Editorial: Detection of small polyps: much ado about nothing?

Computed tomographic (CT) colonography (CTC) represents an alternative to optical colonoscopy for colorectal cancer screening. However, diminutive polyps (≤ 5 mm) are not routinely reported for CTC. An observational study comparing the rates of recovery of subcentimeter adenomas in average-risk patients between two screening strategies, CTC and optical colonoscopy, found that the colonoscopy group had a four and a half-fold greater recovery rate of diminutive adenomas. Although the study was not randomized, the results highlight the difference between the two screening strategies. Because of incomplete understanding of the natural history of diminutive adenomas, further study is needed to determine the long-term impact of the use of CTC for colorectal cancer screening.