Could we safely extend surveillance colonoscopy intervals after high-risk adenoma removal? A randomized trial published in @NEJM challenges the traditional 3-year surveillance interval for patients with high-risk colorectal adenomas. The EPoS II trial randomized 10,799 patients to surveillance colonoscopy at 3 versus 5 years following polyp removal. Key findings at 5 years: -Colorectal cancer incidence: 0.82% (3-year group) vs. 0.77% (5-year group). -The 5-year strategy met the prespecified criterion for noninferiority. -Cancer stage at diagnosis did not differ substantially between groups. These findings raise an important question: Can we safely extend surveillance intervals without compromising colorectal cancer prevention? The implications could be significant for optimizing surveillance practices, improving endoscopy capacity, and expanding access to colorectal cancer screening. Importantly, these are interim findings from an ongoing 10-year trial and current surveillance guidelines remain unchanged pending further evidence and guideline review. #ColorectalCancer #Colonoscopy #ColorectalSurgery #CancerPrevention #EvidenceBasedMedicine @ASCRS_1 @AmericanCancer @SWexner @ASGEendoscopy @AmCollegeGastro @DouglasAdlerMD