Materiały źródłowe

• #1 Colonic Polyps: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172674-overview

  Population and autopsy studies suggest that about 30% of middle-aged or elderly individuals have colonic polyps. In comparison, the incidence of familial adenomatous polyposis (FAP) in the United States is one case for every 6580-8300 persons. […] Accurate comparison of colonic polyp incidence and prevalence among countries is difficult because of the differences in the methods used for detection. Colonic polyp prevalence in patients older than 60 years appears to vary substantially within and among countries, but it appears to be greater than 10% in most areas. […] Race per se is not a major risk factor for colonic polyps. However, studies indicate that black individuals have a somewhat higher incidence and an earlier onset of colorectal carcinoma. Task force guidelines from the US Multi-Society Task Force on Colorectal Cancer as well as those from the American Gastroenterological Association (AGA) recommend beginning colorectal cancer screening in black persons at age 45 years, rather than the standard age of 50 years.

• #2 Colon polyps epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Colon_polyps_epidemiology_and_demographics

  The prevalence of colon polyps is 10,000 in 100,000 sigmoidoscopy studies. […] The prevalence of colon polyps is 25,000 in 100,000 colonoscopy studies. […] The prevalence of hyperplastic colon polyps in autopsy studies is between 7,000-40,000 in 100,000 in individuals younger than 50 years of age. […] The prevalence of hyperplastic colon polyps in autopsy studies is between 20,000-40,000 in individuals older than 50 years of age. […] The incidence of colon polyps increases with age; the median age at diagnosis is 50 years. […] Colon polyps commonly affects individuals older than 50 years of age. […] Colon polyps usually affect individuals of the African American race. […] Men are more commonly affected by colon polyps than women. […] Colon polyps is a common disease worldwide.

• #3 Prevalence and risk factors for colorectal polyps in a Chinese population: a retrospective study | Scientific Reports

  https://www.nature.com/articles/s41598-020-63827-6

  The incidence of colorectal polyps is rising. Certain types of polyps are considered to be the precursor lesions for colorectal cancers. […] The prevalence of colorectal polyps was 18.1%. […] Regular smoking was independently associated with the presence and development of colorectal polyps. […] In conclusion, colorectal polyp is a common disease in China. Exploring the epidemiology and risk factors may improve the prevention of colorectal polyps, even colorectal cancer. […] The incidence of colorectal polyp is rapidly increasing worldwide. […] Smoking is proposed to be closely associated with colorectal polyps, neoplasia, and CRCs. […] We first evaluated the prevalence of colorectal polyps and factors associated with the presence of this disease in a cross-sectional study. Then we investigated the incidence and risk factors for the colorectal polyps via a retrospective cohort study.

• #4 Colon polyps epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Colon_polyps_epidemiology_and_demographics

  The exact incidence and prevalence of colon polyps are unknown. Colon polyps are incidentally found in colonoscopies and sigmoidoscopies. However, the incidence of colon polyps is estimated to be 200,000 cases in the united states annually. The prevalence of colon polyps is between 10,000-25,000 in 100,000 screening studies. The incidence of colon polyps increases with age; the median age at diagnosis is 50 years. Colon polyps usually affect individuals of the African American race. Men are more commonly affected by colon polyps than women. Colon polyps is a common disease worldwide. […] The incidence of colon polyps is estimated to be 200,000 cases in the united states annually. […] The cumulative incidence of polyps in 3 years after normal flexible sigmoidoscopy is 7%. […] The cumulative incidence of polyps in 3 years after normal colonoscopy is 27%.

• #5 Colonic Polyps: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172674-overview

  Population and autopsy studies suggest that about 30% of middle-aged or elderly individuals have colonic polyps. In comparison, the incidence of familial adenomatous polyposis (FAP) in the United States is one case for every 6580-8300 persons. […] Accurate comparison of colonic polyp incidence and prevalence among countries is difficult because of the differences in the methods used for detection. Colonic polyp prevalence in patients older than 60 years appears to vary substantially within and among countries, but it appears to be greater than 10% in most areas. […] Race per se is not a major risk factor for colonic polyps. However, studies indicate that black individuals have a somewhat higher incidence and an earlier onset of colorectal carcinoma. Task force guidelines from the US Multi-Society Task Force on Colorectal Cancer as well as those from the American Gastroenterological Association (AGA) recommend beginning colorectal cancer screening in black persons at age 45 years, rather than the standard age of 50 years.

• #6 Epidemiology and clinical characteristics of colorectal cancer and advanced adenoma: a single center experience in Jordan | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03531-1

  We evaluated the epidemiology and clinical characteristics of colorectal polyps to formulate an appropriate screening program. […] A total of 965 patients were included in the study, with a mean age of 53.917.1 years and a male predominance (52.7%). Polyps were detected in 28.1% of patients, with 18% having one polyp, 10.4% having two polyps, and 3.3% having more than two polyps. […] We highlight the fair prevalence of colorectal polyps and CRC in a Jordanian cohort. Awareness campaigns, screening strategies, and promotion of healthy lifestyles could help alleviate the burden of the disease, particularly among patients with classical risk factors for CRC. […] In Jordan, neoplasms are the second leading cause of death, accounting for 16.4% of all deaths, with CRC being the second most common neoplasm. Recent data from Jordan shows an increasing trend in CRC rates, currently standing at 16.3/100,000 for both genders.

• #7 Colonic Polyps: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172674-overview

  Males appear to have a moderately higher colonic polyp incidence than females, with earlier onset observed in some studies. […] Colonic polyps are strongly associated with increasing age (typically after age 40 y), but they can occur early in patients with polyposis syndromes. For example, colonic polyps can be detected in adolescents with familial adenomatous polyposis and in patients aged 20-40 years with hereditary nonpolyposis colorectal cancer (HNPCC).

• #8 Colon polyps epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Colon_polyps_epidemiology_and_demographics

  The prevalence of colon polyps is 10,000 in 100,000 sigmoidoscopy studies. […] The prevalence of colon polyps is 25,000 in 100,000 colonoscopy studies. […] The prevalence of hyperplastic colon polyps in autopsy studies is between 7,000-40,000 in 100,000 in individuals younger than 50 years of age. […] The prevalence of hyperplastic colon polyps in autopsy studies is between 20,000-40,000 in individuals older than 50 years of age. […] The incidence of colon polyps increases with age; the median age at diagnosis is 50 years. […] Colon polyps commonly affects individuals older than 50 years of age. […] Colon polyps usually affect individuals of the African American race. […] Men are more commonly affected by colon polyps than women. […] Colon polyps is a common disease worldwide.

• #9 Colonic Polyps: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172674-overview

  Males appear to have a moderately higher colonic polyp incidence than females, with earlier onset observed in some studies. […] Colonic polyps are strongly associated with increasing age (typically after age 40 y), but they can occur early in patients with polyposis syndromes. For example, colonic polyps can be detected in adolescents with familial adenomatous polyposis and in patients aged 20-40 years with hereditary nonpolyposis colorectal cancer (HNPCC).

• #10 Colon polyps epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Colon_polyps_epidemiology_and_demographics

  The prevalence of colon polyps is 10,000 in 100,000 sigmoidoscopy studies. […] The prevalence of colon polyps is 25,000 in 100,000 colonoscopy studies. […] The prevalence of hyperplastic colon polyps in autopsy studies is between 7,000-40,000 in 100,000 in individuals younger than 50 years of age. […] The prevalence of hyperplastic colon polyps in autopsy studies is between 20,000-40,000 in individuals older than 50 years of age. […] The incidence of colon polyps increases with age; the median age at diagnosis is 50 years. […] Colon polyps commonly affects individuals older than 50 years of age. […] Colon polyps usually affect individuals of the African American race. […] Men are more commonly affected by colon polyps than women. […] Colon polyps is a common disease worldwide.

