Intest Res.  2023 Oct;21(4):443-451. 10.5217/ir.2023.00107.

Summary and comparison of recently updated post-polypectomy surveillance guidelines

• Jung YS

• KMID: 2547194
• DOI: http://doi.org/10.5217/ir.2023.00107

Abstract

Recently, updated guidelines for post-polypectomy surveillance have been published by the U.S. Multi‐Society Task Force (USMSTF), the British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE), the European Society of Gastrointestinal Endoscopy (ESGE), the Japan Gastroenterological Endoscopy Society (JGES), and the Korean Multi-Society Taskforce Committee. This review summarizes and compares the updated recommendations of these 5 guidelines. There are some differences between the guidelines for the recommended post-polypectomy surveillance intervals. In particular, there are prominent differences between the guidelines for 1–4 tubular adenomas < 10 mm with low-grade dysplasia (nonadvanced adenomas [NAAs]) and tubulovillous or villous adenomas. The USMSTF, JGES, and Korean guidelines recommend colonoscopic surveillance for patients with 1–4 NAAs and those with tubulovillous or villous adenomas, whereas the BSG/ACPGBI/PHE and ESGE guidelines do not recommend endoscopic surveillance for such patients. Surveillance recommendations for patients with serrated polyps (SPs) are limited. Although the USMSTF guidelines provide specific recommendations for patients who have undergone SPs removal, these are weak and based on very lowquality evidence. Future studies should examine this topic to better guide the surveillance recommendations for patients with SPs. For countries that do not have separate guidelines, we hope that this review article will help select the most appropriate guidelines as per each country’s healthcare environment.

Keyword

Polypectomy; Surveillance; Guidelines; Colonoscopy; Colorectal polyp

Figure

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  Fig. 1. Summary of main recommendations from the 5 guidelines. Advanced adenomas (AAs) refer to adenomas ≥10 mm in size or those with high-grade dysplasia or tubulovillous/villous histology. Nonadvanced adenomas (NAAs) refer to tubular adenomas <10 mm and with low-grade dysplasia. Serrated polyps (SPs) include hyperplastic polyps (HPs), sessile serrated lesions (SSLs), and traditional serrated adenomas (TSAs). USMSTF, U.S. Multi-Society Task Force; BSG, British Society of Gastroenterology; ACPGBI, Association of Coloproctology of Great Britain and Ireland; PHE, Public Health England; ESGE, European Society of Gastrointestinal Endoscopy; JGES, Japan Gastroenterological Endoscopy Society; HGD, high-grade dysplasia; VA, villous adenoma; TVA, tubulovillous adenoma; LGD, low-grade dysplasia.

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