A 58-year-old man undergoes screening colonoscopy. Three tubular adenomas less than 5 mm each are completely removed by snare polypectomy. Histology shows low-grade dysplasia with no villous component and margins are clear. When should his next surveillance colonoscopy be performed?

• A 6 months
• B 1 year
• C 3 years
• D 10 years ✓

Explanation

One or two small tubular adenomas under 10 mm with low-grade dysplasia are classified as low-risk findings, and current US Multi-Society Task Force guidance recommends returning to routine 7 to 10 year screening, conventionally quoted as 10 years in exams. A 3 year interval applies to high-risk findings such as three or more adenomas, any adenoma of 10 mm or larger, villous histology, or high-grade dysplasia.

Reference: Sabiston Textbook of Surgery, 21st ed.

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