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Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer

Practice Guideline

Affiliations

• ¹ Veterans Affairs San Diego Healthcare System, San Diego, California; University of California-San Diego, Division of Gastroenterology La Jolla, California; Moores Cancer Center, La Jolla, California. Electronic address: s1gupta@health.ucsd.edu.
• ² Division of Gastroenterology, Department of Medicine, Oregon Health and Science University, Portland, Oregon.
• ³ Veterans Affairs Medical Center, White River Junction, Vermont; The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; University of Connecticut Health Center, Farmington, Connecticut.
• ⁴ Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio.
• ⁵ Veterans Affairs Puget Sound Health Care System, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington.
• ⁶ San Francisco Veterans Affairs Medical Center, San Francisco, California; University of California San Francisco, San Francisco, California.
• ⁷ Veterans Affairs Medical Center, White River Junction, Vermont; The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
• ⁸ Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.
• ⁹ Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, Massachusetts.
• ¹⁰ Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

• PMID: 32044092
• PMCID: PMC7672705
• DOI: 10.1053/j.gastro.2019.10.026

Item in Clipboard

Practice Guideline

Samir Gupta et al. Gastroenterology. 2020 Mar.

• ¹ Veterans Affairs San Diego Healthcare System, San Diego, California; University of California-San Diego, Division of Gastroenterology La Jolla, California; Moores Cancer Center, La Jolla, California. Electronic address: s1gupta@health.ucsd.edu.
• ² Division of Gastroenterology, Department of Medicine, Oregon Health and Science University, Portland, Oregon.
• ³ Veterans Affairs Medical Center, White River Junction, Vermont; The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; University of Connecticut Health Center, Farmington, Connecticut.
• ⁴ Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio.
• ⁵ Veterans Affairs Puget Sound Health Care System, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington.
• ⁶ San Francisco Veterans Affairs Medical Center, San Francisco, California; University of California San Francisco, San Francisco, California.
• ⁷ Veterans Affairs Medical Center, White River Junction, Vermont; The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
• ⁸ Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.
• ⁹ Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, Massachusetts.
• ¹⁰ Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

• PMID: 32044092
• PMCID: PMC7672705
• DOI: 10.1053/j.gastro.2019.10.026

Item in Clipboard

No abstract available

PubMed Disclaimer

Conflicts of interest

The authors disclose no conflicts of interest relative to the current work since 2016. Industry relationships for authors (consulting, research, reimbursement) without conflict of interest relevant to the current work since 2016: Douglas K. Rex (Olympus, Boston Scientific, Covidien, Lumendi, Salix, Aries, Cook Medical, ERBE, Bausch Health Inc, Novo Nordisk, Endochoice, Braintree Laboratories, Norgine, Endokey, EndoAid, Medivators, Satisfai Health); Sapna Syngal (Chirhoclin, Cook, Myriad Genetics, Inc, DC Health, Inc); David Lieberman (Covidien, Freenome Holdings, Inc, Ironwood, Check-Cap, CEGX); Douglas Robertson (Covidien, Freenome Holdings, Inc, Amadix); Tonya Kaltenbach (Aries Pharmaceuticals, Micro-Tech Endoscopy, Olympus, Boston Scientific, Medtronic); Aasma Shaukat (None); Samir Gupta (Freenome Holdings, Inc, Guardant Health, Inc, Mallinckrodt Pharmaceuticals); Carol Burke (Salix Pharmaceuticals, Ferring Pharmaceuticals, Aries Pharmaceuticals, Intuitive Surgical, Pfizer, Covidien, Boston Scientific, US Endoscopy, Abbvie Cancer Prevention Pharmaceuticals, Janssen Pharmaceuticals; SLA Pharma AG; Freenome Holdings, Inc). Jason Dominitz (None); Joseph C. Anderson (None).

