Colonoscopy Intervals and Colorectal Cancer Incidence after Adenoma Removal.
N Engl J MedSep 17, 2026
Clinical ResearchGastroenterology
Rodrigo Jover, Michael Bretthauer, Joaquin Cubiella et al.
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In 30 seconds
This multicenter randomized controlled trial evaluated colonoscopy intervals in patients with high-risk adenomas, comparing 5-year versus 3-year surveillance. After 5.5 years, the cumulative incidence of colorectal cancer was 0.77% in the 5-year group and 0.82% in the 3-year group, demonstrating noninferiority with a difference of -0.05 percentage points.
Key findings
- Cumulative incidence of colorectal cancer at 5 years was 0.77% for the 5-year group and 0.82% for the 3-year group.
- The upper boundary of the 99.12% confidence interval was 0.68, meeting the noninferiority criterion.
- 5 patients died of colorectal cancer: 3 in the 5-year group and 2 in the 3-year group.
Why it matters
The findings suggest that extending the interval for surveillance colonoscopy to 5 years after adenoma removal may be a safe alternative, potentially reducing the burden of unnecessary procedures without increasing cancer risk.