Colorectal polyp size measurement comparing biopsy forceps with visual assessment during real-time colonoscopy: A prospective, multicenter, international study

Table 1 Patients’ demographic and baseline characteristics, n (%)

Parameter	Value
No. of patients	110
Age (years), median (IQR)	68 (18.0)
Sex
Male	62 (56.4)
Female	48 (43.6)
Personal history adenoma	56 (50.9)
Personal history CRC	8 (7.3)
Family history CRC	20 (18.2)
BBPS score, median (IQR)	7 (3.0)
Colonoscopy indication
Screening	47 (42.7)
Surveillance	34 (30.9)
Diagnostic	29 (26.4)

BBPS: Boston Bowel Preparation Scale; CRC: Colorectal cancer; IQR: Interquartile range.

Table 2 Polyp characteristics, n (%)

Parameter	Value
No. of polyps	137
Anatomical location
Cecum	14 (10.2)
Ascending	32 (23.4)
Transverse	36 (26.3)
Descending	30 (21.9)
Sigmoid	20 (14.6)
Rectum	5 (3.6)
Polyp size categories1
≤ 5 mm	115 (83.9)
6-9 mm	18 (13.1)
≥ 10 mm	4 (3.0)
Polyp type
Adenoma	91 (66.4)
Serrated	35 (25.6)
Other	8 (5.8)
Missing	3 (2.2)
Paris classification
0-Ip	8 (5.8)
0-Is	75 (54.7)
0-IIa	52 (38.0)
Missing	2 (1.5)
Resection method
Cold snare	86 (62.8)
Hot snare	8 (5.8)
EMR	1 (0.7)
Missing2	42 (30.7)

¹Number of polyps per size category based on the reference laser-based size measurements.

²In 3 of 5 participating hospitals, the resection method was not routinely recorded as part of the standardized data collection procedure, resulting in missing information for 42 polyps.

EMR: Endoscopic mucosal resection.

Table 3 Polyp size misclassification using biopsy forceps-assisted size measurement and visual assessment compared to the reference laser-based size measurements

Polyp size misclassifications, n/N (%)1	BF	VA
> 5 mm2 as ≤ 5 mm	3/22 (13.6)	3/22 (13.6)
≤ 5 mm as > 5 mm	13/115 (11.3)	13/115 (11.3)
≥ 10 mm as < 10 mm3	2/4 (50.0)	2/4 (50.0)
< 10 mm as ≥ 10 mm	3/133 (2.3)	4/133 (3.0)

¹n = number of polyps misclassified by biopsy forceps and/or visual assessment and N = number of polyps in the respective size category based on the reference laser-based size measurements.

²> 5 mm category is the 6-9 mm category combined with the ≥ 10 mm category.

³< 10 mm category is the ≤ 5 mm category combined with the 6-9 mm category.

BF: Biopsy forceps; VA: Visual assessment.