Table 5.
US Multi-Society Task Force Recommendations for Post-Colonoscopy Follow-Up in Average-Risk Adults With Serrated Polypsa
| Baseline colonoscopy finding | Recommended interval for surveillance colonoscopy | Strength of recommendation | Quality of evidence |
|---|---|---|---|
| ≤20 HPs in rectum or sigmoid colon <10 mmf | 10 yb | Strong | Moderate |
| ≤20 HPs proximal to sigmoid colon <10 mmf | 10 y | Weak | Very low |
| 1–2 SSPs <10 mm | 5–10 y | Weak | Very low |
| 3–4 SSPs <10 mm | 3–5 y | Weak | Very low |
| 5–10 SSPs <10 mm | 3 y | Weak | Very low |
| SSP ≥10 mm | 3 y | Weak | Very low |
| SSP with dysplasiae | 3 y | Weak | Very low |
| HP ≥10 mm | 3–5 yc | Weak | Very low |
| TSA | 3 y | Weak | Very low |
| Piecemeal resection of SSP ≥20 mm | 6 mo | Strong | Moderated |
All 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 syndrome, or malignant polyp, personal history of CRC, or family history of CRC, and must be judiciously applied to individuals with a personal or family history of CRC, favoring the shortest indicated interval based on either history or polyp findings.
Follow-up may be with colonoscopy or other screening modality for average risk individuals.
A 3-year follow-up interval is favored if concern about consistency in distinction between SSP and HP locally, bowel preparation, or complete excision, whereas a 5-year interval is favored if low concerns for consistency in distinction between SSP and HP locally, adequate bowel preparation, and confident complete excision.
See US Multi-Society Task Force recommendations for endoscopic removal of colorectal lesions.69
Assumes high confidence of complete resection.
Patients with cumulative >20 hyperplastic polyps distributed throughout the colon, with at least 5 being proximal to the rectum, as well as those with 5 serrated polyps proximal to the rectum > 5mm, with at least two ≥ 10 mm meet criteria for serrated polyposis syndrome and may require specialized management.112