Update on Colorectal Polyps: Management and Follow-Up Surveillance

Available scientific data and considerable clinical experience indicate that over 95 % of colorectal cancers arise in benign adenomatous polyps that develop and advance very slowly over many years. Interruption of this adenoma–carcinoma sequence by finding and resecting polyps is a highly effective method of preventing colorectal cancer. Colonoscopy is the procedure of choice for both the diagnosis and resection of colorectal polyps. Patients who have had colonoscopic resection of adenomas, and in some cases their close relatives, are at a higher than average risk for developing future polyps and cancer, and likely will benefit from periodic follow-up colonoscopic surveillance. This surveillance should to be tailored to the perceived risk of each individual case depending on the features of the resected adenomas and other patient factors such as family history. Widespread adoption of current polyp guideline recommendations would be highly protective and yet would conserve medical resources.

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