Many patients with low-risk polyps are getting colonoscopies too soon

A large study out of Kaiser Permanente found that endoscopists are frequently scheduling follow-up colonoscopies sooner than guidelines recommend for patients with one to two nonadvanced adenomas — a low-risk group that the 2020 US Multi-Society Task Force says should wait 7–10 years between screenings. The study analyzed over 41,000 patients across 281 endoscopists and found that guideline adherence for this group hovered between 68% and 72% from 2021 to 2024.

By contrast, patients with three to four nonadvanced adenomas fared much better — endoscopists followed the recommended 3–5-year interval more than 90% of the time. The gap suggests that clinicians may be applying more caution than necessary for lower-risk patients, potentially driving unnecessary procedures.

Key Takeaways:

• ~30% of patients with 1–2 nonadvanced adenomas were told to return in under 7 years — shorter than recommended
• Nonadherence was more common in older, male patients with higher BMI, smoking history, or multiple comorbidities
• Guideline authors suggest simplifying ranges (e.g., recommending exactly 7 or 10 years) to improve adherence

Why it matters: Over-surveillance means more colonoscopies than necessary, adding costs, procedural risks, and patient burden — without clear clinical benefit for low-risk individuals. Clearer, more specific guideline intervals could help close the gap.