A 45-year-old patient with Lynch syndrome (MLH1 germline mutation) undergoes colonoscopy revealing a 2 cm adenomatous polyp in the ascending colon. After polypectomy, surveillance colonoscopy interval per current USMSTF/BSG guidelines should be:
- A 2 years
- B 3 years
- C 1 year ✓
- D 5 years
Explanation
In Lynch syndrome (hereditary non-polyposis colorectal cancer — HNPCC), annual colonoscopy is recommended regardless of polyp findings, as these patients have accelerated adenoma-to-carcinoma progression (possibly within 2-3 years compared to 10 years in sporadic cases) due to mismatch repair deficiency. The US Multi-Society Task Force and British Society of Gastroenterology recommend 1-year surveillance intervals for Lynch syndrome carriers post-polypectomy and even between polyp findings. This contrasts with sporadic polyps where 3-year interval post-low risk adenoma and 3-5 year post-high-risk adenoma are standard.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.