Recommendations for follow-up after colonoscopy…

Recommendations for follow-up after colonoscopy and polypectomy. Recommendations for post-colonoscopy follow-up in average…

Recommendations for follow-up after colonoscopy and polypectomy. Recommendations for post-colonoscopy follow-up in average risk adults are depicted. After high-quality colonoscopy defined by examination complete to cecum adequate to detect polyps >5 mm, performed by a colonoscopist with adequate ADR with complete polyp resection, risk-stratified repeat colonoscopy intervals are provided. SSP, sessile serrated polyp/sessile serrated adenoma/sessile serrated lesion.

Risk for metachronous advanced neoplasia…

Risk for metachronous advanced neoplasia among individuals with normal colonoscopy, 1–2 adenomas <10 mm in size, or high-risk adenoma (adenoma >10…10>

Risk for metachronous advanced neoplasia among individuals with normal colonoscopy, 1–2 adenomas <10 mm in size, or high-risk adenoma (adenoma >10 mm in size, adenoma with tubulovillous/villous histology, adenoma with high-grade dysplasia or ≥3 adenomas <10 mm) based on a meta-analysis of 10,139 across 8 surveillance studies is depicted. Risk for metachronous adenoma among individuals with no adenoma or 1–2 small adenomas is similar, and much lower than risk among individuals with baseline high-risk adenoma. In studies that defined high risk as advanced adenoma alone (n = 4 studies), cumulative advanced adenoma risk was 16% (95% CI, 9%–25%), and in studies that defined high risk as advanced adenoma or ≥3 adenomas <10 mm (n = 4 studies), cumulative advanced adenoma risk was 19% (95% CI, 10%–30%; C Dube, personal communication, September 18, 2018).

• Spotlight: US Multi-Society Task Force on Colorectal Cancer Recommendations for Follow-up After Colonoscopy and Polypectomy.

  Gupta S, Lieberman D, Anderson JC, Burke CA, Dominitz JA, Kaltenbach T, Robertson DJ, Shaukat A, Syngal S, Rex DK. Gupta S, et al. Gastroenterology. 2020 Mar;158(4):1154. doi: 10.1053/j.gastro.2020.02.014. Epub 2020 Feb 13. Gastroenterology. 2020. PMID: 32063515 Free PMC article. No abstract available.

• Proximal serrated polyps increase the future risk of colorectal cancer.

  Fillon M. Fillon M. CA Cancer J Clin. 2020 Sep;70(5):317-318. doi: 10.3322/caac.21624. Epub 2020 Jul 28. CA Cancer J Clin. 2020. PMID: 32721054 No abstract available.

• Colonoscopy Follow-up: U.S. Multi-Society Task Force on Colorectal Cancer Updates Recommendations.

  Ford B. Ford B. Am Fam Physician. 2021 Mar 1;103(5):314-316. Am Fam Physician. 2021. PMID: 33630559 No abstract available.

• Endoscopic Removal of Colorectal Lesions-Recommendations by the US Multi-Society Task Force on Colorectal Cancer.

  Kaltenbach T, Anderson JC, Burke CA, Dominitz JA, Gupta S, Lieberman D, Robertson DJ, Shaukat A, Syngal S, Rex DK. Kaltenbach T, et al. Gastroenterology. 2020 Mar;158(4):1095-1129. doi: 10.1053/j.gastro.2019.12.018. Epub 2020 Feb 11. Gastroenterology. 2020. PMID: 32122632 No abstract available.

• Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer.

  Gupta S, Lieberman D, Anderson JC, Burke CA, Dominitz JA, Kaltenbach T, Robertson DJ, Shaukat A, Syngal S, Rex DK. Gupta S, et al. Am J Gastroenterol. 2020 Mar;115(3):415-434. doi: 10.14309/ajg.0000000000000544. Am J Gastroenterol. 2020. PMID: 32039982 Free PMC article. No abstract available.

• Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society.

  Winawer SJ, Zauber AG, Fletcher RH, Stillman JS, O'brien MJ, Levin B, Smith RA, Lieberman DA, Burt RW, Levin TR, Bond JH, Brooks D, Byers T, Hyman N, Kirk L, Thorson A, Simmang C, Johnson D, Rex DK. Winawer SJ, et al. CA Cancer J Clin. 2006 May-Jun;56(3):143-59; quiz 184-5. doi: 10.3322/canjclin.56.3.143. CA Cancer J Clin. 2006. PMID: 16737947

• Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer.

