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This one could reshape post-polypectomy surveillance. In nearly 11,000 patients with high-risk adenomas, waiting 5 years instead of 3 for the first surveillance colonoscopy was noninferior for colorectal cancer incidence (under 1% in both arms), with no apparent shift toward later-stage disease and roughly half as many colonoscopies. The 3-year arm picked up more advanced adenomas (15% vs 11%), but that didn't translate into fewer or earlier cancers. Caveats: this is an interim analysis that only narrowly met noninferiority, and only about two-thirds of patients completed 5-year surveillance, so the 10-year data will be the real test before guidelines move.