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.
Not for intervals after a surveillance colonoscopy.
Tick if any apply.
| Prevalence | Histopathology | Guideline interval |
|---|---|---|
| ~45–60% | Tubular adenoma | 5 years |
| ~20–30% | Hyperplastic | 10 years |
| ~5–15% | Tubulovillous / villous | 3 years |
| ~1–8% | Sessile serrated | 5 years |
| <1% | Traditional serrated | 3 years |
How ColonCancerCheck sets the colonoscopy surveillance interval
Cancer Care Ontario's ColonCancerCheck (CCC) recommendations set the surveillance interval from the size and histology of the most advanced lesion found, and assume a high-quality colonoscopy that reached the cecum with adequate bowel preparation. Lower-risk findings return the patient to fecal immunochemical test (FIT) stool screening rather than a repeat colonoscopy: no polyps or rectosigmoid hyperplastic polyps go to FIT in 10 years, and low risk adenomas to FIT in 5 years. Higher-risk adenomas, serrated lesions, and piecemeal resections stay on colonoscopy surveillance, from 3 years down to a 6-month check of the resection site.
| Finding at the baseline colonoscopy | Surveillance interval |
|---|---|
| No polyps, or hyperplastic polyps in the rectum or sigmoid | FIT in 10 years |
| Low risk adenomas: 1 to 2 tubular adenomas under 10 mm with no high-grade dysplasia | FIT in 5 years |
| Sessile serrated adenoma under 10 mm without dysplasia | Colonoscopy in 5 years |
| High risk (advanced) adenomas: a tubular adenoma 10 mm or larger, 3 or more adenomas, villous histology, or high-grade dysplasia | Colonoscopy in 3 years |
| Sessile serrated adenoma 10 mm or larger, sessile serrated adenoma with dysplasia, or traditional serrated adenoma | Colonoscopy in 3 years |
| Large sessile polyp removed piecemeal | Colonoscopy to check the polypectomy site within 6 months |
| Serrated polyposis syndrome | Colonoscopy in 1 year |
| More than 10 adenomas | Clearing colonoscopy within 1 year |
Ontario returns lower-risk patients to stool-based FIT screening instead of a surveillance colonoscopy: 1 to 2 small tubular adenomas get a FIT in 5 years, where the US schedules a colonoscopy at 7 to 10 years.
Source: ColonCancerCheck / Cancer Care Ontario — Recommendations for Post-Polypectomy Surveillance ↗. 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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