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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