What are the ACG guidelines for postpolypectomy surveillance?

Updated: Oct 08, 2019
  • Author: Elwyn C Cabebe, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Answer

The American College of Gastroenterology has published guidelines for surveillance of patients who have had adenomas detected and removed at colonoscopy. [16]

These patients should have more frequent followup, as they are at increased risk for developing metachronous adenomas or colon cancer.

Colonoscopy findings and recommended scheduling of followup colonoscopy are as follows:

  • No polyps – 10 years
  • Small (< 10 mm) hyperplastic polyps in rectum or sigmoid – 10 years
  • 1–2 small (< 10 mm) tubular adenomas – 5- 10 years
  • 3–10 tubular adenomas – 3 years
  • 10 adenomas – < 3 years
  • One or more tubular adenomas ≥10 mm – 3 years
  • One or more villous adenomas – 3 years
  • Adenoma with high-grade dysplasia – 3 years

For serrated lesions, recommended surveillance intervals are as follows:

  • Sessile serrated polyp(s) < 10 mm with no dysplasia – 5 years
  • Sessile serrated polyp(s) ≥10 mm with no dysplasia – 3 years
  • Sessile serrated polyp with dysplasia – 1 year
  • Traditional serrated adenoma – 1 year
  • Serrated polyposis syndrome – 1 year

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