American Board of Internal Medicine (ABIM) Certification Practice Exam

For patients with ≥10 adenomas on a single examination, what is the recommended follow-up for colonoscopy?

1. 1 year

2. 3 years

3. 5 years

4. Less than 3 years

The correct answer is: Less than 3 years

For patients with 10 or more adenomas detected during a single colonoscopy examination, the recommended follow-up for colonoscopy is less than 3 years. This is necessary because having a high number of adenomas is associated with an increased risk of developing colorectal cancer. Current guidelines suggest that such patients are at an elevated risk for future neoplastic changes and therefore require closer surveillance. A follow-up interval of less than 3 years allows for more frequent monitoring and intervention if new adenomas or dysplastic changes develop. This proactive approach is critical since patients with a higher burden of adenomas may progress to more advanced lesions more quickly than those with fewer adenomas, hence the necessity for closer surveillance. In summary, when a patient presents with 10 or more adenomas at a single colonoscopy, initiating follow-up colonoscopy in less than 3 years is essential to manage their increased colorectal cancer risk effectively.