Table 4.

US Multi-Society Task Force Recommendations for Post-Colonoscopy Follow-Up in Average-Risk Adults With Normal Colonoscopy or Adenomas^a

Baseline colonoscopy finding	Recommended interval for surveillance colonoscopy	Strength of recommendation	Quality of evidence
Normal	10 yb	Strong	High
1–2 tubular adenomas <10 mm	7–10 yc	Strong	Moderate
3–4 tubular adenomas <10 mm	3–5 y	Weak	Very low
5–10 tubular adenomas <10 mm	3 y	Strong	Moderate
Adenoma ≥10 mm	3 y	Strong	High
Adenoma with tubulovillous or villous histology	3 yd	Strong	Moderate
Adenoma with high-grade dysplasia	3 yd	Strong	Moderate
>10 adenomas on single examinatione	1 y	Weak	Very low
Piecemeal resection of adenoma ≥20 mm	6 mo	Strong	Moderatef

^aAll recommendations assume examination complete to cecum with bowel preparation adequate to detect lesions >5 mm in size; recommendations do not apply to individuals with a hereditary CRC syndrome, personal history of inflammatory bowel disease, personal history of hereditary cancer syndrome, serrated polyposis, malignant polyp, personal history of CRC, or family history of CRC, and must be judiciously applied to such individuals, favoring the shortest indicated interval based on either history or polyp findings.

^bFollow-up may be with colonoscopy or other screening modality for average-risk individuals.

^cPatients with recommendations issued before 2020 for shorter than 7- to 10-year follow-up after diagnosis of 1–2 tubular adenomas may follow original recommendations. If feasible, physicians may re-evaluate patients previously recommended an interval shorter than 10 y and reasonably choose to provide an updated recommendation for 7- to 10-year follow-up, taking into account factors such as quality of baseline examination, polyp history, and patient preferences.

^dAssumes high confidence of complete resection.

^ePatients with >10 adenomas or lifetime >10 cumulative adenomas may need to be considered for genetic testing based on absolute/cumulative adenoma number, patient age, and other factors such as family history of CRC (see text).

^fSee US Multi-Society Task Force recommendations for endoscopic removal of colorectal lesions.⁶⁹