From the Guidelines
For a patient of average risk with a single hyperplastic (non-neoplastic) polyp found during colon cancer screening, the recommended follow-up is a routine screening colonoscopy in 10 years. This recommendation is based on the most recent and highest quality study available, which suggests that patients with small distal hyperplastic polyps have a very low risk of future neoplasia and should not be rescreened for 10 years 1. The 10-year interval is appropriate because hyperplastic polyps do not progress to cancer at a rate that would warrant more frequent surveillance.
Some key points to consider in this recommendation include:
- Hyperplastic polyps are benign growths that do not significantly increase the risk of developing colorectal cancer
- The presence of a single hyperplastic polyp does not necessitate more frequent surveillance
- However, if the hyperplastic polyp is large (>10mm) or located in the right colon, or if multiple hyperplastic polyps are found, different follow-up intervals might be recommended as these findings could suggest a serrated polyposis syndrome
- Additionally, if the patient has other risk factors such as a family history of colorectal cancer or personal history of inflammatory bowel disease, the follow-up interval might need to be adjusted accordingly
- The colonoscopy should be performed with high-quality bowel preparation to ensure adequate visualization of the entire colon, as supported by earlier guidelines 1.
It's also important to note that guidelines are dynamic and based on the evidence currently in the literature, understanding of the adenoma carcinoma sequence, and expert opinion, and may be updated as new evidence becomes available 1.
From the Research
Follow-up Recommendations for Colon Cancer Screening
For a patient of average risk with one hyperplastic (non-neoplastic) polyp found during colon cancer screening, the recommended follow-up is as follows:
- The presence of a single hyperplastic polyp is generally considered to be a low-risk finding for the development of colorectal cancer 2, 3.
- However, the risk of colorectal cancer may be higher in patients with multiple hyperplastic polyps, particularly those with hyperplastic polyposis syndrome 3.
- The American College of Gastroenterology recommends a 10-year interval between screening colonoscopies for average-risk individuals with a negative result 4.
- However, some studies suggest that colonoscopic surveillance at intervals of 1-3 years may be prudent for patients with hyperplastic polyposis, depending on the number and size of both adenomatous and hyperplastic polyps 2.
- It is essential to note that the management of hyperplastic polyps should be individualized, taking into account the patient's overall risk profile, family history, and other factors.
Key Considerations
- Hyperplastic polyps are generally considered to be non-neoplastic, but some subtypes may have malignant potential 3.
- The risk of colorectal cancer is higher in patients with a family history of colorectal cancer or adenomatous polyps 5, 6.
- Colonoscopic surveillance is an effective method for detecting and removing precancerous lesions, and can reduce the risk of colorectal cancer 4, 6.