Variation in polyp assessment practices during colonoscopy

Objectives: Colonoscopy is the gold standard method for colorectal cancer screening and diagnosis. Significant variability exists in polyp assessment and management, especially in the Arabian Gulf region, where evidence-based guidelines are limited. The study aims to evaluate differences in practice patterns among endoscopists regarding polyp evaluation during colonoscopy. Methods: Self-administered survey including 21 questions was distributed among practicing physicians performing colonoscopies using an electronic survey tool. Results: A total of 102 physicians completed the survey. Majority of the respondents were male (80.21%). Participants had a mean of 11.53 ± 10.28 years of independent practice performing colonoscopies. Around 87.25% ( n = 89) of the surveyed were gastroenterologists, 6.86% ( n = 7) gastroenterology trainees, 4.9% ( n = 5) surgeons, and 0.98% ( n = 1) general practitioners. Polyps with high-risk features were the main reason for referral to advanced endoscopists, recognized by 58.51% ( n = 55/94) of participants, followed by anatomically challenging locations of polyps, 35.11% ( n = 33/94). The leading reason for surgical referral was the presence of high-risk features suggestive of deep invasion, which was selected by 60.78% ( n = 62/102) of respondents. Conclusion: This study highlights the need for standardization of the clinical approach to colorectal polyps in our region.