Colon polyp characteristics

Surveillance interval

Piecemeal resection of a polyp ≥20 mm

6 months

Serrated polyposis syndrome

1 year

≥10 adenomas

1 year

5 tubular adenomas <10 mm

≥1 tubular adenoma ≥10 mm

Adenoma with high-grade dysplasia

Adenoma with tubulovillous or villous histology

Sessile serrated polyps ≥10 mm

Sessile serrated polyp with dysplasia

Traditional serrated adenoma

5-10 sessile serrated polyps <10 mm without dysplasia

3 years

Hyperplastic polyps ≥10 mmb

3-4 tubular adenomas <10 mm

3-4 sessile serrated polyps <10 mm without dysplasia

3-5 years

1-2 sessile serrated polyps <10 mm without dysplasia

5-10 years

1-2 tubular adenomas <10 mm

7-10 years

Small (<10 mm) hyperplastic polyps in rectum or sigmoid colonc

Normal colonoscopy

10 years

a The exact time intervals for repeat endoscopies may differ slightly among guidelines, as those are both a matter of evidence (frequently limited) and judgment. For instance, the European guidelines suggest a 10-year follow-up for finding of 1-4 adenomas <10 mm with low-grade dysplasia or serrated polyps <10 mm without dysplasia, while North American guidelines suggest a follow-up of 7-10 years for 1-2 tubular adenomas <10 mm. We would like to stress that the most important part of the follow-up is clear information flow and identification of a person responsible for the follow-up.

b The matter of surveillance intervals for hyperplastic polyps ≥10 mm in diameter is controversial. According to the US Multi-Society Task Force on Colorectal Cancer, these lesions should be managed as sessile serrated polyps ≥10 mm, although there is no high-quality evidence to support this.

c The above assumes full colonoscopy (including cecum) of an adequately prepared colon (allowing detection of polyps >5 mm), with thorough mucosal evaluation and with complete removal and histologic assessment of neoplastic lesions.