Coglasno updated recommendations of the Multidisciplinary Task Force on US colorectal cancer surveillance intervals after colonoscopy and polypectomy can be up to 10 years for small low-risk adenomas and hyperplastic polyps, or up to one year with multiple adenomas.

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Dr. Samir Gupta of the University of California at San Diego and his colleagues updated recommendations in 2012 for follow-up colonoscopy after polypectomy with or without it. Recommendations, together with supporting evidence will be published in Gastroenterology. All are based on high-quality colonoscopy with bowel preparation for the detection of polyps larger than 5 mm.

Several changes compared with the recommendations of 2012 deserve special attention. Firstly, recommendations on surveillance of polyps were supported by new data, based on the risk of cancer outcomes, rather than simply the risk of progressive adenoma during surveillance time. Second, after removal of one or two tubular adenomas of less than 10 mm it is now recommended observation after 7-10 years, rather than after 5-10 years. There were more guidance to follow-up after removal of the gear polyps with different recommendations depending on the size and quantity and presence of dysplasia. Fourthly, the currently recommended one-year follow-up after removal of adenomas over 10 instead of the previously recommended a three-year follow-up. Finally, kolonoskopisty to follow-up after removal of the three or four adenomas less than 10 mm may recommend a period of 3-5 years instead of three.

"The evidence in support of best practices for colonoscopy surveillance efforts and helped maintain careful observation of some groups, as well as less intensive observation of others - concludes the task force -. More work is required to fully understand which groups of patients most likely to benefit from the surveillance and supervision of interventions that can be used to optimize colorectal cancer prevention and early detection. "

Dr. Michael Hoffmeister at the German Cancer Research Center in Heidelberg, who is studying colorectal cancer, explains: "The empirical data or the quality of the evidence is still low for some of the recommendations, especially those that refer to the serrated polyps This highlights where. additional research is needed. New evidence suggests that the risk of progressive adenomas and cancer is low and only slightly higher than that of patients with normal (negative) colonoscopy for which a 10-year interval. "

Source: https://www.medscape.com/viewarticle/925829

Date of publication: 
Friday, March 6, 2020