According to a University of Pittsburgh-led study published in the December issue of Gastroenterology, medium-sized polyps found in the colon with flexible sigmoidoscopy and subsequently evaluated by full colonoscopy are associated with a significant number of advanced adenomas (high-risk polyps) and cancers. These findings raise questions about taking a "wait and watch" approach to medium-sized polyps and delaying referral to colonoscopy, a strategy which could become more popular with newer screening tests that are observational and do not remove polyps, such as virtual colonoscopy.