surveillance exam should be. So, not only have we made recommendations, which I hope are now clear, individuals with 1 to 2 tubular adenomas can get a 7 to 10-year interval, and individuals with 3 to 4 tubular adenomas can get a 3 to 5-year pass, and those with either 5 or more or large adenomas or advanced adenomas still are at a 3-year follow-up interval. However, knowing these findings, now, when individuals come for their first surveillance exam, we can start to re-stratify them even more, and the key here is that the stratification goes by the findings at the most recent colonoscopy. So, for instance, an individual that had 1 to 2 tubular adenomas in the past, you bring them back in 7 years, now they have a normal colonoscopy, they go to 10 years. They don't stay at that 7-year or at that 5-year, if that makes sense. However, if now you find an advanced adenoma, then their follow-up would be 3 years. So, if it makes sense, the most recent colonoscopy findings determine the next follow-up. So, for individuals that had 3 to 4 small tubular adenomas, and you brought them back in, say, 3 to 5 years, now they have a normal exam. They don't stay at that 3 to 5 interval, they now go to a 10-year interval. So, we're getting very comfortable at lengthening out these intervals, because having a single or multiple colonoscopies over a lifetime actually is a protective factor, if that makes sense. Individuals that had, say, an advanced adenoma at their last exam, and we gave them a 3-year pass, well, now if they have nothing on their colonoscopy, then they would again go back to a much longer interval. So, truly, their last colonoscopy determines their next follow-up. All right, so here's the same information for individuals that, for some of you that like flowcharts. And again, we're premising this on a high-quality colonoscopy, which is defined as an exam which is complete to the cecum with, hopefully, photo documentation of cecum landmarks, adequate bowel prep, adequate colonoscopist adenoma detection rate, and complete polyp resection. Once those conditions are met for a high-quality colonoscopy, we can re-stratify individuals based on what was found. 10 years for a normal exam, 7 to 10 for 1 to 2 small adenomas, 5 to 10 for 1 to 2 sessile serrated polyps, which I'll address shortly, 3 to 5 years for if they have 3 to 4 adenomas, and 3 years if they have 5 or more adenomas or large adenomas or adenomas with advanced features, and that also applies to findings of SSP.

surveillance exams

colonoscopy findings

tubular adenomas

advanced adenomas

follow-up interval