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Highlights from the March GIE: Gastrointestinal Endoscopy special issue on colorectal cancer
Date:3/19/2013

nable to reliably diagnose polyps, histologic evaluation remains the criterion standard for accurate diagnosis. The most important type of serrated polyp is the sessile serrated adenoma/polyp (SSA/P). The prevalence of SSA/Ps ranges from one percent to nine percent of all colonic polyps. SSA/Ps are most commonly found in women, unlike the male-predominant conventional adenomas. Risk factors for SSA/Ps (and conventional adenomas) include older age, sex, smoking, and obesity; the latter two risk factors also independently predict large (>10 mm) SSA/Ps. Importantly, patients with SSA/Ps are more likely to have a greater polyp burden and synchronous and metachronous neoplastic lesions than patients without SSA/Ps. In addition, the progression from SSA/P with cytologic dysplasia to invasive carcinoma (cancer) may be relatively rapid. Complete removal of polyps, particularly small, flat, right-sided polyps (such as SSA/Ps) is challenging and associated with the development of interval carcinoma, likely through missing or incompletely removing the precursor lesion.

In September 2012, the U.S. Multi-Society Task Force on CRC (colorectal cancer) released updated guidelines for colonoscopy surveillance with a much-needed expansion on the management of serrated polyps. In addition to the U.S. Multi-Society Task Force guidelines, an expert consensus opinion was separately published in 2012 based on an expert panel discussion and review of advancements and insights in the serrated polyp literature. The 2012 guidelines have placed serrated polyps >10 mm or with cytologic dysplasia in the same surveillance category as high-risk adenomas with a three-year surveillance interval. The guidelines also advise a one-year surveillance interval for serrated polyposis (formerly "hyperplastic polyposis") a phenotypically variable condition associated with increased serrated polyps and an up to nearly 40 percent risk of colorectal cancer.

The expert consensus opinions reco
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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