Colon polyps screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

There is insufficient evidence to recommend routine screening for colon polyps. According to the guidelines screening for the colon polyps must be done earlier after the first colon polyps are discovered. Hyperplastic polyps have no malignant tendency and recommendation for the colonoscopy is similar to general population. Adenomatous and serrated polyps have neoplastic nature and must be followed every 3-5 years.

Screening

  • There is insufficient evidence to recommend routine screening for colon polyps in general population.
  • 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
No polyps Colonoscopy every 10 years
Polyps 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

References

  1. 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.
  2. 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
  3. 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.

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