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Got polyps? Here's What Your Colonoscopy Screening Schedule May Look Like

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Colonoscopy can be an arduous form of screening, requiring meticulous preparation. Fortunately, for most people it does not need to be performed very often—every 10 years if you’re at average risk for colorectal cancer and have a clean colonoscopy.

But you’ll be advised to come back sooner if you’ve had precancerous polyps removed (polypectomy) during your colonoscopy. The timing for your subsequent screenings will depend on the number, size and types of polyps found; their location in your colon; and other risk factors for developing colorectal cancer.

The United States Preventive Services Task Force (USPSTF) and other expert medical organizations recommend most people start getting screened for colon cancer at age 50; those with a family history of colorectal cancer or polyps or a personal history of inflammatory bowel disease or certain inherited conditions should get screened sooner.

What you need to know: a primer on polyps

Here’s what you need to know about the various types of polyps that may be found, and how they affect your colonoscopy screening schedule:

  • Hyperplastic polyps have virtually no chance of becoming malignant. Patients who have small, hyperplastic polyps in their rectum or sigmoid colon can usually wait the full 10 years until their next colonoscopy.
  • Adenomas, which do carry a cancer risk, are slow growing and usually take years to become cancer. Generally, the larger the adenoma, the more likely it is to become malignant. Thus, the presence of one or two tubular adenomas less than 10 mm in size is considered low risk. (Adenomas have several different growth patterns, and “tubular” is less likely to be cancerous.) If you have a low-risk adenoma, you can safely wait between five and 10 years until your next colonoscopy. Another colonoscopy will likely be recommended in three years if you have between three and 10 tubular adenomas, or if one of those adenomas is larger than 10 mm. If you have more than 10 tubular adenomas, you should undergo another colonoscopy in less than three years.
  • Shorter surveillance intervals are also recommended for people who have adenomas with a villous growth pattern, which are more likely to quickly develop into cancer, and for people with adenomas that are found to have high-grade cell abnormalities (dysplasia). People with either of these two types should have their next colonoscopy in three years.
  • Serrated polyps are handled like high-risk adenomas if they are larger than 10 mm or contain dysplasia, with a surveillance interval of three years, and like low-risk adenomas if they are less than 10 mm and do not contain dysplasia, with a surveillance interval of five years. Serrated polyps can be removed endoscopically through a process called endoscopic mucosal resection. Patients should have a repeat colonoscopy within one year if there is any question about the thoroughness of resection. The same holds true if bowel preparation was inadequate, which can result in missed adenomas during a screening.

Another factor doctors take into consideration when determining a screening schedule is the state of findings after a patient has undergone a surveillance interval and repeat colonoscopy. For example, if you had a low-risk adenoma detected during your first colonoscopy and no adenomas detected during a subsequent screening, then you can wait 10 years before having the third. But if you had a high-risk adenoma found during your baseline colonoscopy and no adenomas at your second screening, your doctor should advise you to wait no more than five years before your third colonoscopy.

The USPSTF recommends most people stop getting colonoscopies after the age of 75 unless prior findings or other health issues suggest it would be beneficial. Colonoscopy is not recommended for people 85 and older.

Posted in Colon Cancer on June 15, 2015


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Health After 50 Disclaimer


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