Studies have shown clearly that, in the absence of heredity syndromes, the progression from polyp to cancer (adenoma carcinoma sequence) occurs over many years. Thus, the timing of a follow-up surveillance colonoscopy should be determined based on the results of a previous high-quality colonoscopy. Typical colonoscopic surveillance following colon cancer surgery consists of a colonoscopy at one year; thereafter it should not typically exceed every 3 years following detection of an advanced polyp, or every 5 years following a normal exam or one showing small polyps. In Canada, there is both evidence of overuse of surveillance colonoscopy following colon cancer resection and, in areas, a limited availability of endoscopy resources.
Sources:
BC Cancer Agency. Cancer Management Guidelines. Gastrointestinal, Colon [Internet]. 2014 Feb 1 [cited 2014 Sep 23].
Hill MJ, et al. Aetiology of adenoma–carcinoma sequence in large bowel. Lancet. 1978 Feb 4;1(8058):245-7. PMID: 74668.
Leddin D, et al. Colorectal cancer surveillance after index colonoscopy: guidance from the Canadian Association of Gastroenterology. Can J Gastroenterol. 2013 Apr;27(4):224-8. PMID: 23616961.
Levin B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008 May;134(5):1570-95. PMID: 18384785.
Urquhart R, et al. Population-based longitudinal study of follow-up care for patients with colorectal cancer in Nova Scotia. J Oncol Pract. 2012 Jul;8(4):246-52. PMID: 23180991.
van Kooten H, et al. Awareness of postpolypectomy surveillance guidelines: a nationwide survey of colonoscopists in Canada. Can. J. Gastroenterol. Feb 2012;26(2):79-84. PMID: 22312606.
Related Resources:
Patient Pamphlet: Colonoscopy: When you need it and when you don’t