title: Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.
abstract: The following recommendations for post-polypectomy endoscopic surveillance should be applied only after a high quality baseline colonoscopy with complete removal of all detected neoplastic lesions.1 In the low risk group (patients with 1 - 2 tubular adenomas < 10 mm with low grade dysplasia), the ESGE recommends participation in existing national screening programmes 10 years after the index colonoscopy. If no screening programme is available, repetition of colonoscopy 10 years after the index colonoscopy is recommended (strong recommendation, moderate quality evidence). 2 In the high risk group (patients with adenomas with villous histology or high grade dysplasia or ≥10 mm in size, or ≥ 3 adenomas), the ESGE recommends surveillance colonoscopy 3 years after the index colonoscopy (strong recommendation, moderate quality evidence). Patients with 10 or more adenomas should be referred for genetic counselling (strong recommendation, moderate quality evidence). 3 In the high risk group, if no high risk adenomas are detected at the first surveillance examination, the ESGE suggests a 5-year interval before a second surveillance colonoscopy (weak recommendation, low quality evidence). If high risk adenomas are detected at first or subsequent surveillance examinations, a 3-year repetition of surveillance colonoscopy is recommended (strong recommendation, low quality evidence).4 The ESGE recommends that patients with serrated polyps < 10 mm in size with no dysplasia should be classified as low risk (weak recommendation, low quality evidence). The ESGE suggests that patients with large serrated polyps (≥ 10 mm) or those with dysplasia should be classified as high risk (weak recommendation, low quality evidence).5 The ESGE recommends that the endoscopist is responsible for providing a written recommendation for the post-polypectomy surveillance schedule (strong recommendation, low quality evidence).
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Hassan
authors.forename: Enrique
authors.initials: E
authors.lastname: Quintero
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Dumonceau
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Regula
authors.forename: Catarina
authors.initials: C
authors.lastname: Brandão
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.forename: Evelien
authors.initials: E
authors.lastname: Dekker
authors.forename: Mario
authors.initials: M
authors.lastname: Dinis-Ribeiro
authors.forename: Monika
authors.initials: M
authors.lastname: Ferlitsch
authors.forename: Antonio
authors.initials: A
authors.lastname: Gimeno-García
authors.forename: Yark
authors.initials: Y
authors.lastname: Hazewinkel
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jover
authors.forename: Mette
authors.initials: M
authors.lastname: Kalager
authors.forename: Magnus
authors.initials: M
authors.lastname: Loberg
authors.forename: Christian
authors.initials: C
authors.lastname: Pox
authors.forename: Bjorn
authors.initials: B
authors.lastname: Rembacken
authors.forename: David
authors.initials: D
authors.lastname: Lieberman
mesh_terms: D018256:Adenomatous Polyps / Q000473:pathology / Q000601:surgery*; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods / Q000592:standards*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards*; D006801:Humans; D011230:Precancerous Conditions / Q000473:pathology / Q000601:surgery*; D018570:Risk Assessment; D013997:Time Factors