• #11 Colonic Polyps: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172674-overview

  Population and autopsy studies suggest that about 30% of middle-aged or elderly individuals have colonic polyps. In comparison, the incidence of familial adenomatous polyposis (FAP) in the United States is one case for every 6580-8300 persons. […] Accurate comparison of colonic polyp incidence and prevalence among countries is difficult because of the differences in the methods used for detection. Colonic polyp prevalence in patients older than 60 years appears to vary substantially within and among countries, but it appears to be greater than 10% in most areas. […] Race per se is not a major risk factor for colonic polyps. However, studies indicate that black individuals have a somewhat higher incidence and an earlier onset of colorectal carcinoma. Task force guidelines from the US Multi-Society Task Force on Colorectal Cancer as well as those from the American Gastroenterological Association (AGA) recommend beginning colorectal cancer screening in black persons at age 45 years, rather than the standard age of 50 years.

• #12 Colonic polyps – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/colonic-polyps/

  Colonic polyps are most common in people over 50 years of age but can also be found in younger patients who have hereditary polyposis syndromes. […] Regular follow-up surveillance is required following the removal of the polyps. […] Incidence increases with age. […] 70%: adenomatous polyps […] 20%: hyperplastic polyps […] more common in Black populations. […] Epidemiological data refers to the US, unless otherwise specified. […] Patients with polyps that are concerning for malignancy and/or a history of familial adenomatous polyposis syndrome often require surgical resection. […] Follow-up is required for all patients because of the increased risk of malignancy. […] Patients with hereditary polyposis syndromes with multiple polyps that cannot be managed endoscopically should also be referred for surgery. […] For individuals with hereditary polyposis syndromes, follow condition-specific screening procedures. […] Follow-up should be tailored to the histology of the colonic polyp and the patient’s risk factors for colorectal cancer.

• #13 Colonic Polyps: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172674-overview

  Population and autopsy studies suggest that about 30% of middle-aged or elderly individuals have colonic polyps. In comparison, the incidence of familial adenomatous polyposis (FAP) in the United States is one case for every 6580-8300 persons. […] Accurate comparison of colonic polyp incidence and prevalence among countries is difficult because of the differences in the methods used for detection. Colonic polyp prevalence in patients older than 60 years appears to vary substantially within and among countries, but it appears to be greater than 10% in most areas. […] Race per se is not a major risk factor for colonic polyps. However, studies indicate that black individuals have a somewhat higher incidence and an earlier onset of colorectal carcinoma. Task force guidelines from the US Multi-Society Task Force on Colorectal Cancer as well as those from the American Gastroenterological Association (AGA) recommend beginning colorectal cancer screening in black persons at age 45 years, rather than the standard age of 50 years.

• #14 Colonic Polyps: Diagnosis and Surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6878826/

  Colorectal cancer begins as a polyp that is a benign growth on the mucosal surface of the colon or rectum. Over a period of 5 to 15 years, polyps can degenerate into a cancer, thus invading the colonic wall. Colorectal screening methods are designed to diagnose and remove polyps before they acquire invasive potential and develop into cancer. Screening for colorectal cancer can prevent and reduce mortality. Given the benefits and effectiveness of screening, guidelines exist from multiple organizations. These guidelines risk-stratify patients to determine the age of screening initiation and the interval for repeat screening. Categories of colorectal cancer risk include average risk, increased risk, and high risk based on individual and family medical history. Screening methods vary widely in the ability to diagnose and treat polyps and in the degree of invasiveness or risk of complication to the patient. Colonoscopy is held as the gold standard by which all other methods are compared; however, less-invasive modalities including computed tomographic colonography are increasing in popularity.

• #15 Colon and Rectal Polyps | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/colon-and-rectal-polyps

  Colon and rectal polyps occur in about 25 percent of men and women ages 45 and older. […] Not all polyps will turn into cancer, and it may take many years for a polyp to become cancerous. […] Removal of polyps during a colonoscopy reduces the risk of developing colon cancer in the future. […] About 70 percent of all polyps are adenomatous, making it the most common type of colon polyp. […] Only a small percentage become cancerous, but nearly all malignant polyps began as adenomatous. […] Fortunately, the process for these polyps to turn into colon cancer typically takes many years. […] With regular screening, they can be found and removed before that happens. […] Depending on their size and location in the colon, serrated polyps may become cancerous. […] Larger serrated polyps, which are typically flat (sessile), difficult to detect and located in the upper colon, are precancerous. […] Approximately 15 percent of polyps detected in colon cancer screening are villous or tubulovillous adenomas. […] This type of polyp carries a high risk of turning cancerous. […] Polyps can be detected and safely removed during a colonoscopy, preventing them from turning into cancer.

• #16 Colon and Rectal Polyps | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/colon-and-rectal-polyps

  Colon and rectal polyps occur in about 25 percent of men and women ages 45 and older. […] Not all polyps will turn into cancer, and it may take many years for a polyp to become cancerous. […] Removal of polyps during a colonoscopy reduces the risk of developing colon cancer in the future. […] About 70 percent of all polyps are adenomatous, making it the most common type of colon polyp. […] Only a small percentage become cancerous, but nearly all malignant polyps began as adenomatous. […] Fortunately, the process for these polyps to turn into colon cancer typically takes many years. […] With regular screening, they can be found and removed before that happens. […] Depending on their size and location in the colon, serrated polyps may become cancerous. […] Larger serrated polyps, which are typically flat (sessile), difficult to detect and located in the upper colon, are precancerous. […] Approximately 15 percent of polyps detected in colon cancer screening are villous or tubulovillous adenomas. […] This type of polyp carries a high risk of turning cancerous. […] Polyps can be detected and safely removed during a colonoscopy, preventing them from turning into cancer.

• #17 Colon and Rectal Polyps | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/colon-and-rectal-polyps

  Colon and rectal polyps occur in about 25 percent of men and women ages 45 and older. […] Not all polyps will turn into cancer, and it may take many years for a polyp to become cancerous. […] Removal of polyps during a colonoscopy reduces the risk of developing colon cancer in the future. […] About 70 percent of all polyps are adenomatous, making it the most common type of colon polyp. […] Only a small percentage become cancerous, but nearly all malignant polyps began as adenomatous. […] Fortunately, the process for these polyps to turn into colon cancer typically takes many years. […] With regular screening, they can be found and removed before that happens. […] Depending on their size and location in the colon, serrated polyps may become cancerous. […] Larger serrated polyps, which are typically flat (sessile), difficult to detect and located in the upper colon, are precancerous. […] Approximately 15 percent of polyps detected in colon cancer screening are villous or tubulovillous adenomas. […] This type of polyp carries a high risk of turning cancerous. […] Polyps can be detected and safely removed during a colonoscopy, preventing them from turning into cancer.

• #18 Colon and Rectal Polyps | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/colon-and-rectal-polyps

  Colon and rectal polyps occur in about 25 percent of men and women ages 45 and older. […] Not all polyps will turn into cancer, and it may take many years for a polyp to become cancerous. […] Removal of polyps during a colonoscopy reduces the risk of developing colon cancer in the future. […] About 70 percent of all polyps are adenomatous, making it the most common type of colon polyp. […] Only a small percentage become cancerous, but nearly all malignant polyps began as adenomatous. […] Fortunately, the process for these polyps to turn into colon cancer typically takes many years. […] With regular screening, they can be found and removed before that happens. […] Depending on their size and location in the colon, serrated polyps may become cancerous. […] Larger serrated polyps, which are typically flat (sessile), difficult to detect and located in the upper colon, are precancerous. […] Approximately 15 percent of polyps detected in colon cancer screening are villous or tubulovillous adenomas. […] This type of polyp carries a high risk of turning cancerous. […] Polyps can be detected and safely removed during a colonoscopy, preventing them from turning into cancer.

• #19

  https://fascrs.org/patients/diseases-and-conditions/a-z/screening-and-surveillance-for-colorectal-cancer-e

  Surveillance refers to the process of evaluating patients with a personal history of polyps or cancer. People who have precancerous polyps completely removed should have a colonoscopy every 3-5 years, depending on the size and number of polyps found. […] Most patients who have a colorectal cancer removed surgically should have a colonoscopy within one year. […] Patients with ulcerative or Crohns colitis for eight or more years should have a colonoscopy with multiple biopsies every 1-2 years.

