American Board of Internal Medicine (ABIM) Certification Practice Exam

How often should patients with an adenoma 10 mm or larger undergo colonoscopy?

1. 3 years

2. 5 years

3. 1 year

4. 10 years

The correct answer is: 3 years

Patients with an adenoma that is 10 mm or larger should undergo colonoscopy every 3 years. This recommendation is based on guidelines that recognize the increased risk of colorectal cancer associated with larger adenomas. The frequency of surveillance colonoscopy is structured to balance the need for early detection of potential malignancy while also considering the risks associated with the procedure itself. Larger adenomas in particular are associated with a higher likelihood of containing or developing advanced neoplasia. Therefore, a more frequent surveillance interval is warranted to ensure timely identification and management of any potential progression. In contrast, the surveillance intervals for smaller adenomas or those that do not possess certain high-risk features would be longer, such as 5 years or even 10 years for polyps below specified thresholds. The one-year interval is typically reserved for patients with more significant findings or ongoing high-risk factors rather than for those with just a sizable adenoma.