Endoscopic Characterization and Management of Colorectal Polyps
DOI:
https://doi.org/10.52340/GBMN.2026.01.01.194Keywords:
Colorectal cancer prevention, Colorectal polyps, Colonoscopy, Endoscopic imaging, Endoscopic resection, Narrow-band imaging (NBI), Optical diagnosisAbstract
Colorectal polyps are among the most frequently detected lesions during colonoscopy and represent a heterogeneous group with diverse histopathological characteristics and malignant potential. Their accurate detection and management are fundamental to effective colorectal cancer prevention. Recent advances in endoscopic imaging, including high-definition white-light and narrow-band imaging (NBI), have improved optical diagnosis, enabling endoscopists to predict histopathology, identify advanced neoplasia, and estimate submucosal invasion risk to facilitate therapeutic decision-making. This narrative review bridges validated optical classification systems with risk-based therapeutic selection, providing an integrated perspective on endoscopic diagnosis and management. We conducted a narrative literature review using MEDLINE/PubMed, Embase, and the Cochrane Library to synthesize evidence on colorectal polyp detection, optical classification, AI-assisted diagnosis, and endoscopic resection strategies. This review examines key frameworks, including NICE, WASP, and JNET, alongside morphological criteria that guide selection of cold or hot snare polypectomy, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD). Optical diagnosis complements, rather than replaces, formal histopathology and requires validated training and high diagnostic confidence.
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