A 66-year-old male undergoes routine screening colonoscopy, revealing an 8 mm sessile polyp in the sigmoid colon. Histopathology demonstrates tubular adenoma with low-grade dysplasia. Complete resection is confirmed with clear margins. According to clinical surveillance guidelines, when is the next screening colonoscopy indicated?

Answer and explanation

Correct answer: A. In 7 to 10 years

  1. Step 1: Current multi-society task force guidelines categorize 1-2 tubular adenomas < 10 mm with low-grade dysplasia as low-risk adenomas.
  2. Step 2: Following complete resection of 1-2 small low-risk tubular adenomas, the recommended surveillance colonoscopy interval is 7 to 10 years.
  3. Step 3: High-risk adenomas (>= 3 adenomas, >= 10 mm, tubulovillous/villous histology, or high-grade dysplasia) warrant a 3-year surveillance interval.
Answer
In 7 to 10 years.
Why not the others: 3-year interval is for high-risk adenomas (>= 10 mm or >= 3 polyps); 1 year is for incomplete resection or > 10 polyps; 6 months is unnecessary.

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