← Issue №12/ week of Sep 20, 2026/Endoscopy

Endoscopist Adherence to Post-polypectomy Surveillance Interval Recommendations Following Removal of 1-4 Non-advanced Adenomas.

From GI Signals issue №12: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Endoscopy prospective cohort · n=12,345 · Sep 15, 2026 · Clin Gastro Hep · IF 16.2

Endoscopist Adherence to Post-polypectomy Surveillance Interval Recommendations Following Removal of 1-4 Non-advanced Adenomas.

New evidencecolonoscopypolypectomyguidelinehealth services
Clinical takeawayAudit your own post-polypectomy surveillance intervals for 1-2 NAAs, where over-surveillance is more likely compared to 3-4 NAAs, and align with the guideline-recommended 7-10-year interval.
What it foundAdherence to the 7-10-year surveillance interval for 1-2 non-advanced adenomas (NAAs) improved from 68.1% in 2021 to 71.9% in 2024, while adherence to the 3-5-year interval for 3-4 NAAs remained >90%. Endoscopists predominantly assigned the upper or lower bounds of the interval ranges (10 years for 1-2 NAAs, 5 years for 3-4 NAAs).
ContextConfirms persistent underuse of guideline-recommended longer intervals for low-risk adenomas (1-2 NAAs), despite 2020 updates, with higher adherence for 3-4 NAAs.
Reinforcessuggested applicable standard· US Multi-Society Task Force on Colorectal Cancer (Gupta S, et al.), "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2020

Decision at stakeassigning the correct surveillance interval after removal of 1-4 non-advanced adenomas

After polyp removal, assign the next colonoscopy surveillance interval using USMSTF 2020 based on polyp number, size, and histology (e.g., 1-2 tubular adenomas <10 mm 7-10 years; 3-4 tubular adenomas <10 mm 3-5 years; 5-10 tubular adenomas <10 mm, any adenoma ≥10 mm, or adenoma with tubulovillous/villous histology or high-grade dysplasia 3 years; >10 adenomas 1 year with polyposis evaluation; and for serrated polyps, 1-2 sessile serrated lesions <10 mm 5-10 years, 3-4 sessile serrated lesions <10 mm or a hyperplastic polyp ≥10 mm 3-5 years, and a sessile serrated lesion ≥10 mm or with dysplasia or a traditional serrated adenoma 3 years), and apply the shortest interval indicated when findings are mixed.

From our summary of this standard, unedited — the part the paper bears on. marks omitted text. Our wording, not the guideline's; read the source for its own text.

Our full summary of this standard

After polyp removal, assign the next colonoscopy surveillance interval using USMSTF 2020 based on polyp number, size, and histology (e.g., 1-2 tubular adenomas <10 mm 7-10 years; 3-4 tubular adenomas <10 mm 3-5 years; 5-10 tubular adenomas <10 mm, any adenoma ≥10 mm, or adenoma with tubulovillous/villous histology or high-grade dysplasia 3 years; >10 adenomas 1 year with polyposis evaluation; and for serrated polyps, 1-2 sessile serrated lesions <10 mm 5-10 years, 3-4 sessile serrated lesions <10 mm or a hyperplastic polyp ≥10 mm 3-5 years, and a sessile serrated lesion ≥10 mm or with dysplasia or a traditional serrated adenoma 3 years), and apply the shortest interval indicated when findings are mixed. Confirm complete resection and adequate prep before applying an interval, and use site-check/tumor-board pathways for piecemeal resection and malignant (T1) polyps. Refer for genetic evaluation when Lynch, FAP/AFAP/MAP, or serrated polyposis syndrome criteria are met.

US Multi-Society Task Force on Colorectal Cancer (Gupta S, et al.), "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2020 · reviewed 2026-07-23 ↗
Hendel JM … Lee JK · Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association · IF 16.2 · PubMed ↗Permalink
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