Colonoscopic Snare Polypectomy Colonoscopic surveillance is recommended for patients with adenomas because the risks of new (metachronous) adenomas and colorectal cancer among these patients are greater — by a factor of 2 to 4 — than they are among persons without adenomas. However, these risks vary considerably according to the characteristics of the index adenoma. The recognition that a larger size and more advanced histologic features are independent risk factors for the presence of invasive cancer within an adenoma has led to the use of the term "advanced adenoma" for adenomas that are 1 cm or larger in diameter or that have any advanced histologic features (tubulovillous or villous histologic features or high-grade dysplasia)
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