FOLLOW-UP AFTER POLYPECTOMY - CONSENSUS

Patients who have had a colorectal adenoma resected have an increased risk of subsequent cancer and may benefit from follow-up surveillance. Surveillance strategies should be tailored to the assessed risk of each individual patient. A number of long-term follow-up studies indicate that the risk of metachronous neoplasia is higher if on index colonoscopy there were multiple (greater than or equal to 2) adenomas, or if any adenoma was large (greater than or equal to 1 cm), contained villous tissue or severe dysplasia, or if the patient had a family history of colorectal neoplasia. Data from the U.S. National Polyp Study indicate that polyp resection and follow-up surveillance greatly reduces the incidence of metachronous cancer, and that the first follow-up colonoscopy does not need to be performed for 3 years. Current data have been incorporated into a comprehensive consensus practice guideline.