Colonoscopy surveillance interval
Enter the polyps removed and see the surveillance interval the guideline sets, with the rule and its source.
Canada has no maintained national post-polypectomy guideline; the provinces differ.
No lesion at this exam — scored as a normal colonoscopy.
A normal colonoscopy.
Show exact guideline wording
For an average risk patient with no polyps or normal findings on colonoscopy, the panel recommends FIT in 10 years.
Subsection "Initial colonoscopy finding of: Normal or no polyps" > RECOMMENDATION (unnumbered)
How ACRCSP sets the colonoscopy surveillance interval
The Alberta Colorectal Cancer Screening Program (ACRCSP) sets post-polypectomy intervals from the single most advanced finding at a high-quality baseline colonoscopy, confirmed on final pathology. It is distinctive in routing the lowest-risk findings back to stool-based screening: a normal exam, small hyperplastic polyps, and one to two small adenomas all return to the fecal immunochemical test (FIT) rather than to a scheduled colonoscopy. Colonoscopy surveillance at one, three, or five years is reserved for higher adenoma counts, large or advanced lesions, the serrated categories, and piecemeal removals.
| Finding at the baseline colonoscopy | Surveillance interval |
|---|---|
| Normal colonoscopy or no polyps | FIT in 10 years |
| Hyperplastic polyps under 10 mm | FIT in 10 years |
| 1 to 2 tubular adenomas under 10 mm | FIT in 5 years |
| 3 to 4 tubular adenomas under 10 mm | Colonoscopy in 5 years |
| 5 to 10 tubular adenomas under 10 mm, any adenoma 10 mm or larger, or villous/tubulovillous features or high-grade dysplasia | Colonoscopy in 3 years |
| More than 10 tubular adenomas on a single colonoscopy | Colonoscopy in 1 year, and consider genetic counselling |
| 1 to 2 sessile serrated lesions (SSL) under 10 mm | Colonoscopy in 5 years |
| 3 to 10 sessile serrated lesions under 10 mm | Colonoscopy in 3 years |
| Sessile serrated lesion over 10 mm, traditional serrated adenoma of any size, or sessile serrated lesion with dysplasia of any size | Colonoscopy in 3 years |
| Hyperplastic polyp 10 mm or larger, proximal to the sigmoid colon | Colonoscopy in 3 years |
| Hyperplastic polyp 10 mm or larger, in the rectosigmoid | Colonoscopy in 5 years |
| Serrated polyposis syndrome | Colonoscopy in 1 year |
| Synchronous sessile serrated lesion and tubular adenoma | No recommendation made (insufficient evidence) |
| Piecemeal removal of a large (10 mm or larger) non-pedunculated polyp | First repeat endoscopic assessment in 6 months |
Alberta returns one to two small tubular adenomas to a fecal immunochemical test (FIT) in five years, where the US schedules a surveillance colonoscopy at seven to ten years for the same finding.
Source: Alberta Colorectal Cancer Screening Program (Sadowski et al., J Can Assoc Gastroenterol 2024;7(4):319–328) ↗. This is the baseline colonoscopy table; enter specific findings in the calculator above for the rule and its exact wording.
After a surveillance colonoscopy
ACRCSP runs a high-risk pathway of 3 years, then 5 years, then considers a return to faecal screening if both are clear. Three to four tubular adenomas lengthen to 5 to 10 years after a normal 5-year exam. Piecemeal resection follows its own onward schedule.
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. ACRCSP prints no age cap for surveillance.
Risk factors. Hereditary syndromes, inflammatory bowel disease, and a personal or family history of colorectal cancer sit outside these post-polypectomy intervals.
Colonoscopy surveillance intervals: quick answers
How soon should a colonoscopy be repeated after polypectomy under Alberta (ACRCSP)?
The Alberta Colorectal Cancer Screening Program (ACRCSP) sets the interval from the single most advanced finding at a high-quality baseline exam. Higher-risk findings return for colonoscopy at 1, 3, or 5 years. The lowest-risk findings instead route back to a fecal immunochemical test (FIT) at 5 or 10 years.
What surveillance interval applies to 1 to 2 small tubular adenomas under Alberta (ACRCSP)?
One to two tubular adenomas under 10 mm return to a fecal immunochemical test (FIT) in 5 years rather than a surveillance colonoscopy. For the same finding, the US Multi-Society Task Force (USMSTF) instead schedules a colonoscopy at 7 to 10 years.
What is the colonoscopy interval for an adenoma 10 mm or larger or with villous or high-grade dysplasia under Alberta (ACRCSP)?
The Alberta program recommends a surveillance colonoscopy in 3 years for any adenoma 10 mm or larger, for villous features, or for high-grade dysplasia. The same 3-year interval covers 5 to 10 tubular adenomas under 10 mm found at one high-quality baseline colonoscopy.
What surveillance interval applies to sessile serrated lesions under Alberta (ACRCSP)?
One to two sessile serrated lesions (SSL) under 10 mm set a colonoscopy in 5 years. Three to 10 lesions under 10 mm shorten that to 3 years. An SSL over 10 mm, an SSL with dysplasia, or a traditional serrated adenoma of any size also sets 3 years.
When is the first follow-up after piecemeal removal of a large polyp under Alberta (ACRCSP)?
After piecemeal removal of a large, 10 mm or larger, non-pedunculated polyp, the Alberta program sets a first repeat endoscopic assessment in 6 months to confirm complete resection of the site. This short interval reflects the residual-tissue risk that piecemeal removal carries rather than the finding's histology alone.
Which findings return to stool-based screening instead of colonoscopy under Alberta (ACRCSP)?
A normal colonoscopy and hyperplastic polyps under 10 mm return to a fecal immunochemical test (FIT) in 10 years. One to two tubular adenomas under 10 mm return to FIT in 5 years. The Alberta program runs FIT annually for ages 50 to 74 between those points.
What interval applies to more than 10 adenomas or serrated polyposis syndrome under Alberta (ACRCSP)?
More than 10 tubular adenomas at one colonoscopy sets a repeat colonoscopy in 1 year, with genetic counselling to consider. Serrated polyposis syndrome also sets a colonoscopy in 1 year. Both are short intervals the Alberta program assigns for a heavy polyp burden rather than a single lesion.
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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