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After polyps are removed, the date of your next colonoscopy is set by what was found, not by habit. In the UK, most people go back to routine screening; only those with several premalignant polyps or one advanced one are brought back at three years, and people who have had bowel cancer removed have a clearance test at one year.
The UK rules. The British Society of Gastroenterology, the Association of Coloproctology of Great Britain and Ireland and Public Health England set out the first surveillance guidelines to take the national screening programme into account, and the first to cover serrated as well as adenomatous polyps. The high-risk criteria after polypectomy are either two or more premalignant polyps including at least one advanced colorectal polyp (a serrated polyp of at least 10 mm or containing any dysplasia, or an adenoma of at least 10 mm or containing high-grade dysplasia), or five or more premalignant polyps. That group has a one-off surveillance colonoscopy at three years. After resection of a colorectal cancer, the pattern is a clearance colonoscopy at one year and a surveillance colonoscopy three years after that (Rutter 2020).
The European rules, for comparison. Patients with one to four adenomas under 10 mm with low-grade dysplasia, whatever the villous content, or any serrated polyp under 10 mm without dysplasia, need no endoscopic surveillance and return to screening; where organised screening is not available, a colonoscopy at ten years is recommended. Surveillance at three years follows complete removal of an adenoma of 10 mm or more, an adenoma with high-grade dysplasia, five or more adenomas, or a serrated polyp of 10 mm or more or with dysplasia. Piecemeal removal of a polyp of 20 mm or more is checked at three to six months and again at twelve. If the first surveillance test is clear, a second is suggested at five years, after which the patient returns to screening (ESGE 2020).
Why the interval is the treatment. A surveillance colonoscopy is a scarce resource: every interval shortened for one patient is a colonoscopy not available for a screening positive or a symptomatic referral, which is also why the screening threshold sits where it does. NICE NG151 (1.6.1) adds the separate follow-up after curative surgery for non-metastatic disease: carcinoembryonic antigen and computed tomography of the chest, abdomen and pelvis for the first three years.
Showing the technology this term belongs to: Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood).
Shares Interval cancer, NHS bowel cancer screening programme, Colonoscopy, Faecal immunochemical test (FIT) and the tags gi, colorectal.
Shares Interval cancer, NHS bowel cancer screening programme, Faecal immunochemical test (FIT), Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood) and the tags gi, colorectal.
Shares Adenoma-carcinoma sequence, Colon cancer (adenocarcinoma of the colon), Rectal cancer, Colorectal cancer and the tags gi, colorectal.
Shares Adenoma-carcinoma sequence, Colon cancer (adenocarcinoma of the colon), Rectal cancer, Colorectal cancer and the tags gi, colorectal.
Shares Serrated pathway, Colon cancer (adenocarcinoma of the colon), Colorectal cancer and the tags gi, colorectal.
Shares Polyp types in the bowel, Adenoma-carcinoma sequence, Familial adenomatous polyposis-associated colorectal cancer, Colonoscopy and the tags gi, colorectal.
Shares Colonoscopy, Colorectal cancer and the tags gi, colorectal.
Shares Colon cancer (adenocarcinoma of the colon), Rectal cancer, Colorectal cancer and the tags gi, colorectal.