American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended follow-up interval for patients with three to ten adenomas after colonoscopy?

1. 1 year

2. 3 years

3. 5 years

4. 10 years

The correct answer is: 3 years

For patients who have had a colonoscopy revealing three to ten adenomas, the recommended follow-up interval is indeed three years. This guidance is supported by the guidelines established by the American College of Gastroenterology and other relevant organizations, which focus on the significance of adenomas found during screening. The rationale for a three-year follow-up is based on the increased risk of colorectal cancer associated with having multiple adenomas. Specifically, the presence of three to ten adenomas indicates a moderate risk of progression to colorectal cancer, and thereby necessitates closer surveillance compared to patients with fewer or no adenomas. This proactive approach allows for early detection and intervention should more significant changes occur in the colon over time. In contrast, patients with fewer than three adenomas or specific low-risk findings may have longer surveillance intervals, with options such as five or ten years, while those with more than ten adenomas may require more frequent monitoring. The three-year interval thus represents a balanced approach to ensuring patient safety and maintaining vigilance against potential developments in colorectal pathology.