Colonoscopy surveillance interval
Enter the polyps removed and see the surveillance interval the guideline sets, with the rule and its source.
No lesion at this exam — scored as a normal colonoscopy.
A normal colonoscopy.
Show exact guideline wording
| Finding | Interval | Recommendation | Evidence |
|---|---|---|---|
| Normal | 10 y | Strong | High |
Table 4, p.469
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.
After a surveillance colonoscopy
USMSTF 2020 sets the second surveillance interval from Table 7, using both the original baseline findings and the first surveillance findings. A high-risk baseline caps even a clean follow-up at 5 years rather than 10. It publishes no rule beyond the second surveillance, or for serrated lesions across serial exams.
The calculator gives a timeframe wherever the guideline or the screening programme sets one, and labels anything the guideline does not itself specify.
Age, stopping, and risk factors
Age. USMSTF 2020 prints no age cap or formal stopping rule for surveillance.
Risk factors. A hereditary colorectal cancer syndrome, inflammatory bowel disease, or a personal or family history of colorectal cancer falls outside these recommendations. For those patients USMSTF 2020 directs favouring the shortest indicated interval; it does not apply that instruction to the general findings-based intervals.
Colonoscopy surveillance intervals: quick answers
How soon should a colonoscopy be repeated after polypectomy under United States (USMSTF 2020)?
The US Multi-Society Task Force (USMSTF) 2020 guideline sets the next interval from what was removed at a complete exam. Intervals range from 10 years for low-risk findings to 3 years for advanced adenomas, 1 year for more than 10 adenomas, and 6 months after piecemeal removal of a lesion 20 mm or larger.
What is the surveillance interval after removing 1 to 2 small tubular adenomas under USMSTF 2020?
For 1 to 2 tubular adenomas smaller than 10 mm, the US Multi-Society Task Force (USMSTF) recommends colonoscopy in 7 to 10 years. Unlike the European Society of Gastrointestinal Endoscopy (ESGE) guideline, which returns these patients to routine screening, the USMSTF keeps even 1 to 2 small tubular adenomas under colonoscopy surveillance.
What interval applies to an advanced adenoma that is 10 mm or larger or has villous histology or high-grade dysplasia?
The US Multi-Society Task Force (USMSTF) sets colonoscopy in 3 years for an advanced adenoma, meaning one 10 mm or larger, one with tubulovillous or villous histology, or one with high-grade dysplasia. The same 3 year interval applies to a traditional serrated adenoma.
How does the number of adenomas removed change the USMSTF 2020 surveillance interval?
Under the US Multi-Society Task Force (USMSTF), 3 to 4 tubular adenomas smaller than 10 mm set colonoscopy in 3 to 5 years, and 5 to 10 such adenomas set colonoscopy in 3 years. More than 10 adenomas at one exam shorten the interval to colonoscopy in 1 year.
What is the surveillance schedule for sessile serrated lesions under USMSTF 2020?
Sessile serrated lesions follow their own schedule. The US Multi-Society Task Force (USMSTF) sets colonoscopy in 5 to 10 years for 1 to 2 sessile serrated polyps smaller than 10 mm, 3 to 5 years for 3 to 4, and 3 years for 5 to 10 or for any 10 mm or larger or with dysplasia.
What follow-up does USMSTF 2020 recommend after piecemeal removal of a large polyp?
After piecemeal removal of an adenoma or sessile serrated polyp 20 mm or larger, the US Multi-Society Task Force (USMSTF) recommends colonoscopy in 6 months. This short interval reflects the need to confirm complete resection of the lesion at the previous site.
Do patients with low-risk polyps return to stool-based screening under USMSTF 2020?
No. The US Multi-Society Task Force (USMSTF) keeps low-risk polyps under colonoscopy surveillance rather than a stool test. A normal colonoscopy with no polyps returns in 10 years, and 1 to 2 small tubular adenomas return in 7 to 10 years, both by colonoscopy.
For the guideline sources and side-by-side interval tables 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.
Last reviewed against the source guidelines on 14 July 2026.
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