Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

MKSAP: 57-year-old woman is evaluated after a recent screening colonoscopy

mksap
Conditions
May 27, 2017
Share
Tweet
Share

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 57-year-old woman is evaluated after a recent screening colonoscopy. The colonoscopy disclosed a 12-mm polyp in the ascending colon, which was removed. No other lesions were noted. On pathology, the lesion was found to be a sessile serrated polyp.

Physical examination findings are unremarkable.

Which of the following is the most appropriate time to repeat colonoscopy?

A. 1 year
B. 3 years
C. 5 years
D. 10 years

MKSAP Answer and Critique

Correct answer: B. 3 years.

Colonoscopy should be repeated in 3 years. The World Health Organization has classified serrated colorectal polyps into three categories: hyperplastic polyps, sessile serrated polyps, and traditional serrated adenomas. Hyperplastic polyps are believed to have no malignant potential, whereas sessile serrated polyps and traditional serrated adenomas are neoplastic. Sessile serrated polyps are thought to be the precursor of approximately 15% of sporadic colorectal cancers.

Recent guidelines have established recommendations for postpolypectomy surveillance colonoscopy intervals in patients with serrated polyps; the rationale for postpolypectomy surveillance is to detect recurrent neoplasia. Patients with large (≥10 mm) or dysplastic sessile serrated polyps or traditional serrated adenomas should undergo colonoscopy in 3 years.

A 1-year surveillance interval is recommended for patients with serrated polyposis syndrome. Serrated polyposis syndrome is a rare condition characterized by multiple or large serrated polyps, including hyperplastic polyps, sessile serrated polyps, traditional serrated adenomas, and possibly also adenomatous polyps. Patients with serrated polyposis syndrome are at increased risk of colorectal cancer.

The recommended postpolypectomy interval for patients with sessile serrated polyps smaller than 10 mm is 5 years. This patient’s sessile serrated polyp is larger than 10 mm, so this recommendation is not appropriate.

A 10-year average-risk interval is recommended for patients with small rectosigmoid hyperplastic polyps, but it is not appropriate for this patient because her large sessile serrated polyp carries a higher cancer risk.

Key Point

  • For patients with large (≥10 mm) or dysplastic sessile serrated polyps or traditional serrated adenomas, the recommended postpolypectomy surveillance colonoscopy interval is 3 years.

This content is excerpted from MKSAP 17 with permission from the American College of Physicians (ACP). Use is restricted in the same manner as that defined in the MKSAP 16 Digital license agreement. This material should never be used as a substitute for clinical judgment and does not represent an official position of ACP. All content is licensed to KevinMD.com on an “AS IS” basis without any warranty of any nature. The publisher, ACP, shall not be liable for any damage or loss of any kind arising out of or resulting from use of content, regardless of whether such liability is based in tort, contract or otherwise.

Prev

The unhappy couples after a cancer diagnosis

May 26, 2017 Kevin 0
…
Next

Bearing witness: An oncologist's role at the end of life

May 27, 2017 Kevin 0
…

Tagged as: Gastroenterology

Post navigation

< Previous Post
The unhappy couples after a cancer diagnosis
Next Post >
Bearing witness: An oncologist's role at the end of life

ADVERTISEMENT

More by mksap

  • a desk with keyboard and ipad with the kevinmd logo

    MKSAP: 26-year-old man with back pain

    mksap
  • a desk with keyboard and ipad with the kevinmd logo

    MKSAP: 36-year-old man with abdominal cramping, diarrhea, malaise, and nausea

    mksap
  • a desk with keyboard and ipad with the kevinmd logo

    MKSAP: 52-year-old woman with osteoarthritis of the right hip

    mksap

Related Posts

  • a desk with keyboard and ipad with the kevinmd logo

    MKSAP: 35-year-old woman with constipation

    mksap
  • a desk with keyboard and ipad with the kevinmd logo

    MKSAP: 60-year-old woman with persistent constipation

    mksap
  • a desk with keyboard and ipad with the kevinmd logo

    MKSAP: 45-year-old woman with type 2 diabetes mellitus

    mksap
  • 3 ways we’ve failed woman who breastfeed

    Joanna Buscemi, PhD
  • How one woman prevented a pharmaceutical disaster

    James Essinger and Sandra Koutzenko
  • When breast cancer screening guidelines conflict: Some patients face real consequences

    Leda Dederich

More in Conditions

  • America’s ER crisis: Why the system is collapsing from within

    Kristen Cline, BSN, RN
  • Why timing, not surgery, determines patient survival

    Michael Karch, MD
  • Why psychotherapy works and why psychotherapy fails

    Peggy A. Rothbaum, PhD
  • How oral health silently affects your heart, brain, and body

    Charles Reinertsen, DMD
  • How President Biden’s cognitive health shapes political and legal trust

    Muhamad Aly Rifai, MD
  • The emotional first responders of aesthetic medicine

    Sarah White, APRN
  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why financial planning is a critical tool for physician well-being [PODCAST]

      The Podcast by KevinMD | Podcast
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How medicine repurposing enables value-based pain management and insomnia therapy

      Olumuyiwa Bamgbade, MD | Meds
    • Finding balance and meaning in medical practice: a holistic approach to professional fulfillment

      Dr. Saad S. Alshohaib | Physician
    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why financial planning is a critical tool for physician well-being [PODCAST]

      The Podcast by KevinMD | Podcast
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How medicine repurposing enables value-based pain management and insomnia therapy

      Olumuyiwa Bamgbade, MD | Meds
    • Finding balance and meaning in medical practice: a holistic approach to professional fulfillment

      Dr. Saad S. Alshohaib | Physician
    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...