From the Guidelines
When adenomatous polyps are found during a colonoscopy, they should be completely removed during the procedure if possible, and follow-up colonoscopies are necessary based on the number, size, and characteristics of the polyps found, with the timing of subsequent colonoscopies depending on the pathology and number of adenomas detected at follow-up colonoscopy, as recommended by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society 1.
Key Considerations for Follow-Up
- For patients with 1-2 small (less than 10mm) tubular adenomas, a follow-up colonoscopy is typically recommended in 5-10 years, as supported by guidelines from the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society 1.
- For those with 3-10 adenomas, advanced adenomas (larger than 10mm, with villous features, or high-grade dysplasia), or serrated polyps, follow-up is usually needed in 3 years, based on recommendations from the American College of Gastroenterology polyp guidelines from 2000, as referenced in 1.
- Patients with more than 10 adenomas may need follow-up in less than 3 years, depending on individual risk factors and clinical judgment, as suggested by the guidelines for colonoscopy surveillance after polypectomy 1.
Lifestyle Recommendations
Between colonoscopies, maintaining a healthy lifestyle is important, including:
- Eating a diet high in fiber and low in red meat
- Regular exercise
- Limiting alcohol
- Avoiding tobacco
- Maintaining a healthy weight Some physicians may recommend daily aspirin for high-risk patients, though this should be discussed individually due to bleeding risks, as noted in 1.
Family Screening
Family members of patients with adenomatous polyps should be informed about their slightly increased risk and may need earlier screening, as recommended by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society 1. Regular follow-up is crucial because adenomatous polyps can develop into colorectal cancer if left undetected and untreated.
From the Research
Adenomatous Polyps Treatment
When adenomatous polyps are found, the following steps can be taken:
- Removal of the polyps through endoscopic polypectomy, as shown in a study published in 2019 2
- The use of nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin may reduce the risk of adenomatous polyps, as suggested by studies published in 2011 3, 1995 4, and 2004 5
- A biopsy may not be necessary for colon polyps suitable for polypectomy when performing a colonoscopy, as indicated by a study published in 2011 6
Prevention of Adenomatous Polyps
To prevent adenomatous polyps, the following measures can be taken:
- Regular use of NSAIDs and aspirin, as shown to reduce the risk of adenomatous polyps in studies published in 2011 3, 1995 4, and 2004 5
- Screening for colorectal cancer through colonoscopy, as recommended by a study published in 2019 2
Management of Adenomatous Polyps
The management of adenomatous polyps involves:
- Removal of the polyps through endoscopic polypectomy, as shown in a study published in 2019 2
- Follow-up colonoscopy to monitor for recurrence of polyps, as suggested by a study published in 2011 6
- Consideration of the use of NSAIDs and aspirin to reduce the risk of adenomatous polyps, as indicated by studies published in 2011 3, 1995 4, and 2004 5