The recommendations for colonoscopy screening for polyps are based on studies of people aged 50 and up. The purpose of this research was to determine if current colonic polyp surveillance guidelines should be applied to individuals under the age of 45 in light of the recent decrease in colorectal cancer (CRC) screening at that age. For this study, researchers looked at patients with 2 colonoscopies within a decade and found a higher risk of developing colon cancer. Changes in Risk Stratification Groups (RSG) from index to surveillance colonoscopy were compared between 3 age cohorts: those below 45, those between 45 and 49, and those 50 and older, using the 5 RSGs developed using the surveillance colonoscopy interval times recommended by the US Multi-Society Task Force (USMSTF) on CRC. An additional analysis was performed for individuals whose RSG worsened between the index and surveillance colonoscopy because this was considered an improper monitoring interval. There were a total of 1,895 patients considered for this report. There was no statistically significant association between age and a deteriorated RSG in a multivariate regression model comparing those under 45 to those 50 and older (odds ratio [OR]=0.840, 95% CI [0.504-1.399], P=0.50) or those 45-49 to those 50 and older (OR=1.416, 95% CI [0.5905-2.216], P=0.13). After accounting for other factors, it was observed that only being female was statistically linked with poorer RSG (OR=0.652, 95% CI: 0.486-0.875, P<0.01). Patients under the age of 45 and those between the ages of 45 and 49 were not more likely to have more advanced polyps, requiring a shorter time for surveillance colonoscopy than patients 50 and older, according to our study. This finding lends credence to the practice of employing colonoscopy criteria for the surveillance of colonic polyps that were originally designed for patients aged 50 and up, in individuals aged 45–49 as well.