New Colonoscopy Surveillance Guidelines Issued by GI Societies

Guidelines address questionable areas of cancer screening

Many practical recommendations for cancer prevention were recently updated by the US Multi-Society Task Force on Colorectal Cancer and released in the publication, “Guidelines for Colonoscopy Surveillance After Screening and Polypectomy.”

“The US Multi-Society Task Force [comprised of representatives of the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy] believes that the evidence supporting current recommendations for screening and surveillance intervals has become stronger in the past 6 years,” said David Lieberman, MD, lead author of the guidelines. “While these guidelines are dynamic and will continue to be revised in the future as new evidence emerges, we believe the guidelines represent the best science available for the screening, surveillance and prevention of colorectal cancer.”

The following colonoscopy schedule is recommended following a patient’s initial high-quality exam:

·      If the initial exam finds no polyps or small (<10 mm) hyperplastic polyps in the rectum or sigmoid colon, then next colonoscopy in 10 years

·      If the initial exam finds low-risk adenomas defined as 1-2 tubular adenomas <10 mm, then next colonoscopy in 5-10 years

·      Serrated lesion less than 10 mm, nondysplastic, then next colonoscopy in 5 years

·      If the initial exam finds benign, but high-risk neoplastic polyps (includes: adenoma >10 mm, or with villous histology, high-grade dysplasia; 3 or more adenomas; sessile serrated lesions that are dysplastic and/or >10 mm), then next colonoscopy in 3 years

The guidelines also provide advice on problematic areas related to colorectal cancer screening. For example:

·      When should colonoscopy be repeated if the patient’s bowel isn’t properly prepared for colonoscopy?

o   In most cases, repeat the exam within 1 year. Note that splitting the dose of bowel preparation yields better results

·      Should stool tests (guaiac fecal occult blood test or fecal immunochemical test) be used between colonoscopies to check for cancer?

o   Fecal testing between colonoscopies isn’t necessary within 5 years of colonoscopy

Review the full guidelines here.

Source: American Gastroenterological Association.