Colonoscopy is routinely performed for colorectal cancer (CRC) screening, follow-up of other abnormal screening tests, work up of signs and symptoms of gastrointestinal disease, and surveillance after CRC and polyp removal. Post procedure, colonoscopists are expected to provide follow-up recommendations to patients and referring physicians. Recommendations for follow-up after normal colonoscopy among individuals age-eligible for screening, and post-polypectomy among all individuals with polyps are among the most common clinical scenarios requiring guidance1.
Risk of metachronous advanced neoplasia is associated with findings on prior colonoscopy. After high quality colonoscopy, patients with no neoplasia detected are at the lowest risk, and those with polyps are risk stratified based on the histology, number, location, and size of polyps detected. Since release of the last US Multi-Society Task Force (Task Force) recommendations for post colonoscopy follow-up and polyp surveillance in 20122, a number of papers have been published on risk of CRC based on colonoscopy findings and patient characteristics, as well as the potential impact of screening and surveillance colonoscopy on outcomes such as incident CRC and polyps. Further, recent studies increasingly reflect the modern era of colonoscopy with more awareness of the importance of quality factors (e.g. adequate bowel preparation, cecal intubation, adequate adenoma detection, complete polyp resection), and utilization of state of the art technologies (e.g. high definition colonoscopes). Higher quality colonoscopy could impact the importance of previously identified risk factors. Our aim was to review newly available evidence and update recommendations for follow-up after colonoscopy with or without polypectomy.
Keywords: aftercare, colon polyps, colonoscopy, colon cancer, consensus statement, early detection of cancer, practice guideline