Joint UK consensus guidelines for colorectal cancer surveillance

  • Rutter MD & al.
  • Gut
  • 27 Nov 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • The British Society of Gastroenterology, the Association of Coloproctology of Great Britain, and Ireland/Public Health England released guidelines for surveillance after polypectomy or colorectal cancer resection.

Why this matters

  • The guidelines are the first to incorporate the introduction of national bowel cancer screening and are also the first to include recommendations for surveillance after resection of either adenomatous or serrated polyps.
  • The guidelines are an update to guidelines last revised in 2010.

Key points

  • This evidence-based framework applies to individuals aged ≥18 years.
  • The guidelines do not cover subjects with hereditary colorectal syndromes.
  • It is increasingly believed that most cancer prevention benefit comes with the initial polypectomy and that postpolypectomy surveillance benefits few patients.
  • The guidelines help define which patients should undergo surveillance after polypectomy or cancer resection, the appropriate surveillance interval, and when surveillance can stop.
  • High-risk individuals identified after polypectomy should have a one-off surveillance colonoscopy at 3 years. These include:
    • Those with ≥2 premalignant polyps with ≥1 advanced polyp.
    • Patients with ≥5 premalignant polyps.
  • Patients who underwent a colorectal cancer resection should have a clearance colonoscopy at 1 year, followed by a surveillance colonoscopy after 3 more years.