Colonoscopy surveillance interval
Enter the polyps removed and see the surveillance interval the guideline sets, with the rule and its source.
Not for intervals after a surveillance colonoscopy.
Tick if any apply.
| Prevalence | Histopathology | Guideline interval |
|---|---|---|
| ~45–60% | Tubular adenoma | 7 to 10 years |
| ~20–30% | Hyperplastic | 10 years |
| ~5–15% | Tubulovillous / villous | 3 years |
| ~1–8% | Sessile serrated | 5 to 10 years |
| <1% | Traditional serrated | 3 years |
How USMSTF 2020 sets the colonoscopy surveillance interval
The United States Multi-Society Task Force on Colorectal Cancer (USMSTF) 2020 guideline sets the next colonoscopy interval from what was found and removed at a complete, well-prepared baseline exam. Conventional adenomas are stratified by number, size, and histology, while serrated lesions follow their own separate schedule. Intervals range from 6 months after piecemeal removal of a large polyp out to 10 years after a normal exam or a few small low-risk polyps.
| Finding at the baseline colonoscopy | Surveillance interval |
|---|---|
| Normal colonoscopy, no polyps found | Colonoscopy in 10 years |
| 1 to 2 tubular adenomas under 10 mm | Colonoscopy in 7 to 10 years |
| 3 to 4 tubular adenomas under 10 mm | Colonoscopy in 3 to 5 years |
| 5 to 10 tubular adenomas under 10 mm | Colonoscopy in 3 years |
| An adenoma 10 mm or larger | Colonoscopy in 3 years |
| An adenoma with tubulovillous or villous histology | Colonoscopy in 3 years |
| An adenoma with high-grade dysplasia | Colonoscopy in 3 years |
| More than 10 adenomas at one exam | Colonoscopy in 1 year |
| Up to 20 hyperplastic polyps under 10 mm in the rectum or sigmoid colon | Colonoscopy in 10 years |
| Up to 20 hyperplastic polyps under 10 mm proximal to the sigmoid colon | Colonoscopy in 10 years |
| 1 to 2 sessile serrated polyps under 10 mm | Colonoscopy in 5 to 10 years |
| 3 to 4 sessile serrated polyps under 10 mm | Colonoscopy in 3 to 5 years |
| A hyperplastic polyp 10 mm or larger | Colonoscopy in 3 to 5 years |
| 5 to 10 sessile serrated polyps under 10 mm | Colonoscopy in 3 years |
| A sessile serrated polyp 10 mm or larger | Colonoscopy in 3 years |
| A sessile serrated polyp with dysplasia | Colonoscopy in 3 years |
| A traditional serrated adenoma | Colonoscopy in 3 years |
| Piecemeal removal of an adenoma 20 mm or larger | Colonoscopy in 6 months |
| Piecemeal removal of a sessile serrated polyp 20 mm or larger | Colonoscopy in 6 months |
Unlike the European Society of Gastrointestinal Endoscopy (ESGE), which returns patients with 1 to 4 small low-grade adenomas to routine screening, the USMSTF keeps even 1 to 2 small tubular adenomas under colonoscopy surveillance at 7 to 10 years.
Source: US Multi-Society Task Force on Colorectal Cancer, 2020 (Gupta et al., Gastrointest Endosc 2020;91:463–485) ↗. This is the baseline colonoscopy table; enter specific findings in the calculator above for the rule and its exact wording.
For common questions and the source behind each rule across all the guidelines, see the colonoscopy surveillance guideline reference.
Reference tool for health professionals. Not medical advice, not a medical device, and does not make or replace a clinical decision. The calculation runs in your browser; the findings you enter are not transmitted or stored. The Aescia clinical team reviews this tool periodically against the source guidelines and updates it when they change, but guidelines are revised without notice; verify against the current version before acting. If you notice an error, tell us at contact@aesciahealth.com.
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