| DECISION SUPPORT TOOL FOR POLYP SURVEILLANCE AFTER THE FIRST (INDEX) COLONOSCOPY | |
|---|---|
| Answer the following questions with yes or no as instructed. Once a cell lights up red that is the recommended interval for follow-up colonoscopy, if it lights up green proceed to next question as . Please use the shortest recommended interval in the red cell | |
| Question 1 | |
| Were any polyp(s) present? | |
| Does the patient have a family history? Answer yes or no to below options: | |
| Two or more FIRST degree relatives with colorectal cancer | |
| One FIRST degree relative with colorectal cancer | |
| One or more First degree relative with a documented advanced adenoma being any of the following: ≥10mm, villous, or high-grade dysplasia | |
| Recommendation | |
| Go to question 2 | |
| Question 2 | |
| Were there >10 total polyps (Tubular, Villous and/or Serrated)? | No |
| Recommendation | |
| Go to question 3 | |
| Question 3 | |
| Does your patient meet the criteria for serrated polyposis syndome? CRITERIA: (At least five serrated polyps proximal to the sigmoid colon, two of which are greater than 10mm in diameter OR any number of serrated polyps occurring proximal to the sigmoid colon in an individual who has a first-degree relative with serrated polyposis OR more than 20 serrated polyps of any size distributed throughout the colon.) | No |
| Recommendation | |
| Go to question 4 | |
| Question 4 | |
| Were any of the following present? (answer yes or no beside the cells) | |
| 3-10 Tubular Adenomas | no |
| ≥1 Tubular adenomas that are >10mm | No |
| Any adenoma with high grade dysplasia | No |
| ≥ 1 Villous adenoma(s) | no |
| Sessile serrated polyp(s) ≥ 10mm | no |
| Sessile serrated polyp with dysplasia | No |
| Traditional serrated adenoma | No |
| Recommendation | |
| Go to question 5 | |
| Question 5 | |
| Were any of the following present? (answer yes or no beside the cells) | |
| Sessile serrated polyp(s) <10mm with no dysplasia | no |
| Hyperplastic polyp(s) of any size AND ≥4 in number AND proximal to the sigmoid | no |
| Hyperplastic polyp(s) >5mm in size AND ≥1 in number AND proximal to the sigmoid | no |
| Recommendation | |
| Go to question 6 | |
| Question 6 | |
| Were there 1-2 tubular adenomas <10mm each ? | no |
| Recommendation | |
| Go to question 7 | |
| Question 7 | |
| Were there any of the following present? (answer yes or no beside the cells) | |
| Small hyperplastic polyp(s) <10mm in the rectosigmoid | Yes |
| Hyperplastic polyp(s) ≤ 5mm AND ≤ 3 in number AND Proximal to the sigmoid | No |
| Recommendation | |
| Colonoscopy every 5-10 years OR FIT testing every 1-2 years |