Do not take mucosal biopsies when the histopathological results would not change the patient management.

Type of practice

Other tests

Topic Area


The processing of biopsies entails an added energy requirement and generates hazardous waste and a significant carbon footprint. International Guidelines endorsed strategies to safely avoid the need for histological analysis (use of optical diagnosis, apply the resect-and-discard strategy for colorectal polyps, adequate follow-up intervals); unnecessary biopsies may also induce a number of low-yield procedures and harmful treatments.


1. Gordon IO, Sherman JD, Leapman M et al. Life cycle greenhouse gas emissions of gastrointestinal biopsies in a surgical pathology laboratory. Am J Clin Pathol 2021; 156: 540–549.
2. Pouw RE, Barret M, Biermann K et al. Endoscopic tissue sampling–Part 1: Upper gastrointestinal and hepatopancreatobiliary tracts. ESGE Guideline. Endoscopy 2021; 53: 1174–1188.
3. Pouw RE, Bisschops R, Gecse KB et al. Endoscopic tissue sampling–Part 2: Lower gastrointestinal tract. ESGE Guideline. Endoscopy 2021: 1261–1273.
4. Enrique Rodríguez de Santiago E, Dinis-Ribeiro M, Pohl H et al. Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement. Endoscopy 2022; 54: 797–826.



Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.