May 2024 | George M. Pikler, M.D., Ph.D., FACP, Lead Oncology Advocate N1X10

Interval Between a First Negative Colonoscopy and Repeat Colonoscopy

Colorectal cancer [CRC] ranks second among cancer deaths in both men and women in the United States, with an estimated 152,810 new cases and 53,010 deaths anticipated in 2024. Colonoscopy is advocated as an important screening test for CRC in multiple guidelines and has been the predominant form of screening for CRC used in the U.S.

When should a second colonoscopy be performed after a first negative colonoscopy for colorectal polyp, adenoma, carcinoma in situ, or colorectal cancer (CRC)?

For individuals without a family history of CRC, rescreening 10 years after the first normal colonoscopy examination has been the recommended interval. This interval originated primarily from a consensus on the time frame for adenoma to transform to carcinoma.

Emerging studies indicate that the currently recommended 10-year colonoscopy screening interval could probably be extended. One cross-sectional study on findings at a follow-up colonoscopy found a low prevalence of advanced colorectal neoplasms when reexaminations were conducted 10 or more years after a negative screening colonoscopy examination.

A nationwide cohort (1) study conducted in Sweden, from January 1990 to December 2018, found that for the population without a family history of CRC, and a negative first colonoscopy for CRC conducted at ages 45 to 69 years, a repeat colonoscopy 15 years later (instead of the current 10-year interval) could be justifiable. This longer interval could be beneficial in avoiding unnecessary invasive examinations.

1. JAMA Oncol. May 2, 2024

Erica Cross, PA


Erica is a board certified Physician Assistant. She obtained her Master’s degree in Physician Assistant studies from Our Lady of the Lake College in Baton Rouge, LA. She began practicing in 2011 and has worked clinically in Orthopedics and Dermatology. The majority of her career has been spent in a Dermatology practice where she assisted in Mohs surgery, treating various types of skin cancer. She also teaches in the medical simulation department at the University of South Alabama and enjoys every aspect of medical education.