Serrated Polyposis Syndrome
Serrated Polyposis Syndrome
Updated: 02/28/2022
© Jun Wang, MD, PhD
General features
- Previously called hyperplastic polyposis syndrome
- More common age 50-60
- Increased risk for colon rectal cancer
- Associated with cigarettes smoking and high BMI
- Increased risk of colorectal cancer
Clinical presentations
- Usually asymptomatic
- Endoscopic findings of large or flat polyps
Key morphological features
Genetic abnormalities
- Overall uncommon
- BRAF: Type1, commonly female smokers
- KRAS: Type 2,
- RNF43
Diagnostic criteria
- More than 5 serrated polyps proximal to the sigmoid colon, at least 2 of these are larger than 1 cm
- Any serrated polyps proximal to the sigmoid colon in a patient with a first degree relative with serrated polyposis syndrome
- More than 20 serrated polyps of any size in the colon
Treatment
- Polypectomy, complete removal recommended
- Colonoscopy every 1-3 years
- Surgery if treatment/surveillance inadequate
- First degree relatives: screen at the earliest of youngest age of SPS, or 10 years earlier than first colon rectal cancer, or by age 40
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