Abstract Background Computed tomographic colonography (CTC) is sensitive to polyp detection but is considered inaccurate for measuring diminutive polyps (6?mm, cases were categorized as either ‘diminutive’ (largest polyp ?0.05) in mean age (73 vs. 74?years), female proportion (57% vs. 49%), endoscopy‐related morbidity (6% vs. 7%) and CTC‐related morbidity (0 vs. 1%). Most patients (64%) underwent endoscopy, which was more common in the borderline vs. the diminutive group (76% vs. 59%; P?=?0.003). Dysplasia was more common in the borderline vs. the diminutive group (69% vs. 48%; P?=?0.003). No malignancies were diagnosed, and no patients proceeded to surgery. Conclusion Reporting diminutive polyps on CTC for symptomatic patients frequently leads to endoscopy, which often reveals dysplasia but rarely malignancy. This raises the question of how referring clinicians can best counsel and manage symptomatic patients with diminutive polyps on CTC, by considering the balance between utilitarianism and deontology.
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