Skip to content
Clinician reference tool

Colonoscopy surveillance interval

Enter the polyps removed and see the surveillance interval the guideline sets, with the rule and its source.

Baseline colonoscopy only

Not for intervals after a surveillance colonoscopy.

Outside the guidelines

Tick if any apply.

Bowel prep · Boston scale
Right colon
Transverse
Left colon
Total 9 / 9 · Adequate
Polyps removed
Lesion type
Awaiting histology
Interval depends on the result
The interval each possible histology for the pending lesion would give. Confirm once histology returns.
PrevalenceHistopathologyGuideline interval
~45–60%Tubular adenoma10 years (usual screening)
~20–30%Hyperplastic10 years (usual screening)
~5–15%Tubulovillous / villous10 years (usual screening)
~1–8%Sessile serrated10 years (usual screening)
<1%Traditional serrated3 years

Prevalence source ↗

Europe

How ESGE 2020 sets the colonoscopy surveillance interval

The European Society of Gastrointestinal Endoscopy (ESGE) 2020 guideline divides patients into two groups after complete removal of one or more polyps at a high-quality colonoscopy: those who return to routine screening and those who need surveillance. Surveillance applies only to larger, more numerous, or dysplastic lesions, and where it applies the baseline interval is 3 years. ESGE abandoned the older high-risk and low-risk labels, and it does not treat villous histology or polyp location as a reason to shorten the interval.

Finding at the baseline colonoscopySurveillance interval
1 to 4 adenomas under 10 mm with low-grade dysplasia (with or without villous features)Usual screening (colonoscopy in 10 years where no organised screening program exists)
Any serrated polyp under 10 mm without dysplasiaUsual screening (colonoscopy in 10 years where no organised screening program exists)
At least 1 adenoma 10 mm or larger, or an adenoma with high-grade dysplasia3 years, colonoscopy
5 or more adenomas3 years, colonoscopy
Any serrated polyp 10 mm or larger, or with dysplasia3 years, colonoscopy
10 or more adenomasNo surveillance interval set; referral for genetic counselling
Piecemeal resection of a polyp 20 mm or largerEarly repeat colonoscopy at 3 to 6 months, then surveillance colonoscopy 12 months after that

ESGE returns 1 to 4 small adenomas with low-grade dysplasia to routine screening, whether or not they are villous, while the United States keeps the same adenomas in colonoscopy surveillance at 7 to 10 years.

Source: ESGE 2020 (Hassan et al., Endoscopy 2020;52(8):687–700). 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.

Aescia builds pre-procedure and surveillance-recall software for endoscopy clinics. See what we do.