Do I Need Annual Colonoscopies After Polyp Removal? Expert Insights

Q: Do I Need Annual Colonoscopies After Polyp Removal? Expert Insights

Hello, Huya： Generally, individuals who have undergone polypectomy for colorectal polyps are advised by their doctors to have a follow-up colonoscopy annually to monitor for any recurrence. <br>It is recommended that you visit a gastroenterology clinic for this examination.

There are polyps in the colon?

Four years ago, I had blood in my stool and underwent a colonoscopy, during which a polyp was removed using a laser.
The following year, I had another colonoscopy that was normal.
My doctor advised that I need to have a colonoscopy every year.
However, when I consulted another doctor, they said it was not necessary.
I am unsure about what to do.
Should I have a colonoscopy every year? I am very afraid of the procedure because it is uncomfortable and painful.

Hui Ya, 40~49 year old female. Ask Date: 2001/01/01

Dr. Ke Zhengchang reply Internal Medicine

Hello, Huya: Generally, individuals who have undergone polypectomy for colorectal polyps are advised by their doctors to have a follow-up colonoscopy annually to monitor for any recurrence.
It is recommended that you visit a gastroenterology clinic for this examination.

Reply Date: 2001/01/01

More Info

When it comes to the necessity of annual colonoscopies after polyp removal, the answer is not straightforward and can depend on several factors, including the type, size, and number of polyps removed, as well as your personal and family medical history.
In general, the guidelines for follow-up colonoscopy after polyp removal are based on the characteristics of the polyps found during the initial procedure. For instance, if you had adenomatous polyps (the type that can potentially develop into cancer), the recommendations can vary:
1. Low-Risk Adenomatous Polyps: If you had one or two small (<1 cm) tubular adenomas, the typical recommendation is to have a follow-up colonoscopy in 5 to 10 years.

2. Intermediate-Risk Adenomatous Polyps: If you had three to ten adenomas or at least one adenoma that is 1 cm or larger, follow-up colonoscopy is usually recommended in 3 years.

3. High-Risk Adenomatous Polyps: If you had more than ten adenomas or any adenoma with high-grade dysplasia, your doctor may recommend a colonoscopy in 1 to 2 years.

4. Hyperplastic Polyps: These are generally considered low-risk, and if they are found in the rectum or sigmoid colon, follow-up may not be necessary for several years.

Given that you mentioned having had a polyp removed four years ago and that your subsequent colonoscopy was normal, your doctor’s recommendation for annual follow-ups may seem excessive, especially if the initial polyp was low-risk. However, some physicians may adopt a more conservative approach, particularly if there are other risk factors at play, such as a family history of colorectal cancer or personal history of inflammatory bowel disease.

It’s understandable to feel anxious about the discomfort associated with colonoscopies. Many patients report feeling apprehensive about the procedure due to the preparation involved and the potential for discomfort during the examination. However, it’s important to remember that colonoscopy is a crucial tool for early detection of colorectal cancer and for monitoring any potential recurrence of polyps.

If you are uncertain about the frequency of your colonoscopies, it may be beneficial to seek a second opinion from a gastroenterologist. They can review your medical history, the specifics of your previous polyps, and your overall risk factors to provide personalized recommendations.
In addition to colonoscopy, you can also discuss other screening options with your healthcare provider, such as stool-based tests (like FIT or Cologuard), which can be less invasive and may be appropriate depending on your risk profile.

Ultimately, the decision on how often to have a colonoscopy should be made collaboratively with your healthcare provider, taking into account your individual circumstances and preferences. Regular screenings are essential for maintaining gastrointestinal health, especially after a history of polyps, but the frequency can often be tailored to suit your needs and comfort level.

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