Management of the Malignant Colorectal Polyp: ACPGBI Position Statement

This is a clinical practice guideline for patients with a malignant polyp. The guideline reviews topics such as colonoscopy and endoscopic technique for the removal of large adenomas, the histopathology of adenomas and polypoid carcinomas, how prognostic indicators influence the risk of residual cancer in the bowel wall or lymph nodes, and the likelihood of recurrence if additional treatment is not taken. As well, the benefits and harms of endoscopic resection are reviewed, and the role of endoscopic and radiological imaging in the assessment and follow up of malignant polyps is discussed. Outcomes of interest include risk of post-surgical morbidity and mortality, risk of recurrence, disease-specific survival, and nodal metastasis.