Colonoscopy After Polyps

Last Modified: April 23, 2010

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Question

Dear OncoLink "Ask The Experts,"

I had 2 polyps found on colonoscopy that were removed. When do I need to have my next colonoscopy?

Answer

Jenia Jenab-Wolcott, MD, PhD, Gastroenterologist at the Hospital of the University of Pennsylvania, responds:

As you may know there are different types of colonic polyps. Some polyps (called adenomas) have the potential to become cancerous while others (hyperplastic or inflammatory polyps) are considered benign, without the potential to become cancerous. Nearly all colorectal cancers (CRC) arise from adenomas, but only a small minority of adenomas progress to cancer (1 in 20 or less). The histological features (meaning what the pathologist sees under the microscope) and size of colonic adenomas are major predictors of their potential to progress to a cancerous lesion. Therefore, the frequency of repeat colonoscopy when a polyp is found depends upon the number, type, size, and location of the polyp. In general for low risk adenomas (defined as < 2 polyps, <1cm, tubular histology) it is recommended to repeat a colonoscopy in 5 yrs. For advanced or multiple adenomas (those with high-grade dysplasia, >1cm, villous histology, between 3-10 polyps), it is recommended to repeat a colonoscopy in 3 yrs. For greater than 10-polyps found, most experts recommend close individualized monitoring and consideration of referral to specialized centers for cancer genetic risk evaluation.

Therefore without knowledge of the above information I am afraid I would not be able to provide you with a specific recommendation. You should follow-up with your gastroenterologist regarding the interval for your next colonoscopy.

This question and answer was part of the OncoLink Brown Bag Chat Series, Colorectal cancer Webchat. View the entire transcript here.


News
Post-Polyp Detection, CRC Risk ID'd by Colonoscopy Factors

Aug 21, 2012 - In the community setting, after colonoscopic polyp detection, colonoscopy-related factors such as incomplete polyp removal and lack of surveillance colonoscopies are more important than polyp characteristics in predicting subsequent colorectal cancer risk, according to a study published in the Aug. 21 issue of the Annals of Internal Medicine.



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