Patients at average risk of colorectal cancer who have a clean colonoscopy do not need to repeat the test for 10 years. This and many other practical recommendations for cancer prevention were issued in "Guidelines for Colonoscopy Surveillance After Screening and Polypectomy," a consensus update issued by the U.S. Multisociety Task Force on Colorectal Cancer.
Colorectal cancer is preventable when precancerous polyps (growths) are found and removed before they turn into cancer. Screening for average risk patients is recommended to begin at age 50, and there are many screening tests available. During a colonoscopy, a physician examines the full length of the large intestine and removes polyps. Surveillance refers to the schedule on which doctors recheck patients for recurring polyps after their first screening.
The U.S. Multisociety Task Force - comprised of representatives of the American College of Gastroenterology, the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy - evaluated the guidelines for colorectal cancer surveillance published in 2006 to determine if they should be updated based on new evidence.
"The U.S. Multisociety Task Force believes that the evidence supporting current recommendations for screening and surveillance intervals has become stronger in the past six years," said David Lieberman, MD, lead author of the guidelines. "While these guidelines are dynamic and will continue be revised in the future as new evidence emerges, we believe the guidelines represent the best science available for the screening, surveillance and prevention of colorectal cancer."
The task force recommends that all endoscopists monitor key quality indicators as part of a colonoscopy screening and surveillance program. The following colonoscopy schedule is recommended following a patient's initial high-quality exam:
The full guidelines are available online at http://www.gastrojournal.org/article/S0016-5085(12)00812-8/fulltext.
The guidelines also provide advice on murky areas related to colorectal cancer screening: