2373050176"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62186-2"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10090877"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-009-1683-0"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.11.007"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-012-2632-x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.11272"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-014-3435-z"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-8-200504190-00013"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-020-00281-3"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i2.328"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-102569"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5070.175024"},{"key":"e_1_2_8_19_1","unstructured":"Standards of practice for computed tomography colonography (CTC). The Royal College of Radiologists and the British Society of Gastrointestinal & Abdominal Radiology. [Cited 25 Aug 2021.] Available from URL:https:\/\/www.rcr.ac.uk\/system\/files\/publication\/field_publication_files\/bfcr201\u2010standards\u2010of\u2010practice\u2010for\u2010computed\u2010tomography\u2010colonography\u2010ctc.pdf."},{"key":"e_1_2_8_20_1","unstructured":"Bowel cancer screening: guideline for CTC imaging (12 March 2021 update). NHS bowel cancer screening (BCSP) programme. [Cited 9 Oct 2022.] Available from URL:https:\/\/www.gov.uk\/government\/publications\/bowel\u2010cancer\u2010screening\u2010imaging\u2010use\/bowel\u2010cancer\u2010screening\u2010guidelines\u2010for\u2010ctc\u2010imaging."}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.18152","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.18152","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.18152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T19:56:58Z","timestamp":1692734218000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.18152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,9]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1111\/ans.18152"],"URL":"https:\/\/doi.org\/10.1111\/ans.18152","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"type":"print","value":"1445-1433"},{"type":"electronic","value":"1445-2197"}],"subject":[],"published":{"date-parts":[[2022,11,9]]},"assertion":[{"value":"2022-09-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}