Colonoscopy Guidelines 2021 I Dallas, Tx

Colonoscopy Guidelines 2021 l Dallas, Tx; Colonoscopy is a test that is done to check for polyps or abnormalities in the colon. If polyps or abnormalities are found in the colon, they are removed during the colonoscopy.

The second leading cause of death in the U.S is colorectal cancer. It can be prevented when precancerous polyps are found and removed before they turn cancerous.

What is the difference between a Screening Test and a Diagnostic Colonoscopy?

A screening test is a test provided in the absence of signs or symptoms based on a patient’s age, gender, medical history and family history. A screening test is a routine test performed on a patient without any signs or symptoms for the purpose of testing for the presence of colon cancer or colon polyps. Whether or not a polyp or abnormality is found doesn’t change the intent of the screening.

Diagnostic colonoscopy is a test performed on a patient with signs or symptoms. Diagnostic colonoscopy is used to find out the cause of the symptoms that a patient is experiencing.

An individual is considered high risk for developing colorectal cancer if he or she has one or more of the following:

• Has a close relative such as sibling, parent or child, who has had colorectal cancer or an adenomatous polyp.
• Has a family history of familial adenomatous polyposis.
• Has a family history of hereditary nonpolyposis colorectal cancer.
• Has a personal history of adenomatous polyps.
• Has a personal history of colorectal cancer.
• Suffer from inflammatory bowel disease, including Crohn’s Disease, and ulcerative colitis.

Such person may need to undergo diagnostic colonoscopy.

Individuals at average risk of colorectal cancer who have undergone a screening colonoscopy do not need to repeat the screening for 10 years.

During a colonoscopy, polyps are typically removed and tested if found in the colon. However, the amount and size of the polyps removed will change the schedule of the patient’s follow-up screening.

The U.S. Multisociety Task Force (MSTF) on Colorectal Cancer, medical experts provide a timeline for patients to be rescreened for colorectal cancer based on their initial colonoscopy. Recommendations were also provided for physicians to apply the safest and most effective techniques to completely remove polyps.

Colonoscopy screening for average-risk individuals is recommended to start at age 50. The recommendations from MSTF aim to improve colon cancer prevention through early detection and removal of polyps.

Regular screening is an effective way to prevent colorectal cancer. Medical experts recommend that adults between the ages of 50 to 75 be screened for colorectal cancer at least once every 10 years. The Task Force also recommends that adults between the age of 76 to 85 first ask their doctor if they should be screened or not.

Recommendations for Follow-Up After Colonoscopy

Schedule for follow-up colonoscopy after the initial colonoscopy include:

• Patient has no polyps: Next colonoscopy in 10 years
• Patient has 1-2 polyps <10mm: Next colonoscopy in 7-10 years (instead of 5-10 years)
• Patient has 3-4 polyps <10mm: Next colonoscopy in 3-5 years (instead of 3 years)
• Patient has more than 10 polyps: Next colonoscopy in 1 year (instead of 3 years)
• Patient has serrated polyps: Review the document for complete recommendations
• Patient has advanced polyps: Next colonoscopy in 3 years

Best practices for polyp removal

The primary aim of polypectomy is to completely remove any colorectal lesion found and to prevent colorectal cancer. Majority of benign colorectal lesions can be safely and effectively removed using endoscopic removal techniques.

When an endoscopist encounters a suspected benign colorectal polyp that he/she is finding difficult to remove completely, MSTF recommends that the endoscopist refers to an endoscopist that is experienced in advanced polypectomy for subsequent evaluation and removal.

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