Follow – up of Colorectal Polyps or Cancer
#1 Where do the majority of colorectal cancers arise from ?
Adenomas, which is explained by the adenoma–carcinoma sequence
#2 What are the two major types of polyps found in the colorectum ?
#3 Do hyperplastic polyps have malignant potentials ?
Answer : No
#4 How do you follow up patients with <1 cm tubular adenomas with low-grade dysplasia ?
Patient should undergo follow-up colonoscopy in 5 – 10 years
#5 What clinical factors should determine timing of colonoscopy within 5 – 10 years ?
Family history of colorectal cancer
Previous colonoscopy findings
Physician’s clinical judgment
#6 How do you follow up patients with serrated sessile polyps <1 cm with no dysplasia
Patients should have colonoscopy in 5 years
#7 Which category of patients should have colonoscopy in 3 years following complete polypectomy ?
Patients with 3 to 10 tubular adenomas
Patients with tubular adenomas ≥1 cm
Patients with villous adenomas
Patients who have adenoma with high-grade dysplasia
Patients who have sessile serrated polyps ≥1 cm
Patients who have sessile serrated polyps with dysplasia
Patients who have traditional serrated adenoma
#8 What do you do patients whose follow-up colonoscopy is normal or shows only 1 or 2 small (<1 cm) tubular adenomas with low-grade dysplasia ?
Subsequent colonoscopies should be 5 years intervals
#9 When will you do colonoscopy for patients who has sessile adenomas where complete removal is uncertain ?
Patient should have follow-up colonoscopy within 6 months to verify complete removal
#10 At what intervals should patients with family history of colorectal cancer have colonoscopy ?
Individuals with family or genetic history of colorectal cancer such as HNPCC or FAP should have colonoscopy every 1 to 2 years