Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines

Background: The risk of metachronous advanced neoplasia is linked to the presence of polyps on initial colonoscopy. Consequently, it is crucial to establish an appropriate colonoscopy surveillance period post-polypectomy.Current Concepts: The US Multi-Society Task Force, the European Society of Gastrointestinal Endoscopy, and the British Society of Gastroenterology revised their respective foreign guidelines in the 2020s. In Korea, a revised edition of post-polypectomy colonoscopic surveillance was announced in 2022, with the following risk factors: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesions containing any grade of dysplasia; (7) serrated polyps of at least 10 mm in size; and (8) 3 to 5 (or more) sessile serrated lesions. In these guidelines, suitable surveillance periods are suggested for each risk factor.Discussion and Conclusion: The evidence supporting the best practices for post-polypectomy colonoscopy surveillance has strengthened, helping to support both close follow-up for some populations and less intense follow-up for others.