American Board of Internal Medicine (ABIM) Certification Practice Exam

In patients with large colon adenomas, what is the recommended interval for postpolypectomy surveillance?

1. 1 year

2. 3 to 6 months

3. 5 years

4. 10 years

The correct answer is: 3 to 6 months

The recommended interval for postpolypectomy surveillance in patients with large colon adenomas is typically 3 to 6 months. This recommendation is based on the increased risk of developing colorectal cancer associated with adenomas, especially when they are large (greater than 1 cm) or have high-grade dysplasia. The rationale is that after the removal of such adenomas, careful monitoring is necessary to ensure that new adenomas do not develop or that any remaining dysplastic tissue does not lead to malignancy. Regular surveillance allows for timely detection and management of recurrent or new polyps. Ideally, a colonoscopy during this timeframe will provide a clear view of the remaining mucosa in the colon and allow for any subsequent interventions if necessary. For smaller adenomas or patients with a lower risk profile, longer intervals between surveillance procedures are appropriate, which is why the other time frames mentioned, such as 1 year, 5 years, or 10 years, do not fit the recommended practice for those with large adenomas.