Colon polyps secondary prevention
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Effective measures for the secondary prevention of colon polyps include surveillance after finding polyps on routine screening. According to guidelines for colonoscopysurveillance after screening and polypectomy by the US Multi-Society Task Force on colorectal cancer, surveillance and screening are more frequent after first or second adenomatous polyps or serrated polyps. Hyperplastic polyps are considered benign and screening remains similar to general population.
Secondary Prevention
- Effective measures for the secondary prevention of colon polyps include:
- Surveillance after finding polyps on routine screening
- According to guidelines for colonoscopy surveillance after screening and polypectomy by the US Multi-Society Task Force on colorectal cancer, recommendations for surveillance and screening are as follows:[1][2][3]
| Baseline colonoscopy | Recommendation | |
|---|---|---|
| Hyperplastic polyps | Size <10 mm | Colonoscopy every 10 years |
| Adenomatous polyps | 1-2 tubular adenomas <10 mm | Colonoscopy every 5-10 years |
| 3-10 tubular adenomas <10 mm | Colonoscopy every 3 years | |
| >10 adenomas | Colonoscopy <3 years | |
| Tubular adenomas ≥10 mm | Colonoscopy every 3 years | |
| Villous adenomas | Colonoscopy every 3 years | |
| Adenoma with high grade dysplasia | Colonoscopy every 3 years | |
| No adenoma after first low-risk adenoma | Colonoscopy every 10 years | |
| No adenoma after first high-risk adenoma | Colonoscopy every 5 years | |
| Second adenomatous polyps | Second low-risk adenoma | Colonoscopy after 5 years |
| High-risk adenoma following low-risk adenoma | Colonoscopy every 3 years | |
| Low-risk adenoma following high-risk adenoma | Colonoscopy after 5 years | |
| Second high-risk adenoma | Colonoscopy every 3 years | |
| Serrated polyps | Sessile serrated polyp(s) <10 mm with no dysplasia | Colonoscopy every 5 years |
| Sessile serrated polyp(s) ≥10 mm | Colonoscopy every 3 years | |
| Sessile serrated polyp with dysplasia | Colonoscopy every 3 years | |
| Traditional serrated adenoma | Colonoscopy every 3 years | |
| Serrated polyposis syndrome | Colonoscopy every year | |
Oversue of surveillance colonoscopy has been documented[4][5][6].
References
- ↑ Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR (2012). “Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer”. Gastroenterology. 143 (3): 844–857. doi:10.1053/j.gastro.2012.06.001. PMID 22763141.
- ↑ National Guideline Clearinghouse (NGC). Guideline summary: Follow-up of colorectal polyps or cancer. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2013 Jan 16. [cited 2017 Dec 28]. Available: https://www.guideline.gov
- ↑ Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, Levin TR, Lieberman D, Robertson DJ (2017). “Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer”. Am. J. Gastroenterol. 112 (7): 1016–1030. doi:10.1038/ajg.2017.174. PMID 28555630.
- ↑ Heisser T, Peng L, Weigl K, Hoffmeister M, Brenner H (2019). “Outcomes at follow-up of negative colonoscopy in average risk population: systematic review and meta-analysis”. BMJ. 367: l6109. doi:10.1136/bmj.l6109. PMC 6853024 Check
|pmc=value (help). PMID 31722884. - ↑ Schoen RE, Pinsky PF, Weissfeld JL, Yokochi LA, Reding DJ, Hayes RB; et al. (2010). “Utilization of surveillance colonoscopy in community practice”. Gastroenterology. 138 (1): 73–81. doi:10.1053/j.gastro.2009.09.062. PMC 2813330. PMID 19818779.
- ↑ Shaheen NJ, Fennerty MB, Bergman JJ (2018). “Less Is More: A Minimalist Approach to Endoscopy”. Gastroenterology. 154 (7): 1993–2003. doi:10.1053/j.gastro.2017.12.044. PMID 29454789.
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