Rishabh Sachdev1, Rahul Sao1, John W Birk1, Joseph C Anderson2,3, Joel Levine1,4. 1. Department of Medicine in the Division of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT, USA. 2. Department of Medicine in the Division of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT, USA. Joseph.C.Anderson@dartmouth.edu. 3. Department of Medicine, Department of Veterans Affairs Medical Center, White River Junction, VT, USA. Joseph.C.Anderson@dartmouth.edu. 4. Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington, CT, USA.
Abstract
PURPOSE OF REVIEW: Conventional adenomas, which are precursors to almost 70% of colorectal carcinomas, are found in more than one-third of screening colonoscopies. Surveillance recommendations, based on adenoma size, histology, and number, have evolved over the years and are currently reflective of index adenoma categorization as either low-risk (LRA) or high-risk (HRA). In this review, recent guideline recommendations as well as primary data that have helped to shape these recommendations are presented. RECENT FINDINGS: Recent data have demonstrated that individuals with HRA on index exams may be at increased risk for CRC while those with LRA may have a minimal long-term risk for CRC, similar to those adults with normal index exams. Furthermore, the quality of the index exams is important for minimizing CRC risk. While individuals with HRA may require close surveillance intervals of 3 years, those with LRA or normal exams may need longer such as 10-year follow-up.
PURPOSE OF REVIEW: Conventional adenomas, which are precursors to almost 70% of colorectal carcinomas, are found in more than one-third of screening colonoscopies. Surveillance recommendations, based on adenoma size, histology, and number, have evolved over the years and are currently reflective of index adenoma categorization as either low-risk (LRA) or high-risk (HRA). In this review, recent guideline recommendations as well as primary data that have helped to shape these recommendations are presented. RECENT FINDINGS: Recent data have demonstrated that individuals with HRA on index exams may be at increased risk for CRC while those with LRA may have a minimal long-term risk for CRC, similar to those adults with normal index exams. Furthermore, the quality of the index exams is important for minimizing CRC risk. While individuals with HRA may require close surveillance intervals of 3 years, those with LRA or normal exams may need longer such as 10-year follow-up.
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