• #20 Surveillance guidelines after removal of colorectal adenomatous polyps | Gut

  https://gut.bmj.com/content/51/suppl_5/v6

  The concept that most cancers arise from pre-existing adenomas is now widely accepted, based on epidemiological, clinical, postmortem, and molecular biological studies. […] The rationale for colonoscopic surveillance has always been based on the high detection rate of colorectal adenomas at follow up (30%50%) after a complete clearance colonoscopy. […] However, the main object of colonoscopic surveillance is the prevention of subsequent colorectal cancer rather than the detection and removal of adenomas, most of which will not become malignant. […] The high recurrence rate of advanced neoplasia found at follow up after removal of multiple adenomas might result from a higher miss rate combined with a potential for such adenomas to be more advanced. […] Although not entirely consistent, the data suggest that an additional colonoscopy at 12 months is warranted in people found at a single colonoscopy to have five or more, small adenomas or three or more adenomas, at least one of which is large.

• #21 Surveillance of colonic polyps: Are we getting it right?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4726668/

  Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. The identification of colonic polyps can reduce CRC mortality through earlier diagnosis of cancers and the removal of polyps: the precursor lesion of CRC. […] Following the finding and removal of colonic polyps at an initial colonoscopy, some patients are at an increased risk of developing CRC in the future. This is the rationale for post-polypectomy surveillance colonoscopy. However, not all individuals found to have colonic adenomas have a risk of CRC higher than that of the general population. […] The potential benefits of surveillance procedures must be weighed against the burden of colonoscopy: resource use, the potential for patient discomfort, and the risk of complications. Therefore surveillance colonoscopy is best utilised in a selected group of individuals at a high risk of developing cancer. […] Further study is needed into the specific factors conferring higher risk as well as the efficacy of surveillance in mitigating this risk. Such evidence will better inform clinicians and patients of the relative benefits of colonoscopic surveillance for the individual. […] In addition, the decision to continue with surveillance must be informed by the changing profile of risks and benefits of further procedures with the patients advancing age.

• #22 Surveillance of colonic polyps: Are we getting it right?

  https://www.wjgnet.com/1007-9327/full/v22/i6/1925.htm

  Increasing numbers of surveillance colonoscopies for previous colonic polyps are being performed. Each colonoscopy brings the burden of bowel preparation, potential discomfort, and risk of complications. Colonoscopy is a finite resource and must be recommended only with a strong indication. Individuals with non-advanced adenomas have no significantly increased risk of colorectal cancer (CRC) compared to the general population. Patients with an advanced adenoma, have a CRC risk similar to that of the general population after just one surveillance colonoscopy. This review examines the evidence behind current surveillance guidelines and questions the rationale for surveillance in individuals with relatively low cancer risk. […] Individuals found to have colonic polyps are at increased risk of advanced neoplasia in the future. This risk may be due to a number of mechanisms: (1) Missed lesions at the initial colonoscopy; (2) Incomplete removal of adenomatous tissue at initial colonoscopy; and (3) The individuals propensity to colonic neoplasia (either lifestyle factors, an inherent imbalance of cell proliferation, or a combination of these). In view of the increased risk of CRC, it seems logical that this group may benefit from closer monitoring than the general population. There are two reasons to consider surveillance colonoscopy in patients found to have adenomas at the index procedure. Firstly, as discussed above, there may be missed lesions, particularly small polyps, which may be identified at a subsequent procedure. Secondly, after a time interval, new lesions may have developed.

• #23 Surveillance of colonic polyps: Are we getting it right?

  https://www.wjgnet.com/1007-9327/full/v22/i6/1925.htm

  Increasing numbers of surveillance colonoscopies for previous colonic polyps are being performed. Each colonoscopy brings the burden of bowel preparation, potential discomfort, and risk of complications. Colonoscopy is a finite resource and must be recommended only with a strong indication. Individuals with non-advanced adenomas have no significantly increased risk of colorectal cancer (CRC) compared to the general population. Patients with an advanced adenoma, have a CRC risk similar to that of the general population after just one surveillance colonoscopy. This review examines the evidence behind current surveillance guidelines and questions the rationale for surveillance in individuals with relatively low cancer risk. […] Individuals found to have colonic polyps are at increased risk of advanced neoplasia in the future. This risk may be due to a number of mechanisms: (1) Missed lesions at the initial colonoscopy; (2) Incomplete removal of adenomatous tissue at initial colonoscopy; and (3) The individuals propensity to colonic neoplasia (either lifestyle factors, an inherent imbalance of cell proliferation, or a combination of these). In view of the increased risk of CRC, it seems logical that this group may benefit from closer monitoring than the general population. There are two reasons to consider surveillance colonoscopy in patients found to have adenomas at the index procedure. Firstly, as discussed above, there may be missed lesions, particularly small polyps, which may be identified at a subsequent procedure. Secondly, after a time interval, new lesions may have developed.

• #24 Surveillance of colonic polyps: Are we getting it right?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4726668/

  Increasing numbers of surveillance colonoscopies for previous colonic polyps are being performed. Each colonoscopy brings the burden of bowel preparation, potential discomfort, and risk of complications. Colonoscopy is a finite resource and must be recommended only with a strong indication. […] Individuals with non-advanced adenomas have no significantly increased risk of colorectal cancer (CRC) compared to the general population. Patients with an advanced adenoma, have a CRC risk similar to that of the general population after just one surveillance colonoscopy. […] This review examines the evidence behind current surveillance guidelines and questions the rationale for surveillance in individuals with relatively low cancer risk. […] Individuals found to have colonic polyps are at increased risk of advanced neoplasia in the future. This risk may be due to a number of mechanisms: (1) Missed lesions at the initial colonoscopy; (2) Incomplete removal of adenomatous tissue at initial colonoscopy; and (3) The individuals propensity to colonic neoplasia (either lifestyle factors, an inherent imbalance of cell proliferation, or a combination of these). […] It is established that individuals with previously identified adenomas have an increased risk of further adenomas at a follow-up examination. At 4 year interval, 35.5% of patients will again be found to have at least one adenoma, but only 8.6%-12% will have advanced neoplasia (either an advanced adenoma or carcinoma) with 0.6% having carcinoma. […] Factors conferring higher risk of further adenomas at surveillance are age greater than 60 years, male sex, and the presence of more than one adenoma at the initial procedure.

• #25 Surveillance of colonic polyps: Are we getting it right?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4726668/

  The evidence to support the use of surveillance applies predominantly to the high risk group. The incidence of advanced neoplasia and carcinoma in these individuals is significantly increased at follow-up, and CRC mortality is reduced by their surveillance. […] Current guidelines differ most in recommendations for individuals with intermediate risk. It is in this group of patients that the benefit of surveillance is most uncertain. […] Patients with 3 or 4 diminutive adenomas at index colonoscopy would be offered a surveillance procedure at 3 years according to United Kingdom, European, and United States guidelines. However, there is little evidence that this group of patients carries any significantly increased CRC risk compared to the general population. […] Current guidelines take account of findings at both the index and first surveillance colonoscopy in determining the second surveillance interval. This approach would be supported by a recent study showing that high risk features identified at either the index or first surveillance procedure increase the risk of advanced neoplasia at second surveillance.

