Colorectal Polyp Follow-Up: How Often Should You Get Screened?

Colon polyp surveillance issues?

I am 27 years old and experienced abdominal pain for two weeks in January 2017, which led to hospitalization and a recommendation for a colonoscopy.
During the colonoscopy, a 1 cm polyp was found and removed, but I forgot the type of polyp.
The doctor initially advised me to have follow-up screenings every three years, but later changed it to every two years, expressing concern that it was unusual for someone my age to have polyps.
After researching online, I found that many sources suggest follow-up screenings should be done annually.
Should I follow my doctor's recommendation for a two-year follow-up, or is it advisable to have screenings every year? Thank you for taking the time to respond!

Na, 20~29 year old female. Ask Date: 2017/05/04

Dr. Lin Minghui reply Gastroenterology and Hepatology

1.
Colorectal polyps are primarily classified into hyperplastic polyps and adenomatous polyps.
Most hyperplastic polyps do not undergo malignant transformation.
Tubular adenomas, villous adenomas, and serrated adenomas have a higher risk of carcinogenesis, and early removal can reduce the chance of polyps developing into colorectal cancer.

2.
The timing for follow-up after polyp removal should consider the size, number, morphology, histology, and degree of differentiation of the polyps.
According to international guidelines, follow-up for adenomatous polyps is typically every 3-5 years, while serrated polyposis syndrome requires annual follow-up.
The above information is for reference; it is advisable to follow your physician's recommendations for your health.

Reply Date: 2017/05/04

More Info

When it comes to colorectal polyps and the appropriate follow-up screening intervals, it is essential to consider both the type of polyp that was removed and individual risk factors. In your case, you mentioned that you had a 1 cm polyp removed during a colonoscopy at the age of 27. The recommendation for follow-up screening can vary based on several factors, including the histological type of the polyp (e.g., adenomatous, hyperplastic, etc.), the number of polyps found, and your personal and family medical history.

Generally, adenomatous polyps, especially those larger than 1 cm, have a higher risk of progressing to colorectal cancer. Therefore, the standard follow-up recommendations for patients with a history of adenomatous polyps typically suggest a colonoscopy every 3 to 5 years, depending on the number and characteristics of the polyps. However, since you are relatively young and had only one polyp removed, your physician may have opted for a more conservative approach, suggesting a follow-up every two years.

The confusion arises when you read online sources that suggest annual follow-ups. While annual screenings may be recommended for individuals with a higher risk of colorectal cancer (such as those with a family history of colorectal cancer or multiple polyps), for someone like you, who had a single polyp removed and is otherwise healthy, the two-year follow-up may be appropriate.

It is crucial to have a detailed discussion with your healthcare provider about the specific type of polyp you had and any other risk factors that may influence your screening schedule. If the polyp was found to be adenomatous, and especially if it had any dysplastic features, a more frequent follow-up might be warranted. On the other hand, if it was a hyperplastic polyp, the risk of developing colorectal cancer is significantly lower, which could justify the two-year interval.

In summary, while the general guidelines suggest follow-ups based on the type and number of polyps, your physician's recommendation of a two-year follow-up is likely based on your specific situation. If you have any concerns or if your family history changes, it would be wise to revisit this topic with your doctor. They can provide the most personalized advice based on your medical history and the characteristics of the polyp that was removed. Always prioritize open communication with your healthcare provider to ensure that your follow-up care aligns with your health needs.

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