  Gupta S, Lieberman D, Anderson JC, Burke CA, Dominitz JA, Kaltenbach T, Robertson DJ, Shaukat A, Syngal S, Rex DK. Gupta S, et al. Gastrointest Endosc. 2020 Mar;91(3):463-485.e5. doi: 10.1016/j.gie.2020.01.014. Epub 2020 Feb 7. Gastrointest Endosc. 2020. PMID: 32044106 Free PMC article. No abstract available.

• Endoscopic Removal of Colorectal Lesions: Recommendations by the US Multi-Society Task Force on Colorectal Cancer.

  Kaltenbach T, Anderson JC, Burke CA, Dominitz JA, Gupta S, Lieberman D, Robertson DJ, Shaukat A, Syngal S, Rex DK. Kaltenbach T, et al. Am J Gastroenterol. 2020 Mar;115(3):435-464. doi: 10.14309/ajg.0000000000000555. Am J Gastroenterol. 2020. PMID: 32058340 No abstract available.

• Post-polypectomy surveillance colonoscopy: Comparison of the updated guidelines.

  Abu-Freha N, Katz LH, Kariv R, Vainer E, Laish I, Gluck N, Half EE, Levi Z. Abu-Freha N, et al. United European Gastroenterol J. 2021 Jul;9(6):681-687. doi: 10.1002/ueg2.12106. Epub 2021 Jun 2. United European Gastroenterol J. 2021. PMID: 34077635 Free PMC article. Review.

• FIT-based risk-stratification model effectively screens colorectal neoplasia and early-onset colorectal cancer in Chinese population: a nationwide multicenter prospective study.

  Zhao S, Wang S, Pan P, Xia T, Wang R, Cai Q, Chang X, Yang F, Gu L, He Z, Wu J, Meng Q, Wang T, Fang Q, Mou X, Yu H, Zheng J, Bai C, Zou Y, Chen D, Zou X, Ren X, Xu L, Yao P, Xiong G, Shu X, Dang T, Zhang L, Wang W, Kang S, Cao H, Gong A, Li J, Zhang H, Du Y, Li Z, Bai Y; Gastrointestinal Early Cancer Prevention & Treatment Alliance of China (GECA). Zhao S, et al. J Hematol Oncol. 2022 Nov 4;15(1):162. doi: 10.1186/s13045-022-01378-1. J Hematol Oncol. 2022. PMID: 36333749 Free PMC article.

• Potential Impact of Extending Surveillance Intervals for Patients With 1-2 Low-Risk Adenomas.

  Trivedi M, Mai D, Gupta S. Trivedi M, et al. Gastro Hep Adv. 2022 Nov 29;2(3):298-300. doi: 10.1016/j.gastha.2022.11.011. eCollection 2023. Gastro Hep Adv. 2022. PMID: 39132662 Free PMC article. Review. No abstract available.

• Adenoma characteristics associated with post-polypectomy proximal colon cancer incidence: a retrospective cohort study.

  Harewood R, Wooldrage K, Robbins EC, Kinross J, von Wagner C, Cross AJ. Harewood R, et al. Br J Cancer. 2022 Jun;126(12):1744-1754. doi: 10.1038/s41416-022-01719-4. Epub 2022 Feb 11. Br J Cancer. 2022. PMID: 35149853 Free PMC article.

• The impact of surgical weight loss procedures on the risk of metachronous colorectal neoplasia: the differential effect of surgery type, sex, and anatomic location.

  Hussan H, Ali MR, Hussain SK, Lyo V, McLaughlin E, Chiang C, Thompson HJ. Hussan H, et al. J Natl Cancer Inst Monogr. 2023 May 4;2023(61):77-83. doi: 10.1093/jncimonographs/lgac029. J Natl Cancer Inst Monogr. 2023. PMID: 37139983 Free PMC article.

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