Update in Surveillance Recommendations in Individuals With Conventional Adenomas

  • Rishabh Sachdev
  • Rahul Sao
  • John W. Birk
  • Joseph C. AndersonEmail author
  • Joel Levine
Colon (JC Anderson, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Colon


Purpose of review

Conventional adenomas, which are precursors to almost 70% of colorectal carcinomas, are found in more than one-third of screening colonoscopies. Surveillance recommendations, based on adenoma size, histology, and number, have evolved over the years and are currently reflective of index adenoma categorization as either low-risk (LRA) or high-risk (HRA). In this review, recent guideline recommendations as well as primary data that have helped to shape these recommendations are presented.

Recent findings

Recent data have demonstrated that individuals with HRA on index exams may be at increased risk for CRC while those with LRA may have a minimal long-term risk for CRC, similar to those adults with normal index exams. Furthermore, the quality of the index exams is important for minimizing CRC risk.


While individuals with HRA may require close surveillance intervals of 3 years, those with LRA or normal exams may need longer such as 10-year follow-up.


Colorectal cancer screening Metachronous neoplasia Conventional adenoma Advanced adenoma Surveillance interval 


Compliance with Ethical Standards

Conflict of Interest

Rishabh Sachdev, Rahul Sao, John W. Birk, Joseph C. Anderson, and Joel Levine declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  • Rishabh Sachdev
    • 1
  • Rahul Sao
    • 1
  • John W. Birk
    • 1
  • Joseph C. Anderson
    • 1
    • 2
    Email author
  • Joel Levine
    • 1
    • 3
  1. 1.Department of Medicine in the Division of Gastroenterology and HepatologyUniversity of Connecticut Health CenterFarmingtonUSA
  2. 2.Department of MedicineDepartment of Veterans Affairs Medical CenterWhite River JunctionUSA
  3. 3.Colon Cancer Prevention Program, Neag Comprehensive Cancer CenterUniversity of Connecticut Health CenterFarmingtonUSA

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