Adenomatous Polyps of the Colon

Colonic adenomas are the precursor lesions of almost all colorectal cancers but 90 % of adenoma do not progress to cancer.

Consensus guidelines for colonoscopic surveillance after polypectomy:

• 1 - 2 low risk adenomas - 5 to 10 years
• 3 - 10 low risk adenomas or any high risk adenoma - 3 years
• More than 10 adenomas - less than 3 years
• Inadequately removed adenomas - 2 to 6 months
• Small, rectal, hyperplastic polyps - 10 yr or other average risk screening option.

More intensive surveillance is indicated when the patient's family history is suggestive of hereditary nonpolyposis colorectal cancer, an adenomatous syndrome, or a hyperplastic polyposis syndrome.

High risk adenomas are adenoma larger than 1 cm or histologically advanced adenomas ( tubulovillous or villous and those with high grade dysplasia.