Post-polypectomy colonoscopy surveillance: Can we improve the diagnostic yield?

Area of Science:

• Gastroenterology
• Oncology
• Endoscopy

Background:

• Adenomas and serrated polyps are preneoplastic lesions for colorectal cancer, but few progress to malignancy.
• Post-polypectomy surveillance aims to detect metachronous advanced neoplasia after initial polyp removal.

Purpose of the Study:

• To provide a comprehensive overview of current and future post-polypectomy colonoscopy surveillance strategies.
• To compare updated surveillance guidelines and identify predictors for metachronous advanced colorectal polyps.
• To explore molecular biomarkers for improved risk stratification and discuss resource optimization, especially post-COVID-19.

Main Methods:

• Review of current post-polypectomy surveillance guidelines.
• Literature review of molecular biomarkers associated with metachronous advanced colorectal polyps.
• Analysis of strategies for enhancing endoscopic resource utilization.

Main Results:

• Recent updates in surveillance guidelines advocate for more selective and less frequent colonoscopies.
• Identifying predictors for metachronous polyps is crucial for better risk identification.
• Molecular biomarkers show potential for improving the diagnostic yield of surveillance.

Conclusions:

• Future post-polypectomy surveillance should be more personalized and efficient.
• Integrating molecular biomarker research can enhance the detection of high-risk individuals.
• Optimizing endoscopic resources is essential, particularly in light of the COVID-19 pandemic.