This case represents a common dilemma facing primary care providers and their gastrointestinal consultants. With an aging population and increased use of colonoscopy for screening, more elderly patients with neoplasia will be detected, and decisions regarding surveillance will be challenging. We need to use colonoscopy resources wisely. There is considerable evidence that many patients with small adenomas or hyperplastic polyps are getting frequent surveillance examinations. A good starting point for wise resource utilization would be close adherence to the new surveillance guidelines (Table 1).
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