• #26 Follow-up after colonoscopy and polypectomy – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/follow-up-after-colonoscopy-and-polypectomy-a-consensus-update-by-the-u-s-multi-society-task-force-on-colorectal-cancer/

  Recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer (CRC) for follow-up after normal colonoscopy among individuals age-eligible for CRC screening, and post-polypectomy among all individuals with polyps. […] 1. For patients with normal, high-quality colonoscopy, repeat colorectal cancer (CRC) screening in 10 years. 2. For patients with 1-2 tubular adenomas <10 mm in size completely removed at a high-quality examination, repeat colonoscopy in 7-10 years. 3. For patients with 3-4 tubular adenomas <10 mm in size completely removed at a high-quality examination, repeat colonoscopy in 3-5 years. 4. For patients with 5-10 tubular adenomas <10 mm in size completely removed at a high-quality examination, repeat colonoscopy in 3 years. 5. For patients with 1 or more adenomas ≥10 mm in size completely removed at high-quality examination, repeat colonoscopy in 3 years. 6. For patients with adenoma containing villous histology completely removed at high-quality examination, repeat colonoscopy in 3 years. 7. For patients with adenoma containing high-grade dysplasia completely removed at high-quality examination, repeat colonoscopy in 3 years. 8. For patients with >10 adenomas completely removed at high-quality examination, repeat colonoscopy in 1 year. 9. For patients with ≤ 20 hyperplastic polyps (HPs) <10 mm in size in the rectum or sigmoid colon removed at a high-quality examination, repeat CRC screening in 10 years. 10. For patients with ≤ 20 HPs <10 mm in size proximal to the sigmoid colon removed at a high-quality examination, repeat colonoscopy in 10 years. 11. For patients with 1-2 sessile serrated polyps (SSPs) <10 mm in size completely removed at high-quality examination, repeat colonoscopy in 5-10 years. 12. For patients with traditional serrated adenomas (TSAs) completely removed at a high-quality examination, repeat colonoscopy in 3 years. 13. For patients with 3-4 SSPs <10 mm at high-quality examination, repeat colonoscopy in 3-5 years. 14. For patients with any combination of 5-10 SSPs <10 mm at high-quality examination, repeat colonoscopy in 3 years. 15. For patients with SSP ≥10 mm at a high-quality examination, repeat colonoscopy in 3 years. 16. For patients with HP ≥10 mm, repeat colonoscopy in 3-5 years. A 3-year follow-up interval is favored if concern about pathologist consistency in distinguishing SSPs from HPs, quality of bowel preparation, or complete polyp excision, whereas a 5-year interval is favored if low concerns for consistency in distinguishing between SSP and HP by the pathologist, adequate bowel preparation, and confident complete polyp excision. 17. For patients with SSP containing dysplasia at a high-quality examination, repeat colonoscopy in 3 years. 18. For patients with history of baseline adenoma removal and one subsequent colonoscopy, recommendations for subsequent surveillance should take into account findings at baseline and first surveillance. 19. For patients with piecemeal resection of adenoma or SSP >20 mm, repeat colonoscopy in 6 months.

• #27 Updated Polypectomy Surveillance Recommendationslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na50884/2020/02/12/updated-polypectomy-surveillance-recommendations

  This document is based on recent evidence regarding the effect of screening and surveillance on incident colorectal cancer (CRC) and polyp risk, in the era of heightened focus on the importance of high-quality colonoscopy and broader use of technological advances. […] Recommendations assume high-quality baseline colonoscopy, defined as complete examination to the cecum, adequate bowel preparation, performance by a colonoscopist with adequate adenoma detection rate, and attention to complete polyp excision. […] Individuals with normal colonoscopy, or with <20 hyperplastic polyps <10 mm, should undergo surveillance in 10 years. [...] Individuals with 1–2 adenomas <10 mm should undergo surveillance colonoscopy in 7–10 years. In those with 3–4 adenomas <10 mm, surveillance should occur in 3–5 years.

• #28 Updated Polypectomy Surveillance Recommendationslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na50884/2020/02/12/updated-polypectomy-surveillance-recommendations

  This document is based on recent evidence regarding the effect of screening and surveillance on incident colorectal cancer (CRC) and polyp risk, in the era of heightened focus on the importance of high-quality colonoscopy and broader use of technological advances. […] Recommendations assume high-quality baseline colonoscopy, defined as complete examination to the cecum, adequate bowel preparation, performance by a colonoscopist with adequate adenoma detection rate, and attention to complete polyp excision. […] Individuals with normal colonoscopy, or with <20 hyperplastic polyps <10 mm, should undergo surveillance in 10 years. [...] Individuals with 1–2 adenomas <10 mm should undergo surveillance colonoscopy in 7–10 years. In those with 3–4 adenomas <10 mm, surveillance should occur in 3–5 years.

• #29 Updated Polypectomy Surveillance Recommendationslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na50884/2020/02/12/updated-polypectomy-surveillance-recommendations

  This document is based on recent evidence regarding the effect of screening and surveillance on incident colorectal cancer (CRC) and polyp risk, in the era of heightened focus on the importance of high-quality colonoscopy and broader use of technological advances. […] Recommendations assume high-quality baseline colonoscopy, defined as complete examination to the cecum, adequate bowel preparation, performance by a colonoscopist with adequate adenoma detection rate, and attention to complete polyp excision. […] Individuals with normal colonoscopy, or with <20 hyperplastic polyps <10 mm, should undergo surveillance in 10 years. [...] Individuals with 1–2 adenomas <10 mm should undergo surveillance colonoscopy in 7–10 years. In those with 3–4 adenomas <10 mm, surveillance should occur in 3–5 years.

• #30 Updated Polypectomy Surveillance Recommendationslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na50884/2020/02/12/updated-polypectomy-surveillance-recommendations

  Individuals with 5–10 adenomas, adenoma ≥10 mm, or adenoma with villous component or high-grade dysplasia should undergo surveillance in 3 years. […] Patients with >10 adenomas should return for surveillance in 1 year, with consideration for genetic testing based on adenoma burden, age, and family history. […] In case of piecemeal resection of adenoma ≥20 mm, surveillance colonoscopy should occur in 6 months, then 1 year later, then 3 years after the second examination. […] Individuals with 1–2 sessile serrated polyps (SSPs) <10 mm should undergo surveillance colonoscopy in 5–10 years. In those with 3–4 SSPs <10 mm or hyperplastic polyp ≥10 mm, surveillance should occur in 3–5 years. [...] Individuals with 5–10 SSPs, SSP ≥10 mm, SSP with dysplasia, or traditional serrated adenoma should undergo surveillance in 3 years.

• #31 Updated Polypectomy Surveillance Recommendationslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na50884/2020/02/12/updated-polypectomy-surveillance-recommendations

  Individuals with 5–10 adenomas, adenoma ≥10 mm, or adenoma with villous component or high-grade dysplasia should undergo surveillance in 3 years. […] Patients with >10 adenomas should return for surveillance in 1 year, with consideration for genetic testing based on adenoma burden, age, and family history. […] In case of piecemeal resection of adenoma ≥20 mm, surveillance colonoscopy should occur in 6 months, then 1 year later, then 3 years after the second examination. […] Individuals with 1–2 sessile serrated polyps (SSPs) <10 mm should undergo surveillance colonoscopy in 5–10 years. In those with 3–4 SSPs <10 mm or hyperplastic polyp ≥10 mm, surveillance should occur in 3–5 years. [...] Individuals with 5–10 SSPs, SSP ≥10 mm, SSP with dysplasia, or traditional serrated adenoma should undergo surveillance in 3 years.

• #32 Updated Polypectomy Surveillance Recommendationslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na50884/2020/02/12/updated-polypectomy-surveillance-recommendations

  Individuals with 5–10 adenomas, adenoma ≥10 mm, or adenoma with villous component or high-grade dysplasia should undergo surveillance in 3 years. […] Patients with >10 adenomas should return for surveillance in 1 year, with consideration for genetic testing based on adenoma burden, age, and family history. […] In case of piecemeal resection of adenoma ≥20 mm, surveillance colonoscopy should occur in 6 months, then 1 year later, then 3 years after the second examination. […] Individuals with 1–2 sessile serrated polyps (SSPs) <10 mm should undergo surveillance colonoscopy in 5–10 years. In those with 3–4 SSPs <10 mm or hyperplastic polyp ≥10 mm, surveillance should occur in 3–5 years. [...] Individuals with 5–10 SSPs, SSP ≥10 mm, SSP with dysplasia, or traditional serrated adenoma should undergo surveillance in 3 years.

