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Who Needs Follow-Up after Endoscopic Resection of Colorectal Adenomas?
1II. Medizinische Klinik, Universitätsmedizin Mannheim, Germany.
Background:
Surveillance colonoscopy after endoscopic resection of colorectal adenomas is a crucial step in the concept of colorectal cancer screening. After identifying the patients at risk with screening and resection of adenomas, there has to be a tailored surveillance. Surveillance colonoscopy should detect recurrent and metachronal adenomas at a stage where they can be removed endoscopically. In the following, the criteria for a risk-adapted surveillance interval are presented.
Methods:
A literature review based on American, European, and German guidelines for surveillance after polypectomy and the German guideline for the diagnosis and treatment of ulcerative colitis, as well as a selective literature search into hereditary colorectal cancer were performed.
Results:
State of the art surveillance after endoscopic resection of colorectal adenomas is based on a focused anamnesis and the index colonoscopy. On the basis of existing guidelines, a risk-adapted surveillance strategy can be implemented.
Conclusions:
Adherence to surveillance guidelines is a basic part of colorectal cancer screening and should be the starting point for further research.
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