American Board of Internal Medicine (ABIM) Certification Practice Exam

What follow-up is advised for patients with polyps larger than 20 mm?

1. 3 months

2. 6 months

3. 1 year

4. 3 to 6 months

The correct answer is: 3 to 6 months

For patients with polyps larger than 20 mm, the recommended follow-up is typically 3 to 6 months after the initial detection. This interval is crucial because larger polyps are associated with a higher risk of colorectal cancer and may require careful monitoring and possibly further intervention. The rationale behind this relatively short follow-up period is to ensure that any potentially malignant transformation is identified and managed promptly. In the context of surveillance guidelines, polyps of this size are often considered to be adenomatous, and their presence can indicate an increased risk of advanced neoplasia. Therefore, following up too far in the future could allow for a more significant progression of disease that might be preventable with earlier intervention. Monitoring within 3 to 6 months allows for a balance between necessary vigilance and practical follow-up care, enabling clinicians to act swiftly if any concerning changes are identified during surveillance.