• #33 Updated Polypectomy Surveillance Recommendationslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na50884/2020/02/12/updated-polypectomy-surveillance-recommendations

  Individuals with 5–10 adenomas, adenoma ≥10 mm, or adenoma with villous component or high-grade dysplasia should undergo surveillance in 3 years. […] Patients with >10 adenomas should return for surveillance in 1 year, with consideration for genetic testing based on adenoma burden, age, and family history. […] In case of piecemeal resection of adenoma ≥20 mm, surveillance colonoscopy should occur in 6 months, then 1 year later, then 3 years after the second examination. […] Individuals with 1–2 sessile serrated polyps (SSPs) <10 mm should undergo surveillance colonoscopy in 5–10 years. In those with 3–4 SSPs <10 mm or hyperplastic polyp ≥10 mm, surveillance should occur in 3–5 years. [...] Individuals with 5–10 SSPs, SSP ≥10 mm, SSP with dysplasia, or traditional serrated adenoma should undergo surveillance in 3 years.

• #34 Polyp & Colonoscopy Surveillance Guidelines: BSG/ACPGBI/PHE

  https://www.bsg.org.uk/clinical-resource/list-of-recommendations

  These guidelines have been reviewed and endorsed by BSG CSSC and ACPGBI, and have now been published in Gut: Rutter MD, East J, Rees CJ, et al. Gut 2020;69:201–223. […] These consensus guidelines were jointly commissioned by the British Society of Gastroenterology, the Association of Coloproctology of Great Britain and Ireland and Public Health England. They provide an evidence-based framework for the use of surveillance colonoscopy and non-colonoscopic colorectal imaging in people aged 18 and over. […] They are the first guidelines that take into account the introduction of national bowel cancer screening. For the first time, they also incorporate surveillance of patients following resection of either adenomatous or serrated polyps and also post-colorectal cancer-resection. […] The key recommendations are that the high-risk criteria for future colorectal cancer (CRC) following polypectomy comprise EITHER: 2 or more premalignant polyps including at least one advanced colorectal polyp (defined as a serrated polyp of at least 10mm in size or containing any grade of dysplasia, or an adenoma of at least 10mm in size or containing high-grade dysplasia); OR 5 or more premalignant polyps. […] This cohort should undergo a one-off surveillance colonoscopy at 3 years. Post-CRC-resection patients should undergo a 1-year clearance colonoscopy, then a surveillance colonoscopy after 3 more years.

• #35 Updated surveillance guidance for people who have had polyps or previous cancer removed | Bowel Cancer UK

  https://www.bowelcanceruk.org.uk/news-and-blogs/research-blog/updated-surveillance-guidance-for-people-who-have-had-polyps-or-previous-cancer-removed/

  For people who have had a bowel cancer removed, it is recommended that, after treatment, patients should have a follow-up colonoscopy after one year and another surveillance colonoscopy after a further three years. […] High risk of developing more polyps: Most people with 'high risk findings’ during a colonoscopy will be invited to have surveillance after three years. […] It usually takes at least 10 years for a polyp to develop into a high-risk polyp or cancer. Although colonoscopy is generally a safe procedure, the risks of a complication are greater in people over 75, so in general surveillance colonoscopy is not recommended for those over this age. […] This new guidance is more tailored to an individual’s level of risk, as it considers how old someone is, as well as the number and type of polyps that were found at their initial colonoscopy. […] These guidelines are being applied retrospectively, which means some low-risk people currently receiving surveillance colonoscopies will no longer need to.

• #36 British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines | Gut

  https://gut.bmj.com/content/69/2/201

  This cohort should undergo a one-off surveillance colonoscopy at 3 years. Post-CRC resection patients should undergo a 1-year clearance colonoscopy, then a surveillance colonoscopy after 3 more years. […] Some patients who have premalignant polyps (adenomas or serrated polyps) detected at colonoscopy are more likely to develop metachronous polyps or CRC. Endoscopic follow-up of patients with such polyps is referred to as a post-polypectomy surveillance colonoscopy. Likewise, people who have had a CRC resection may develop a metachronous CRC and are offered post-CRC resection colonoscopic surveillance. Surveillance aims to detect and resect metachronous premalignant polyps and to detect lesions not identified on the initial examination, thereby preventing cancer and reducing CRC mortality; however, no randomised trial has directly assessed the benefit of post-polypectomy or post-cancer resection surveillance.

• #37 Updated surveillance guidance for people who have had polyps or previous cancer removed | Bowel Cancer UK

  https://www.bowelcanceruk.org.uk/news-and-blogs/research-blog/updated-surveillance-guidance-for-people-who-have-had-polyps-or-previous-cancer-removed/

  For people who have had a bowel cancer removed, it is recommended that, after treatment, patients should have a follow-up colonoscopy after one year and another surveillance colonoscopy after a further three years. […] High risk of developing more polyps: Most people with 'high risk findings’ during a colonoscopy will be invited to have surveillance after three years. […] It usually takes at least 10 years for a polyp to develop into a high-risk polyp or cancer. Although colonoscopy is generally a safe procedure, the risks of a complication are greater in people over 75, so in general surveillance colonoscopy is not recommended for those over this age. […] This new guidance is more tailored to an individual’s level of risk, as it considers how old someone is, as well as the number and type of polyps that were found at their initial colonoscopy. […] These guidelines are being applied retrospectively, which means some low-risk people currently receiving surveillance colonoscopies will no longer need to.

• #38 Colonic Polyps Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/172674-guidelines

  These MSTF guidelines may be found here. Strong recommendations include the following: Patients with colorectal cancer should undergo high-quality perioperative clearing with colonoscopy, either preoperatively or, in the case of obstructive colorectal cancer, within a 3-6 month interval after surgery. […] Following the 1-year colonoscopy, the next colonoscopies should be 3 years and then 5 years, and thereafter at 5-year intervals until the benefits of continued surveillance are outweighed by decreased life expectancy. […] Recommendations for polyp surveillance after first surveillance colonoscopy include: In the presence of low-risk or high-risk adenomas at baseline evaluation and then high-risk adenoma at first surveillance, the second surveillance should take place in 3 years. But if low-risk adenomas are present at first surveillance, the next surveillance is in 5 years.

• #39

  https://fascrs.org/patients/diseases-and-conditions/a-z/screening-and-surveillance-for-colorectal-cancer-e

  Patients with inflammatory conditions of the colon, such as Crohns disease or ulcerative colitis, have an increased risk of colorectal cancer as well. […] Like other serious, common medical problems such as high blood pressure and diabetes, colorectal cancer is considered to be a silent disease in its early stages. Large studies done both in the United States and in Europe have shown that routine colonoscopy with the removal of polyps may reduce the incidence of colorectal cancer by about 75%. […] Unfortunately, not everyone receives proper screening. Although most screening modalities are now covered by insurance or Medicare, up to half of the population is not current on the appropriate tests. […] For average risk individuals, screening should start at age 45. […] Of the screening methods discussed above, FOBT should be done yearly, along with a flexible sigmoidoscopy every 5 years. If colonoscopy is chosen, then it should be done every 10 years if the initial examination was normal and no new symptoms develop.

• #40 Colonic Polyps: Diagnosis and Surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6878826/

  Given the high lifetime risk of CRC in IBD patients, the USPSTF/ACS/ACR screening guidelines recommend high-risk categorization. […] In IBD patients, it is recommended for initial colonoscopy starting 8 years after onset of pan-colitis, or 12 to 15 years after onset of left-sided colitis, with ongoing surveillance every 1 to 2 years. […] Screening and surveillance methods for CRC vary widely in effectiveness for polyp and CRC detection, patient compliance, and invasiveness. […] Colonoscopy is widely considered the gold standard for CR screening, as it allows for both detection and excision of premalignant lesions from the entire colon and rectum. […] Colonoscopy remains a procedure with rare but serious complications, and therefore informed consent is imperative. […] If the initial method for CR screening for an average-risk patient was a colonoscopy, ongoing screening and surveillance depends on findings at initial colonoscopy and any applicable histopathology.

