Gupta et al reported the SMSA score for evaluating a colorectal polyp. This can help to identify a polyp that will be difficult to remove or more likely to recur.
SMSA refers to size, morphology, site and access.
Patient selection: colorectal polyp
Parameters:
(1) size in mm
(2) morphology
(3) site in colon
(4) access
Parameter
Finding
Points
size
< 10 mm
1
10 to 19 mm
3
20 to 29 mm
5
30 to 39 mm
7
>= 40 mm
9
morphology
pedunculated
1
sessile
2
flat
3
site
left-sided
1
right-sided
2
access
easy
1
difficult
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 4
• maximum score: 17
• The higher the score the greater the difficulty to excise the polyp and the greater the risk of leaving residual adenoma.
Score
Level
4 or 5
1
6 to 8
2
9 to 12
3
13 to 17
4
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