American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended intervention for polyps larger than 5 mm found during endoscopy?

1. Biopsy only

2. Surgical resection

3. Polypectomy

4. No intervention required

The correct answer is: Polypectomy

For polyps larger than 5 mm identified during endoscopic examinations, polypectomy is the recommended intervention. This is because polyps of this size have a higher potential for malignancy compared to smaller polyps, particularly those that are adenomatous. Removing these polyps not only allows for histological examination to determine the type of polyp but also serves as a preventive measure to reduce the risk of colorectal cancer. While a biopsy may be performed, it is typically not sufficient for larger polyps, as the goal is to remove the entire polyp for both diagnostic and therapeutic purposes. Surgical resection is more invasive and usually reserved for larger lesions or when there is suspicion of invasive cancer. Lastly, not intervening could pose a significant risk considering the potential for malignant transformation, hence no intervention is not advisable. Polypectomy effectively addresses the issue by allowing for complete removal and evaluation of these potentially harmful growths.