In the United States and worldwide, public health officials are publishing guidelines for the management of high risk patients with biopsy proven colorectal polyps [1]. With respect to high risk patients with colorectal polyps , they have 20.6%risk of developing a recurrence in 3 years when compared with those without this diagnosis following an initial colonoscopy Further, such high risk patients who are diagnosed with advanced colorectal polyps have a 3 fold higher subsequent risk of developing colorectal cancer [2, 3]. These alarming increased rates of recurrence of colorectal polyps as well as colorectal cancer pose clinical and public health challenges.