Table 4: Guidelines for Surveillance of Colorectal Cancer (CRCa) and polyps

Table 4:
Guidelines for Surveillance of Colorectal Cancer (CRCa) and polyps
Moderate Risk	Recommendation	Interval
1 small (< 1 cm) tubular adenoma and no family history of CRCa	Colonoscopy	5 yrs after polyp removal; if normal, resume average-risk screening
> 2, or > 1 cm adenoma, or adenomas that are villous or have high grade dysplasia, or adenoma patients with a family history of CRCa	Colonoscopy	3 yrs after polyp removal; if normal, repeat every 5 yrs
Personal history of CRCa	Colonoscopy	3 yrs after surgery; if normal, repeat every 5 yrs
CRCa in FDR age < 60, or 2 or more FDR any age with CRCa	Colonoscopy	Every 3-5 yrs beginning age 40, or 10 yrs younger than the youngest cancer in FDR, whichever is earlier
High Risk	Recommendation	Interval
Family history of FAP	Refer to specialty center for genetic counseling and consideration of genetic counseling	At time of diagnosis
Family history of FAP	Sigmoidoscopy or colonoscopy	Every 1-2 yrs beginning at puberty
Family history of HNPCC	Refer to specialty center for genetic counseling and consideration of genetic testing	At time of diagnosis
Family history of HNPCC	Colonoscopy	Every 2 yrs beginning at age 21-25 until age 40, then annually
Inflammatory bowel disease	Colonoscopy with biopsy for dysplasia	8 years after the start of pancolitis/12-15 yrs after the start of L-sided colitis
FDR = first-degree relatives; FAP = familial adenomatous polyposis; HNPCC = hereditary nonpolyposis colorectal cancer

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