There are a variety of opinions about this, among both doctors and J-pouchers. It also depends on the purpose of the surveillance. The risk of cancer developing in the rectal cuff is low but rectal cuff cancers do show up now and then. Sometimes inflammation or strictures or fistulas need to be managed. Folks who had colectomies because of cancer or dysplasia often choose annual pouchoscopies, and folks who had colectomies for FAP issues may have even more frequent scopes. Others tend to work out a plan with their GI or surgeon - some choose a time-based interval, and others don’t bother unless there are symptoms that need clarification. I tend toward the less frequent, symptom-based approach, so it’s been at least five years since my last pouchoscopy. It will be interesting to see what Dr. Shen recommends for you, but I’d suggest making sure he’s aware of the financial hardship first, so he can strike a proper balance in his recommendation.
Some folks are quite certain that some particular frequency is *correct*, but there’s not really much justification for that kind of certainty. The cancer risk in particular, which is positively enormous for folks with longstanding UC and intact colons, becomes a much smaller matter when the amount of colonic tissue is also much smaller.
This has been discussed frequently here in the past, and if you can fashion a search that turns up some of those discussions you will likely find them useful. I’d suggest including “annual” as one of the search terms to help locate the most relevant conversations.