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Results We identified 6148 reports and used 32 studies, with a total of 9282 polyps, in our quantitative analysis. The IRR for snare removal of polyps 1-20 mm was 13.8% (95% CI, 10.3-17.3; 13 studies, 5128 polypectomies). IRRs were 15.9% for snare removal of polyps 1-10 mm (95% CI, 9.6-22.1; 9 studies, 2531 polypectomies) and 20.8% for snare removal of polyps 10-20 mm (95% CI, 12.9-28.8; 6 studies, 412 polypectomies). The IRR for hot snare removal of polyps 1-10 mm was 14.2% (95% CI, 5.2-23.2) vs 17.3% for cold-snare polypectomy (95% CI