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For example, for someone who has three or four growths known as tubular adenomas that measure less than 10 millimeters (1 centimeter), the recommendation would be to come back for another colonoscopy in three to five years. A single tubular adenoma considered \u201cadvanced,\u201d measuring 10 millimeters or more, would lead to a recommendation of three years. If no adenomas are found, the recommendation is 10 years.<\/p>\n
\u201cPeople who have one or two of these small tubular adenomas, less than a centimeter, now really can go longer, with the guidelines now saying seven to 10 years, so you probably can go at least seven years instead of five years until your next colonoscopy, where we used to say five years,\u201d Birk says.<\/p>\n
If the colonoscopy turns up a growth known as a sessile serrated polyp (SSP), the recommendations are for an earlier follow-up colonoscopy. Less threatening is what\u2019s known as a hyperplastic polyp found in or near the rectum. If they\u2019re small enough \u2013 less than 10 millimeters \u2013 it would take more than 20 of these polyps to become worrisome.<\/p>\n
\u201cIf you have pure hyperplastic polyps, it\u2019s probably low-risk and you probably can wait 10 years,\u201d Birk says. \u201cHowever, now, if you have a sessile serrated polyp, you\u2019re at a little increased risk, and we\u2019ve shortened the interval for your next screening.\u201d<\/p>\n
Despite having a colonoscopy, you still can develop a cancer before your next one, which is what\u2019s known as an interval cancer. Identifying those patients who are at higher risk to develop something malignant in the interval between screenings allows doctors to appropriately decrease the interval time between colonoscopies and minimize that risk.<\/p>\n
\u201cDepending on what that first colonoscopy shows, it will tell us if you\u2019re a 10-year person or a three-year person,\u201d Birk says. \u201cNow, family history can dictate your course no matter what the findings are, but these new guidelines bring an added nuance to it.\u201d<\/p>\n
Family history still rules. The updated guidelines apply to adults considered \u201caverage risk\u201d and do not negate family history when it comes to recommending screening intervals, Birk says. For example, if you have a family member who had a colon cancer diagnosis or significant polyp before age 60, you still would come back in five years, even if your first colonoscopy found nothing.<\/p>\n
The new guidelines come from a collaboration of the American Gastroenterological Association, the American College of Gastroenterology, and the American Society for Gastrointestinal Endoscopy. One of the contributors is Dr. Joseph Anderson, formerly of UConn Health, who retains a faculty appointment at the UConn School of Medicine and still collaborates with Birk.<\/p>\n