• #41

  https://bpac.org.nz/2021/bowel-polyps.aspx

  Inflammatory bowel disease (IBD) is associated with an increased risk of development of bowel cancer. The risk can be classified as low, intermediate or high, largely reflecting the extensiveness and level of activity of the two main forms of IBD, either ulcerative colitis or Crohns disease. Recommendations from 2012, state that: A baseline colonoscopy and biopsies as appropriate should be performed 8 10 years after a definitive diagnosis of IBD. Ongoing surveillance with colonoscopy should be offered depending on the patients level of risk: Low risk: colonoscopy at five years, Intermediate risk: colonoscopy at three years, High risk: colonoscopy at one year. […] N.B. For those at intermediate or high risk, the intervals can be extended to five years provided there have been two consecutive colonoscopies that show quiescent disease with no dysplasia, and no other risk factors (i.e. family history, a stricture or primary sclerosing cholangitis).

• #42

  https://bpac.org.nz/2021/bowel-polyps.aspx

  Inflammatory bowel disease (IBD) is associated with an increased risk of development of bowel cancer. The risk can be classified as low, intermediate or high, largely reflecting the extensiveness and level of activity of the two main forms of IBD, either ulcerative colitis or Crohns disease. Recommendations from 2012, state that: A baseline colonoscopy and biopsies as appropriate should be performed 8 10 years after a definitive diagnosis of IBD. Ongoing surveillance with colonoscopy should be offered depending on the patients level of risk: Low risk: colonoscopy at five years, Intermediate risk: colonoscopy at three years, High risk: colonoscopy at one year. […] N.B. For those at intermediate or high risk, the intervals can be extended to five years provided there have been two consecutive colonoscopies that show quiescent disease with no dysplasia, and no other risk factors (i.e. family history, a stricture or primary sclerosing cholangitis).

• #43 Surveillance of colonic polyps: Are we getting it right?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4726668/

  Increasing numbers of surveillance colonoscopies for previous colonic polyps are being performed. Each colonoscopy brings the burden of bowel preparation, potential discomfort, and risk of complications. Colonoscopy is a finite resource and must be recommended only with a strong indication. […] Individuals with non-advanced adenomas have no significantly increased risk of colorectal cancer (CRC) compared to the general population. Patients with an advanced adenoma, have a CRC risk similar to that of the general population after just one surveillance colonoscopy. […] This review examines the evidence behind current surveillance guidelines and questions the rationale for surveillance in individuals with relatively low cancer risk. […] Individuals found to have colonic polyps are at increased risk of advanced neoplasia in the future. This risk may be due to a number of mechanisms: (1) Missed lesions at the initial colonoscopy; (2) Incomplete removal of adenomatous tissue at initial colonoscopy; and (3) The individuals propensity to colonic neoplasia (either lifestyle factors, an inherent imbalance of cell proliferation, or a combination of these). […] It is established that individuals with previously identified adenomas have an increased risk of further adenomas at a follow-up examination. At 4 year interval, 35.5% of patients will again be found to have at least one adenoma, but only 8.6%-12% will have advanced neoplasia (either an advanced adenoma or carcinoma) with 0.6% having carcinoma. […] Factors conferring higher risk of further adenomas at surveillance are age greater than 60 years, male sex, and the presence of more than one adenoma at the initial procedure.

• #44 Clinical outcomes of colonoscopic polypectomy with strategic surveillance colonoscopies in patients with 10 or more polyps | Scientific Reports

  https://www.nature.com/articles/s41598-023-29604-x

  The cumulative incidence of metachronous advanced neoplasia including cancer, adenoma 1 cm, and adenoma with high-grade dysplasia and/or villous component, was 6.3% at 1 year, 11.9% at 3 years, and 15.6% at 5 years. […] The effectiveness of screening and surveillance colonoscopies can be assessed by achieving their goal, which is reducing colorectal cancer mortality and possible prevention of colorectal cancer by polypectomy. […] Therefore, we suggest a 1-year interval for surveillance colonoscopy after removal of 10 polyps at baseline colonoscopy.

• #45 Association between the location of colon polyps at baseline and surveillance colonoscopy: a retrospective study

  http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000900006

  There seems to be a significant association between polyp location at baseline and surveillance colonoscopy. […] In our study we found a significant association between the initial polyp location and the recurrent one. For all the colon segments, the presence of polyps at baseline colonoscopy confers a significant risk for recurrence in the same location at surveillance colonoscopy. This risk is about four times higher in the distal colon, closely followed by the proximal colon.

• #46 Prevalence and risk factors for colorectal polyps in a Chinese population: a retrospective study | Scientific Reports

  https://www.nature.com/articles/s41598-020-63827-6

  The incidence of colorectal polyps is rising. Certain types of polyps are considered to be the precursor lesions for colorectal cancers. […] The prevalence of colorectal polyps was 18.1%. […] Regular smoking was independently associated with the presence and development of colorectal polyps. […] In conclusion, colorectal polyp is a common disease in China. Exploring the epidemiology and risk factors may improve the prevention of colorectal polyps, even colorectal cancer. […] The incidence of colorectal polyp is rapidly increasing worldwide. […] Smoking is proposed to be closely associated with colorectal polyps, neoplasia, and CRCs. […] We first evaluated the prevalence of colorectal polyps and factors associated with the presence of this disease in a cross-sectional study. Then we investigated the incidence and risk factors for the colorectal polyps via a retrospective cohort study.

• #47 Prevalence and risk factors for colorectal polyps in a Chinese population: a retrospective study | Scientific Reports

  https://www.nature.com/articles/s41598-020-63827-6

  The prevalence of colorectal polyps was 18.1% in our study population. Age, gender, TC, regular smoking and WBC count were independently associated with the presence of colorectal polyps. […] Regular cigarette smoking and albumin were independent risk factors for the development of colorectal polyps. […] Further analyses showed those who were current smokers, had more daily smoking consumption, and combined with regular drinking had a higher risk of developing colorectal polyps. […] Smoking was significantly associated with the presence and development of polyps, especially related to the rectal, small and single polyp. […] The incidence of colorectal polyps was also influenced by smoking status, daily tobacco consumption, and whether smoking was combined with a drinking habit.

• #48 Family History of Polyps Raises CRC Risk

  https://www.gastroendonews.com/Endoscopy-Suite/Article/09-21/Family-History-of-Polyps-Raises-CRC-Risk/64552

  A new study has found that siblings and children of people with colorectal polyps are at a significantly increased risk for CRC, particularly when such lesions occur in more than one first-degree relative (FDR) or before the age of 50 years. […] Our findings suggest that early screening may be tailored for first-degree relatives of individuals with polyps, particularly those with multiple first-degree relatives having a history of polyps and whose first-degree relatives polyps were diagnosed at a younger age, said Mingyang Song, MBBS, ScD, an assistant professor in the Departments of Epidemiology and Nutrition at the Harvard T.H. Chan School of Public Health, in Boston. […] The prevalence of at least one polyp in an FDR was 7.7% among cases and 5.3% among controls; advanced polyps accounted for 3.2% and 1.9% of lesions, respectively. The prevalence of CRC in an FDR was 10.4% for cases and 6.4% for controls.

• #49 Family History of Polyps Raises CRC Risk

  https://www.gastroendonews.com/Endoscopy-Suite/Article/09-21/Family-History-of-Polyps-Raises-CRC-Risk/64552

  Compared with individuals without a positive family history, those with an FDR with any polyp had a 62% increased risk for CRC on multivariable analysis and a 40% increased risk when the analysis adjusted for family history of CRC. […] The risk elevation was more prominent for early-onset CRC and heightened by the coexistence of a family history of CRC, Dr. Song said. […] A family history of serrated polyps appeared to be strongly associated with the risk for proximal colon cancer, but not distal colon or rectal cancer, Dr. Song added. […] Dr. Kupfer said she sees room for improvement in incorporating polyp history into screening recommendations.

