A 55-year-old man undergoes screening colonoscopy at which three tubular adenomas are removed by snare polypectomy. The largest measures 12 mm and shows high-grade dysplasia on histology; all margins are clear. After complete excision, when should his next surveillance colonoscopy be performed?
- A Within 6 months
- B At 1 year
- C At 3 years ✓
- D At 5 years
Correct answer: C. At 3 years
Explanation
Multiple adenomas, any adenoma of 10 mm or larger, villous histology, or high-grade dysplasia define the high-risk category after polypectomy, for which guideline surveillance is colonoscopy at 3 years. Low-risk patients (one or two small tubular adenomas without high-grade features) return at 5 to 10 years. Intervals of 6 months to 1 year apply only to piecemeal resection of large sessile polyps needing early scar inspection, which is not described here.
Reference: Sabiston Textbook of Surgery, 21st ed.
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