[Revised CBO guideline 'Follow-up after polypectomy']

Abstract

The purpose of follow-up after polypectomy of one or more colorectal adenomatous polyps, is the timely removal of new adenomas and thereby the prevention of colorectal cancer. The first check-up following index-polypectomy can be carried out after six years if one or two adenomas were encountered during the index polypectomy, and after three years if three or more adenomas were encountered. The same check-up interval of six and three years respectively applies if none to two or more than three adenomas are encountered when a check-up colonoscopy is carried out. A check-up one year after the polypectomy and check-ups more frequently than respectively six and three years after polypectomy are not considered to be useful, while each check-up is accompanied by risks and costs. Check-ups can be suspended for patients in whom cumulatively one adenomatous polyp has been removed: from the age of 65 years, for patients in whom cumulatively two adenomas have been removed: from the age of 75 years, and for patients in whom cumulatively three adenomas have been removed check-ups must be continued for as long as the patient's vitality justifies this. Also if no adenomas are encountered during three consecutive check-ups, a suspension of the check-ups can be considered. Separate guidelines apply to patients with genetically determined adenomas.