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Updated CRC screening recommendations from US Multi-Society Task Force

Mon, 03/16/2020 - 09:12
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The US Multisociety Task Force on Colorectal Cancer has published two updated recommendations for follow-up after colonoscopy and polypectomy. The consensus papers, ‘Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer’ and ‘Endoscopic Removal of Colorectal Lesions—Recommendations by the US Multi-Society Task Force on Colorectal Cancer’, were published in Gastroenterology.

Patients with average risk of colorectal cancer who receive a normal colonoscopy (recommended to begin at age 50 years) often do not receive a repeat screening for ten years. However, it is common for precancerous polyps to be removed and tested during a colonoscopy.

The US Multisociety Task Force - comprised of representatives of the American College of Gastroenterology, the American Gastroenterology Association, and the American Society for Gastrointestinal Endoscopy - provided an update to their 2012 guideline to improve colorectal cancer prevention and early detection.

Experts offered an updated schedule for follow-up colonoscopy after initial high-quality exam:

  • Patients with no polyps should receive next colonoscopy in ten years.
  • Patients with 1 to 2 polyps that are less than 10mm should receive next colonoscopy in seven to ten years.
  • Patients with 3 to 4 polyps that are less than 10mm should receive next colonoscopy in three to five years.
  • Patients with more than 10 polyps should receive next colonoscopy in one year.
  • For patients with serrated polyps, clinicians should review the document for complete recommendations.
  • Patients with advanced polyps should receive next colonoscopy in three years.

Additionally, the guideline offers recommendations for endoscopic removal of colorectal lesions, best practices for polyp assessment and description, and best practices for polyp removal.

For patients with diminutive and small polyps, the guideline recommends cold snare polypectomy and against the use of ablative techniques on endoscopically visible residual tissue of a polyp.

Finally, the guideline calls for an intensive follow-up schedule in patients following piecemeal endoscopic mucosal resection, with the first surveillance colonoscopy at 6 months and intervals to the next colonoscopy at one year and then three years.

To access the paper, ‘Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer’, please click here

To access the paper, ‘Endoscopic Removal of Colorectal Lesions—Recommendations by the US Multi-Society Task Force on Colorectal Cancer’, please click here