• #50 Family History of Polyps Raises CRC Risk

  https://www.gastroendonews.com/Endoscopy-Suite/Article/09-21/Family-History-of-Polyps-Raises-CRC-Risk/64552

  Compared with individuals without a positive family history, those with an FDR with any polyp had a 62% increased risk for CRC on multivariable analysis and a 40% increased risk when the analysis adjusted for family history of CRC. […] The risk elevation was more prominent for early-onset CRC and heightened by the coexistence of a family history of CRC, Dr. Song said. […] A family history of serrated polyps appeared to be strongly associated with the risk for proximal colon cancer, but not distal colon or rectal cancer, Dr. Song added. […] Dr. Kupfer said she sees room for improvement in incorporating polyp history into screening recommendations.

• #51 Updated Polypectomy Surveillance Recommendationslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na50884/2020/02/12/updated-polypectomy-surveillance-recommendations

  This document is based on recent evidence regarding the effect of screening and surveillance on incident colorectal cancer (CRC) and polyp risk, in the era of heightened focus on the importance of high-quality colonoscopy and broader use of technological advances. […] Recommendations assume high-quality baseline colonoscopy, defined as complete examination to the cecum, adequate bowel preparation, performance by a colonoscopist with adequate adenoma detection rate, and attention to complete polyp excision. […] Individuals with normal colonoscopy, or with <20 hyperplastic polyps <10 mm, should undergo surveillance in 10 years. [...] Individuals with 1–2 adenomas <10 mm should undergo surveillance colonoscopy in 7–10 years. In those with 3–4 adenomas <10 mm, surveillance should occur in 3–5 years.

• #52 Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey

  https://www.gutnliver.org/journal/view.html?pn=search&uid=1826&vmd=Full

  Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey […] Background/Aims: As the number of colonoscopies and polypectomies performed continues to increase in many Asian countries, there is a great demand for surveillance colonoscopy. The aim of this study was to investigate the adherence to postpolypectomy surveillance guidelines among physicians in Asia. […] Methods: A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios. […] Results: Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma 10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed: 20 colonoscopies per month (high volume group) and 20 colonoscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%).

• #53 Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey

  https://www.gutnliver.org/journal/view.html?pn=search&uid=1826&vmd=Full

  Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey […] Background/Aims: As the number of colonoscopies and polypectomies performed continues to increase in many Asian countries, there is a great demand for surveillance colonoscopy. The aim of this study was to investigate the adherence to postpolypectomy surveillance guidelines among physicians in Asia. […] Methods: A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios. […] Results: Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma 10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed: 20 colonoscopies per month (high volume group) and 20 colonoscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%).

• #54 Surveillance of colonic polyps: Are we getting it right?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4726668/

  Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. The identification of colonic polyps can reduce CRC mortality through earlier diagnosis of cancers and the removal of polyps: the precursor lesion of CRC. […] Following the finding and removal of colonic polyps at an initial colonoscopy, some patients are at an increased risk of developing CRC in the future. This is the rationale for post-polypectomy surveillance colonoscopy. However, not all individuals found to have colonic adenomas have a risk of CRC higher than that of the general population. […] The potential benefits of surveillance procedures must be weighed against the burden of colonoscopy: resource use, the potential for patient discomfort, and the risk of complications. Therefore surveillance colonoscopy is best utilised in a selected group of individuals at a high risk of developing cancer. […] Further study is needed into the specific factors conferring higher risk as well as the efficacy of surveillance in mitigating this risk. Such evidence will better inform clinicians and patients of the relative benefits of colonoscopic surveillance for the individual. […] In addition, the decision to continue with surveillance must be informed by the changing profile of risks and benefits of further procedures with the patients advancing age.

• #55 Updated surveillance guidance for people who have had polyps or previous cancer removed | Bowel Cancer UK

  https://www.bowelcanceruk.org.uk/news-and-blogs/research-blog/updated-surveillance-guidance-for-people-who-have-had-polyps-or-previous-cancer-removed/

  For people who have had a bowel cancer removed, it is recommended that, after treatment, patients should have a follow-up colonoscopy after one year and another surveillance colonoscopy after a further three years. […] High risk of developing more polyps: Most people with 'high risk findings’ during a colonoscopy will be invited to have surveillance after three years. […] It usually takes at least 10 years for a polyp to develop into a high-risk polyp or cancer. Although colonoscopy is generally a safe procedure, the risks of a complication are greater in people over 75, so in general surveillance colonoscopy is not recommended for those over this age. […] This new guidance is more tailored to an individual’s level of risk, as it considers how old someone is, as well as the number and type of polyps that were found at their initial colonoscopy. […] These guidelines are being applied retrospectively, which means some low-risk people currently receiving surveillance colonoscopies will no longer need to.

• #56 When to Discontinue Colon Polyp Surveillance in Older Adults? – American College of Gastroenterology

  https://gi.org/journals-publications/ebgi/yen_june2024/

  Outcomes: Rates of CRC and advanced adenoma, defined as villous adenoma, adenoma with high grade dysplasia, and adenoma >10 mm on surveillance colonoscopy were recorded with results stratified based on age group (70-74, 75-79 or 80-85 years old) at time of surveillance colonoscopy and whether patient had non-advanced or advanced adenoma on last colonoscopy. […] Results: Of 9,740 surveillance colonoscopies in 9,601 patients, 58.9%, 33.1% and 8.0% were performed in 70-74, 75-79 and 80-85 year-olds, respectively. Overall, 0.3% had findings of CRC, 11.7% advanced adenoma, and 12.0% advanced neoplasia. There were no differences between age groups. CRC (0.5% vs 0.2%, P = 0.02) and advanced neoplasia (16.5% vs 10.6%, P < 0.001) were higher with prior advanced vs non-advanced adenomas. [...] Colonoscopies in elderly patients have increased risk of complications, and gastroenterologists have to weigh this risk against the diagnostic/therapeutic benefits of colonoscopy. There is inadequate existing evidence guiding how to approach surveillance colonoscopies (i.e., when to stop colonoscopies) among older adults with prior adenoma, particularly among those with prior non-advanced adenomas (who can go 10 years between colonoscopies based on revised guidelines) vs those with prior advanced polyps given their elevated subsequent CRC risk.

• #57 When to Discontinue Colon Polyp Surveillance in Older Adults? – American College of Gastroenterology

  https://gi.org/journals-publications/ebgi/yen_june2024/

  Overall, the rate of CRC on surveillance colonoscopy in individuals ≥70 years old with non-advanced adenomas on prior colonoscopy was 0.2% with 10.4% having advanced adenomas. Considering that it takes multiple years for an advanced adenoma to develop into CRC, the yield of surveillance colonoscopy to prevent CRC in patients with history of non-advanced adenomas seems low. […] In older patients ≥ 70 years old with prior non-advanced adenomas, I tend to encourage cessation or limitation of future colonoscopies. This does not preclude future onset of CRC, but it is important to discuss with the patient that performing colonoscopy at an elderly age may not be worth the burden of bowel preparation or procedural risk compared to a low future CRC risk.

• #58 Study Reveals Nearly 40 Percent of Young Adults with Polyps on Colonoscopy Have High-Risk Polyps

  https://consultqd.clevelandclinic.org/new-study-reveals-nearly-40-percent-of-young-adults-with-polyps-on-colonoscopy-have-high-risk-polyps

  Study reveals nearly 40 percent of young adults with polyps on colonoscopy have high-risk polyps. […] Their goal is to decrease the risk of cancer and utilize resources appropriately. However, there are no published guidelines for colorectal cancer screening or alterations in surveillance colonoscopy for young adults who have had polyps. […] The study revealed that 38 percent of young adults who had polyps found on colonoscopy had high-risk polyps. […] When stratifying risk based upon baseline polyp characteristics, in our small study, young adults with high-risk features were no more likely than older adults to have an advanced polyp detected during a follow-up colonoscopy, explains Dr. Burke. Thus, we recommend following the same surveillance guidelines that are derived from studies involving older adults. […] Larger studies are needed to develop screening guidelines for young adults and further characterize polyp behavior. […] A colorectal cancer screening program for young adults could involve testing that’s simpler than a colonoscopy.

