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prevention of colon carcinoma - kallastro
#1
A healthy 53-year-old black man undergoes routine screening colonoscopy. He has no family history of colon cancer and no symptoms of any gastrointestinal illness. A single 0.7-cm polyp found at the rectosigmoid junction is successfully removed. Pathologic examination shows a tubular adenoma with low-grade dysplasia. What is the most appropriate follow-up?
A. None; schedule repeat colonoscopy in 10 years
B. Flexible sigmoidoscopy in 1 year
C. Colonoscopy in 1 year
D. Colonoscopy in 3 years
E. Colonoscopy in 5 years
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#2
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#3
E.

Two thirds of polyps found on colonoscopy are adenomas, which are by definition dysplastic and, therefore, have malignant potential. They are classified based on glandular architecture (tubular, villous, tubulovillous) and degree of dysplasia (low- or high-grade). Joint guidelines from the American College of Gastroenterology and the American Gastroenterological Association recommend surveillance colonoscopy in 5 years for patients with 1 or 2 small (<1 cm) tubular adenomas and no family history of colon cancer. Patients with multiple adenomas (>3), a large adenoma (>1 cm), villous histology or high-grade dysplasia, or a positive family history of colon cancer should undergo repeat surveillance colonoscopy in 3 years
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#4
E.
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