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Guidelines for Surveillance Intervals after Polypectomy: Coping with the Evidence

Thomas F. Imperiale, MD; and Harold C. Sox, MD, Editor
[+] Article, Author, and Disclosure Information

From Indiana University, Indianapolis, IN 46202, and American College of Physicians, Philadelphia, PA 19106.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Thomas F. Imperiale, MD, Indiana University, Regenstrief Institute, 1050 Wishard Boulevard, Indianapolis, IN 46202.

Current Author Addresses: Dr. Imperiale: Indiana University, Regenstrief Institute, 1050 Wishard Boulevard, Indianapolis, IN 46202.

Dr. Sox: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.

Ann Intern Med. 2008;148(6):477-479. doi:10.7326/0003-4819-148-6-200803180-00010
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Economically advanced countries are having trouble coping with the consequences of advancing technology. They are asking how much health care is the right amount. The factors influencing how often to do surveillance colonoscopy after polypectomy encapsulate many elements of this debate. Patients are afraid of harboring undetected cancer, and physicians are afraid of missing an opportunity to prevent cancer. The resources devoted to surveillance colonoscopy may limit access to health care for other valid indications (13) and leave less to spend on disease prevention, prenatal care, or elementary school education. Finally, the evidence provides little guidance on optimal surveillance frequency.

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