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Intramocusal andenocarcinoma on rectum
Hello Doctor.
I had intramucosal adenocarcinoma of the rectum about 9 years ago, arising from a 2 × 2 cm tubulovillous adenoma, moderately differentiated, with no invasion beyond the muscularis mucosa. Only polypectomy was performed, and no further treatment was required. The report showed MSI-negative / MMR-proficient.
At that time, MRI of the pelvis and a CT scan were normal, and the post-polypectomy site biopsy showed no dysplasia or malignancy.
Follow-up has been done regularly: • Colonoscopy – about 10 times, all normal (last on 12 November 2025)
• Whole abdomen ultrasound – about 10 times, all normal
• Blood tests – about 6 times, all normal
• Chest X-ray (PA view) – 4 times, all normal
Kindly advise the appropriate interval for my future surveillance colonoscopy. Also, if a new polyp appears in the future, would it necessarily be malignant in my case, or would it usually be benign? If I undergo colonoscopy every year, what is the risk that a new polyp could be malignancy?
Answers (10)
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Since it was intramucosal (very early) cancer and 9 years of normal follow-up, risk of recurrence is very low.
Usually colonoscopy every 3–5 years is enough if previous ones are normal.
New polyps are often benign, not necessarily cancer. Continue follow-up with your gastroenterologist.
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Hello.
From your history, the lesion was intramucosal adenocarcinoma arising from an adenoma and completely removed by polypectomy, with no invasion beyond the mucosa and normal follow-up investigations for many years. This generally indicates a very good prognosis.
Next steps:
If your recent colonoscopies have been consistently normal, many guidelines suggest surveillance colonoscopy every 3–5 years, rather than yearly, unless your treating gastroenterologist advises otherwise based on individual risk factors.
Helpful tips:
• If a new polyp appears in the future, it does not necessarily mean cancer. Most colon polyps are benign adenomas.
• Regular surveillance helps detect and remove polyps before they become malignant.
• Maintain a healthy lifestyle: high-fiber diet, regular exercise, avoiding smoking, and limiting processed/red meat.
Since you have had a significant past history, it would be best to continue follow-up with your gastroenterologist, who can decide the exact surveillance interval based on your previous pathology and risk profile.
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Yearly colonoscopy for five years and if that is normal then every three years
Every year CBP
Every year Faecal occult blood- if turns positive at any point, additional colonoscopy.
Screening Gastroscopy at least once to check for duodenal polyps.
No way of knowing which polyps will be benign to be honest.
All the best.
WWW.JGSR-HEALTH-EDUCATION.IN
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