Serrated Polyposis Syndrome Remains Very Underdiagnosed by Community Endoscopists
Douglas K. Rex, MD, MASGE, reviewing McWhinney CD, et al. Endosc Int Open 2023 Aug 21.
Serrated polyposis syndrome (SPS) is the most common type of polyposis syndrome, affecting as many as one in every 250 persons undergoing screening colonoscopy. It is also frequently underdiagnosed.
This study assessed 212 patients with SPS referred to a single U.S. center for resection of one or more lesions detected at a previous colonoscopy by a community endoscopist.
A review of outside records demonstrated that only 25 patients (11.7%) had a diagnosis or suspicion of polyposis syndrome before referral, and only 12 (5.7%) had a specific diagnosis of SPS before referral. There were 39 patients with a sufficient number of serrated lesions removed by the community endoscopist to make an SPS diagnosis, yet the diagnosis was not made. The remaining patients required resection of serrated lesions at the referral center.
COMMENTSPS is very common, and making the diagnosis and labeling the patient as having SPS provides extra protection against colorectal cancer because short-interval follow-up is recommended for patients with SPS. When multiple serrated lesions are detected, a careful search for additional serrated lesions, combined with clear documentation of the number, size, and location, can optimize the sensitivity for SPS diagnosis.
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)
McWhinney CD, Lahr RE, Rex DK. Frequency of serrated polyposis syndrome recognition by community in endoscopists. Endosc Int Open 2023 Aug 21. (Epub ahead of print) (https://doi.org/10.1055/a-2157-4125)
