De-implementation of Outdated Colonoscopy Surveillance Interval Recommendations Among Patients With Low-risk Adenomas

Inclusion Criteria: * Kaiser Permanente Northern California (KPNC) membership\>12 months * Primary medical center is either KP San Rafael, KP San Francisco, KP San Leandro, or KP Walnut Creek * 54-70 years of age at time of 5-year surveillance colonoscopy interval * A baseline colonoscopy with a finding of 1-2 small tubular adenomas and are due for their 5-year surveillance procedure in 2022 * Average risk for CRC * A valid mailing address, kp.org account (i.e., KPNC's secure messaging portal), and telephone number at time of study enrollment. Exclusion Criteria: * More than 12 months of membership prior to index colonoscopy, and indications that would make an individual above average risk for CRC, such as: adenoma with advanced histology on colonoscopy, adenoma \>10 mm on colonoscopy, family history of CRC, prior history of colonoscopy, prior history of adenomas or colon polyp diagnoses, history of IBD, history of hereditary polyposis syndrome, 3 or more adenomas, adenoma 10 mm in size or greater, adenoma with advanced histology, and any sessile serrated polyp or traditional serrated adenoma