Colorectal Cancer Screening for the Serrated Pathway - 19/05/20

Doi : 10.1016/j.giec.2020.02.007

Joseph C. Anderson, MD, MHCDS ^a,^b,^c,^⁎ , Amitabh Srivastava, MD ^d
^a Department of Veterans Affairs Medical Center, White River Junction, VT, USA
^b The Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755, USA
^c Division of Gastroenterology and Hepatology, University of Connecticut School of Medicine, Farmington, CT 06030, USA
^d Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA

^∗Corresponding author. The Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755.The Geisel School of Medicine at Dartmouth1 Rope Ferry RoadHanoverNH03755

Résumé

Serrated polyps are classified into hyperplastic polyps, sessile serrated adenomas/polyps, and traditional serrated adenomas. Although all serrated polyps share characteristic colonic crypts serrations, distinguishing hyperplastic polyps from sessile serrated adenomas/polyps is challenging. Traditional serrated adenomas are cytologically dysplastic lesions; sessile serrated adenomas/polyps develop cytologic dysplasia as they progress to colorectal cancer. A flat and pale appearance of serrated polyps may make detection difficult. Endoscopic mucosal resection has higher rates of complete resection. Close surveillance is recommended for sessile serrated adenomas/polyps, sessile serrated adenomas/polyp with dysplasia, hyperplastic polyps ≥10 mm, and traditional serrated adenomas.

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Keywords : Serrated polyps, Colorectal cancer, Hyperplastic polyps, Sessile serrated polyps, Traditional serrated adenomas, Resection and surveillance