How Can the Over-Use of Surveillance Colonoscopy After Polypectomy Be Modified?
It is evident that colorectal cancer screening programs have contributed to a decrease in mortality [1–3]. Since professional groups, especially gastroenterologists, generally prefer colonoscopy as the most effective tool for colorectal cancer prevention , a considerable proportion of people with adenomatous polyps are discovered at the time of screening. Accordingly, a large number of people require post-polypectomy surveillance, which places a huge burden on medical resources [4, 5]. Recent data showing that 20% of colonoscopies performed in practice were for surveillance after polypectomy  indicate the importance of appropriate allocation of medical resources. Therefore, efficient and safe guidelines on surveillance colonoscopy are needed to decrease the cost, risk and over-use of colonoscopy.
Before the 1990s, because there was no available guidelines, annual follow-up colonoscopy was common practice after polypectomy. The National Polyp Study, showing that it was safe to defe
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