Post written by Samir C. Grover, MD, MEd, FRCPC, FASGE, from Scarborough Health Network and the University of Toronto, Toronto, Ontario, Canada.

This study aimed to establish consensus-based standards for the referral of large nonpedunculated colorectal polyps (LNPCPs) for endoscopic resection. Given the complexity and risks associated with resecting LNPCPs, especially those exceeding 20 mm, comprehensive and accurate referral information is essential for optimal patient outcomes. This study used a Delphi method to derive minimum standards for referral documentation, ensuring that therapeutic endoscopists are equipped with the necessary information to perform safe and effective resection.

LNPCP resection is a technically challenging procedure that requires detailed planning for decision-making on whether and how to resect the lesion. Inadequate referral documentation can result in poor procedural outcomes, increased risk of adverse events, and unnecessary diagnostic procedures. By defining clear referral standards, this study aims to improve the quality and consistency of referral information, thus facilitating better procedural planning and patient care.

This study resulted in identification of 19 key consensus statements outlining essential elements of LNPCP referrals (table). These include patient demographics, medical history, details of previous endoscopies, lesion characteristics, and the requirement for high-quality photographic documentation. By adhering to these standards, referring physicians can ensure that receiving endoscopists are fully informed, leading to more efficient and effective treatment decisions. Future research should focus on implementation of these standards in clinical practice and their impact on patient outcomes, particularly in reducing unnecessary procedures and optimizing resource use.

The consensus statements developed through this study provide a robust framework for LNPCP referrals, aiming to standardize and enhance the referral process. The adoption of these standards across healthcare systems could significantly improve management of LNPCPs, resulting in improved patient outcomes and more efficient use of healthcare resources. Further investigation is needed to assess the real-world impact of these standards and to refine them as necessary.

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