Colonoscopy surveillance after polypectomy and colorectal cancer resection.
This article describes a joint update of guidelines by the American Cancer Society and the U.S. Multi-Society Task Force on Colorectal Cancer delineating evidence-based surveillance recommendations for patients after polypectomy and colorectal cancer resection. Although there are some qualifying conditions, the following general guidelines apply: after colonoscopic polypectomy, patients with hyperplastic polyps should be considered to have normal colonoscopies, and subsequent colonoscopy is recommended at 10 years. Patients with one or two small (less than 1 cm) tubular adenomas, including those with only low-grade dysplasia, should have their next colonoscopy in five to 10 years. Patients with three to 10 adenomas, any adenoma 1 cm or larger, or any adenoma with villous features or high-grade dysplasia should have their next colonoscopy in three years. Following curative resection of colorectal cancer, patients should undergo a colonoscopy at one year, with subsequent follow-up intervals determined by the results of this examination. Adoption of these guidelines will have a dramatic impact on the quality of care provided to patients after a colorectal cancer diagnosis, will assist in shifting available resources from intensive surveillance to screening, and will ultimately decrease suffering and death related to colorectal cancer.
Brooks
Durado D
DD
American Cancer Society, Atlanta, Georgia, USA.
Winawer
Sidney J
SJ
Rex
Douglas K
DK
Zauber
Ann G
AG
Kahi
Charles J
CJ
Smith
Robert A
RA
Levin
Bernard
B
Wender
Richard
R
D018256:Adenomatous Polyps / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery; D000570:American Cancer Society; D003111:Colonic Polyps / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery; D006801:Humans; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology