ESGE Expands the Postpolypectomy Cohort With No Recommended Surveillance

The European Society of Gastrointestinal Endoscopy (ESGE) has issued its first update of postpolypectomy surveillance recommendations since 2013. Key recommendations include the following:

• Patients with complete removal of 1 to 4 ≤10-mm adenomas with low-grade dysplasia, with or without villous components, or any serrated polyp <10 mm without dysplasia require no surveillance and should be returned to screening. In the absence of organized screening, this means repeat colonoscopy in 10 years.
• Patients with any of the following should have surveillance colonoscopy at 3 years: at least 1 adenoma ≥10 mm, any adenoma with high-grade dysplasia, 5 or more adenomas, a serrated polyp ≥10 mm, or any serrated polyp with dysplasia.
• If a surveillance colonoscopy at 3 years detects no findings requiring further surveillance, another colonoscopy should be performed at 5 years. 
• At the 5-year colonoscopy, if there are no findings requiring surveillance, the patient should be returned to screening. 
• A repeat colonoscopy should be performed 3 to 6 months after piecemeal resection of a polyp ≥20 mm. A second surveillance is recommended 12 months later. 
• Surveillance intervals should not be altered for a family history of colorectal cancer.
• Colonoscopists should consider stopping surveillance in patients who are age ≥80 years or earlier if life expectancy is lower because of comorbidities.