Estimating Cancer Risk in Serrated Polyposis Syndrome
Douglas K. Rex, MD, MASGE, reviewing Muller C, et al. Clin Gastroenterol Hepatol 2021 Jun 2.
In a meta-analysis involving 36 studies and 2788 patients with serrated polyposis syndrome (SPS), the overall risk of colorectal cancer (CRC) was 19.9%. However, most patients were diagnosed with CRC at the same colonoscopy at which they were diagnosed with SPS, and the risk during surveillance was 2.8%. Interestingly, 7% of the patients with SPS had a history of CRC before the SPS diagnosis.
COMMENTThese data indicate that SPS is still frequently undiagnosed. A significant number of patients have been diagnosed with and operated on for CRC prior to the SPS diagnosis at a subsequent colonoscopy.
At our center, about 30% of patients referred for resection of a large serrated polyp are diagnosed with SPS at the index colonoscopy, but almost all previously went unrecognized as SPS. Surveillance risk can be decreased significantly below 2.8% by performing meticulous colonoscopic clearing involving almost entirely cold resection techniques.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Muller C, Yamada A, Ikegami S, et al. Risk of colorectal cancer in serrated polyposis syndrome: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2021 Jun 2. (Epub ahead of print) (https://doi.org/10.1016/j.cgh.2021.05.057)
