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Colorectal cancer secondary prevention On the Web |
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To view the secondary prevention of familial adenomatous polyposis (FAP), click here
To view the secondary prevention of hereditary nonpolyposis colorectal cancer (HNPCC), click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.
Secondary prevention of colorectal cancer, as opposed to primary prevention, indicates that a person has already had the disease and there are steps being taken to prevent cancer recurrence, usually as metachronous tumors. This involves annual surveillance with colonoscopy after surgical removal and possibly an adjunct after the initial operation. The timing for secondary prevention is critical to prevent recurrent advanced disease.
The table below displays the guidelines for colonoscopy surveillance after the primary tumor resection[3].
Colonoscopy Findings | Recommeded Surveillance Interval (years) |
No polyps | 10 |
Small (< 10 mm) hyperplastic polyps in rectum or sigmoid | 10 |
1-2 small (< 10 mm) tubular adenomas | 5-10 |
3-10 tubular adenomas | 3 |
>10 adenomas | < 3 |
One or more tubular adenomas ≥ 10 mm | 3 |
One or more villous adenomas | 3 |
Adenoma with high grade dysplasia (HGD) | 3 |
Sessile serrated polyp(s) < 10 mm with no dysplasia | 5 |
Sessile serrated polyp(s) ≥ 10 mm | 3 |
Sessile serrated polyp with dysplasia | 3 |
Traditional serrated adenoma | 3 |
Serrated polyposis syndrome (one of the following criteria according to WHO: (1) at least 5 serrated polyps proximal to sigmoid, with 2 or more ≥ 10 mm (2) any serrated polyps proximal to sigmoid with family history of serrated polyposis syndrome (3) > 20 serrated polyps of any size throughout the colon) | 1 |