Frequency of colonoscopy after removal of cancerous polyp

Last Modified: May 1, 2003

Question:

Dear OncoLink "Ask The Experts,"
I'm 54 years old and last October I had a routine colonoscopy and they found a medium size polyp and removed it. I was told the top part of the polyp contained cancer cells but not the stem so to be on the safe side my doctor recommended I have a sigmoid colon resection. Everything came out clean. I was told to get another screening in 3 years but would feel better if I got one every year instead. Is there any disadvantage to having this done yearly to be on the safe side? I have no history of colon cancer in my family.

Answer:

Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:

Your situation occurs with some frequency and you have a very good question. First, I am glad they were able to get all the cancer out. In general, you might consider your polyp an advanced polyp. A study published in 1993 demonstrated that with advanced polyps, a colonoscopy performed at 3 years was as effective as one done at 1 year. This important study changed the way GI was practiced. You have had a polyp that was removed. Although it had cancer, it appears to have remained very local. The concern is not whether this polyp will recur; they generally do not. (And the region your polyp was located has been removed, in any case.) Rather, the follow-up procedures are done to look for new polyps. In most cases, the process of moving from normal to polyp to cancer is a 10 to 15 year process or longer. There are a few instances where things can progress more quickly, but it is unlikely. I understand the concern and desire for more frequent studies, but I think you would be very safe waiting for 3 years. Colonoscopies are very safe but they do have some risk associated with them. The last thing one wants is a complication from a procedure that really wasn't necessary in the first place. My recommendation for individuals in this circumstance to get a repeat colonoscopy at three years.

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