Whether colonoscopy surveillance is useful depends on the impact of colonoscopy surveillance on colorectal cancer incidence and colorectal cancer related mortality. After the introduction of colorectal cancer screening programs, with improved colonoscopy quality, and the publication of new scientific literature, the European guideline for colonoscopy surveillance was revised in 2020. The new guideline is easy to follow and differentiates between individuals with a high- and low-risk profile. Individuals with a high-risk profile have an increased risk of colorectal cancer and colorectal cancer related mortality and should therefore undergo a surveillance colonoscopy. The new Dutch colonoscopy surveillance guideline is based on the European guideline. It is expected that, following the new guideline, less individuals will need to undergo colonoscopy surveillance without increasing their risk of colorectal cancer or colorectal cancer related mortality as compared to the general population. In our view, this is a good example of meaningful care.