Treatment patterns and costs associated with sessile colorectal polyps

Am J Gastroenterol. 2002 Nov;97(11):2896-901. doi: 10.1111/j.1572-0241.2002.07058.x.


Objectives: Because of the paucity of existing literature on treatment and costs associated with sessile lesions, the objectives of this study were to perform a retrospective analysis on patients with sessile polyps to identify patient and polyp characteristics, to determine treatment patterns, and to estimate the cost of treating these patients.

Methods: We conducted a retrospective, observational cohort study of 280 patients who presented to a large teaching hospital between 1997 and 2000 with at least one sessile or broad-based pedunculated colorectal polyp of any size or histology, not including adenocarcinoma greater than stage T1.

Results: Mean polyp size was 1.3 cm, and two thirds of polyps were removed in a single procedure. The number of repeat procedures increased with polyp size (Kendall T-b = 0.47; 95% CI = 0.39-0.55). Patients with polyps > or = 2 cm were 5.88 times more likely than patients with smaller polyps to undergo a surgical procedure. Surgical procedures required 88.01 min longer than nonsurgical procedures (95% CI = 74.43-102.42). Mean total cost of treatment was $2,038 (range $153 to $14,838). Open resection ($6,165) was the most costly surgical procedure, and piecemeal polypectomy ($892) was the most costly nonsurgical therapeutic procedure.

Conclusions: One third of polyps required more than one procedure. Surgical procedures accounted for the majority of resource use in this sample. Finally, patients with polyps > or = 2 cm incurred almost half the total costs while accounting for only 22% of the sample. The greatest economic gains could be made by improving efficiency of polyp removal for these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma / economics
  • Adenoma / surgery
  • Aged
  • Carcinoma / economics
  • Carcinoma / surgery
  • Cohort Studies
  • Colonic Polyps / economics*
  • Colonic Polyps / pathology
  • Colonic Polyps / surgery*
  • Digestive System Surgical Procedures / economics*
  • Digestive System Surgical Procedures / statistics & numerical data*
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Practice Patterns, Physicians' / economics*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Referral and Consultation / economics
  • Retrospective Studies
  • United States