There are times when a biopsy should not be taken.
"You never want to biopsy a blood vessel ... [or] varix, sort of a variscose vein of the esophagus or the stomach," Lawrence said.
Abrams also emphasized that large polyps greater than one-third the luminal circumference or cross two haustal folds should be referred for surgery.
While there are tools such as magnifying scopes and different stains that can be applied to the lining of the bowel to help visualize a mass or polyp, the only sure-fire way to make a diagnosis or non-diagnosis is removal.
“We are really at an era in endoscopy where there is a lot of research going into making a non-biopsy diagnosis," Lawrence said. “In the future, we might be able to arrive at a diagnosis of what type of a polyp a polyp is without taking a biopsy. There is a lot of buzz around endoscopic cytology, which is a way to look beneath the surface to find distinguishing characteristics between hyperplastic polyps versus true polyp adenomas. It’s similar to what a pathologist does with a microscope."