The SMSA (Size, Morphology, Site, Access) polyp grading tool is used as a predictor of the complexity of endoscopic resection.
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Table 1. SMSA scoring system.
| Benchmarks | Points | |
|---|---|---|
| Size | <1 cm | 1 |
| 1–1.9 cm | 3 | |
| 2–2.9 cm | 5 | |
| 3–3.9 cm | 7 | |
| >4 cm | 9 | |
| Morphology | Pedunculated | 1 |
| Sessile | 2 | |
| Flat | 3 | |
| Site | Left | 1 |
| Right | 2 | |
| Access | Easy | 1 |
| Difficult | 3 |
Level 1: 4–5 points. Level 2: 6–9 points. Level 3: 10–12 points. Level 4: >12 points.
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