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Many average-risk patients who undergo screening colonoscopy have a few small tubular adenomas without high-grade dysplasia. Although the 2012 multisociety guideline that has served as a U.S. practice standard recommends a 5- to10-year surveillance interval for patients with 1 or 2 tubular adenomas measuring <10 mm (Gastroenterology 2012; 143:844), many are asked to return for repeat colonoscopy every 5 years. In 2019, a host of new studies added information particularly relevant to such patients. For example:
In a study from Japan, patients with 1 or 2 unresected diminutive adenomas (<5 mm) were not more likely than patients with no adenomas to develop advanced colorectal neoplasia — defined as adenoma ≥10 mm, adenoma with high-grade dyspla…