• #59 Study Reveals Nearly 40 Percent of Young Adults with Polyps on Colonoscopy Have High-Risk Polyps

  https://consultqd.clevelandclinic.org/new-study-reveals-nearly-40-percent-of-young-adults-with-polyps-on-colonoscopy-have-high-risk-polyps

  Study reveals nearly 40 percent of young adults with polyps on colonoscopy have high-risk polyps. […] Their goal is to decrease the risk of cancer and utilize resources appropriately. However, there are no published guidelines for colorectal cancer screening or alterations in surveillance colonoscopy for young adults who have had polyps. […] The study revealed that 38 percent of young adults who had polyps found on colonoscopy had high-risk polyps. […] When stratifying risk based upon baseline polyp characteristics, in our small study, young adults with high-risk features were no more likely than older adults to have an advanced polyp detected during a follow-up colonoscopy, explains Dr. Burke. Thus, we recommend following the same surveillance guidelines that are derived from studies involving older adults. […] Larger studies are needed to develop screening guidelines for young adults and further characterize polyp behavior. […] A colorectal cancer screening program for young adults could involve testing that’s simpler than a colonoscopy.

• #60 Study Reveals Nearly 40 Percent of Young Adults with Polyps on Colonoscopy Have High-Risk Polyps

  https://consultqd.clevelandclinic.org/new-study-reveals-nearly-40-percent-of-young-adults-with-polyps-on-colonoscopy-have-high-risk-polyps

  Study reveals nearly 40 percent of young adults with polyps on colonoscopy have high-risk polyps. […] Their goal is to decrease the risk of cancer and utilize resources appropriately. However, there are no published guidelines for colorectal cancer screening or alterations in surveillance colonoscopy for young adults who have had polyps. […] The study revealed that 38 percent of young adults who had polyps found on colonoscopy had high-risk polyps. […] When stratifying risk based upon baseline polyp characteristics, in our small study, young adults with high-risk features were no more likely than older adults to have an advanced polyp detected during a follow-up colonoscopy, explains Dr. Burke. Thus, we recommend following the same surveillance guidelines that are derived from studies involving older adults. […] Larger studies are needed to develop screening guidelines for young adults and further characterize polyp behavior. […] A colorectal cancer screening program for young adults could involve testing that’s simpler than a colonoscopy.

• #61 Surveillance of colonic polyps: Are we getting it right?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4726668/

  Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. The identification of colonic polyps can reduce CRC mortality through earlier diagnosis of cancers and the removal of polyps: the precursor lesion of CRC. […] Following the finding and removal of colonic polyps at an initial colonoscopy, some patients are at an increased risk of developing CRC in the future. This is the rationale for post-polypectomy surveillance colonoscopy. However, not all individuals found to have colonic adenomas have a risk of CRC higher than that of the general population. […] The potential benefits of surveillance procedures must be weighed against the burden of colonoscopy: resource use, the potential for patient discomfort, and the risk of complications. Therefore surveillance colonoscopy is best utilised in a selected group of individuals at a high risk of developing cancer. […] Further study is needed into the specific factors conferring higher risk as well as the efficacy of surveillance in mitigating this risk. Such evidence will better inform clinicians and patients of the relative benefits of colonoscopic surveillance for the individual. […] In addition, the decision to continue with surveillance must be informed by the changing profile of risks and benefits of further procedures with the patients advancing age.

• #62 Surveillance polyps show little growth at follow-up | AuntMinnie

  https://www.auntminnie.com/clinical-news/ct/article/15593355/surveillance-polyps-show-little-growth-at-follow-up

  A preliminary study from Italy adds weight to the argument that two- to three-year surveillance of 6- to 9-mm polyps doesn’t unduly increase the risk of colorectal cancers. […] Previous research by Dr. David Kim and colleagues from the University of Wisconsin in Madison, and other groups, suggests that surveillance is safe, but the practice remains controversial. […] These preliminary results suggest that polyp follow-up in a maximum three-year period does not increase the risk of developing colorectal cancer.

• #63 Surveillance polyps show little growth at follow-up | AuntMinnie

  https://www.auntminnie.com/clinical-news/ct/article/15593355/surveillance-polyps-show-little-growth-at-follow-up

  A preliminary study from Italy adds weight to the argument that two- to three-year surveillance of 6- to 9-mm polyps doesn’t unduly increase the risk of colorectal cancers. […] Previous research by Dr. David Kim and colleagues from the University of Wisconsin in Madison, and other groups, suggests that surveillance is safe, but the practice remains controversial. […] These preliminary results suggest that polyp follow-up in a maximum three-year period does not increase the risk of developing colorectal cancer.

• #64 Colonoscopy surveillance after colon (colonic) polyp (polyps) – Primary Care Notebook

  https://primarycarenotebook.com/pages/gastroenterology/colonoscopy-surveillance-after-colon-colonic-polyp-polyps

  Consensus guidelines have been developed by the British Society of Gastroenterology, the Association of Coloproctology of Great Britain and Ireland and Public Health England. […] Key recommendations are that the high-risk criteria for future colorectal cancer (CRC) following polypectomy comprise EITHER: 2 or more premalignant polyps including at least one advanced colorectal polyp (defined as a serrated polyp of at least 10mm in size or containing any grade of dysplasia, or an adenoma of at least 10mm in size or containing high-grade dysplasia); OR 5 or more premalignant polyps. […] A study found that stool-based post-polypectomy surveillance strategies (microsimulation modelling using annual FIT-based surveillance with FOB-gold at a threshold 32 g/g faeces) can be safe and cost-effective, with potential to reduce the number of colonoscopies by up to 41%.

• #65 Study sets framework for precision surveillance of colorectal cancer – VUMC News

  https://news.vumc.org/2021/12/14/study-sets-framework-for-precision-surveillance-of-colorectal-cancer/

  Vanderbilt research has revealed some of the mechanisms by which polyps develop into colorectal cancer, setting the framework for improved surveillance for the cancer utilizing precision medicine. […] Their study, published Dec. 14 in Cell, describes findings from a single-cell transcriptomic and imaging atlas of the two most common colorectal polyps found in humans: conventional adenomas and serrated polyps. […] The study provided a number of other findings of clinical significance. For instance, sessile serrated lesions can be challenging to identify, and the study suggest biomarkers that may confirm their diagnosis. […] The findings in our atlas lay the foundation for opening novel strategies for interception of cancer progression, including better surveillance protocols, chemoprevention and pre-biotic and pro-biotic therapies said Martha Shrubsole, PhD, research professor in the Division of Epidemiology, and a corresponding author.

• #66 Study sets framework for precision surveillance of colorectal cancer – VUMC News

  https://news.vumc.org/2021/12/14/study-sets-framework-for-precision-surveillance-of-colorectal-cancer/

  A trans-institutional team of researchers at Vanderbilt University Medical Center and Vanderbilt University has received an $11 million Cancer Moonshot grant to build a single-cell resolution atlas to map out the routes that benign colonic polyps take to progress to colorectal cancer, the third most common cancer among both men and women in the United States.

• #67 Colonoscopy versus Stool-Based Testing for Colorectal Cancer Screening in Older Patients with a History of Colon Polyps, The COOP Trial – NCIFacebookFollow on XInstagramYoutubeLinkedin

  https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/v?id=NCI-2023-01093

  This clinical trial compares how well a colonoscopy works versus at-home stool-based testing (fecal immunochemical test [FIT]) in screening for and detecting colorectal cancer in patients age 70-82 who have a history of colon polyps. […] Therefore, adults aged 45 or older who have had colorectal polyps are considered to be at higher risk for colorectal cancer. […] Because of this increased risk, these patients are referred for colonoscopies more often than patients who did not have polyps to look for additional polyps. These follow-up colonoscopies are called “surveillance colonoscopy”. […] By comparing FIT to surveillance colonoscopy in this study, the researchers hope to learn more about patients’ preferences for surveillance and how well FIT works compared to colonoscopy for surveillance in people who’ve had polyps.

Zobacz więcej