What are the colonoscopy findings and associated recommended follow up in patients at risk for rectal cancer?

Updated: Apr 06, 2021
  • Author: Burt Cagir, MD, FACS; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

The American College of Gastroenterology has published guidelines for surveillance of patients who have had adenomas detected and removed at colonoscopy. [97]

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

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