Dealing with uncertainty: surveillance colonoscopy after polypectomy.

Post-polypectomy surveillance is often done sooner than guideline recommendations. This practice is driven by physician intolerance of uncertainty. The accompanying article by Brenner et al. supports the recommendation to wait 5 years or longer following adenoma removal before performing surveillance colonoscopy. This is particularly true for patients with 1 or 2 small adenomas. Unnecessarily aggressive post-polypectomy surveillance exposes patients to excessive risk of colonoscopy complications without clinical benefit. It also diverts colonoscopy resources away from the more valuable practice of primary screening.