ROSH Gastrointestinal Practice Exam

What is the recommended timeframe for a repeat colonoscopy after an initial colonoscopy and polypectomy for small tubular adenomas with no family history of cancer?

1. 1 year to 3 years

2. 3 years to 5 years

3. 5 years to 10 years

4. 6 months to 1 year

The correct answer is: 5 years to 10 years

In considering the appropriate timeframe for a repeat colonoscopy after the initial colonoscopy and polypectomy, particularly involving small tubular adenomas and no family history of colorectal cancer, current guidelines suggest that the recommended interval is generally 5 years to 10 years. This recommendation is based on research indicating that small tubular adenomas, particularly when there are no additional risk factors such as multiple adenomas, high-grade dysplasia, or family history of colorectal cancer, have a relatively low risk of progression to colorectal cancer. Therefore, surveillance can be appropriately spaced further apart after these findings. The rationale behind allowing for a 5 to 10-year interval is to balance the need for monitoring with the overall low risk posed by small adenomas in individuals without other complications or risk factors. This is in alignment with the standards set by organizations such as the American College of Gastroenterology, which aim to minimize unnecessary procedures while ensuring that patients still receive adequate surveillance for potential issues. Other timeframes proposed in the options either suggest more frequent colonoscopies than necessary or are inconsistent with the established guidelines for surveillance after polypectomy for small tubular adenomas. Thus, favoring a 5 to 10-year interval is sound practice in clinical gastroenterology for this