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The clinical impact of serrated colorectal polyps

Authors O’Connell BM, Crockett SD

Received 11 October 2016

Accepted for publication 12 January 2017

Published 22 February 2017 Volume 2017:9 Pages 113—125

DOI https://doi.org/10.2147/CLEP.S106257

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Professor Henrik Toft Sørensen


Brendon M O’Connell,1 Seth D Crockett2

1Department of Medicine, 2Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

Abstract: Serrated polyps (SPs) of the colorectum pose a novel challenge to practicing gastroenterologists. Previously thought benign and unimportant, there is now compelling evidence that SPs are responsible for a significant percentage of incident colorectal cancer worldwide. In contrast to conventional adenomas, which tend to be slow growing and polypoid, SPs have unique features that undermine current screening and surveillance practices. For example, sessile serrated polyps (SSPs) are flat, predominately right-sided, and thought to have the potential for rapid growth. Moreover, SSPs are subject to wide variations in endoscopic detection and pathologic interpretation. Unfortunately, little is known about the natural history of SPs, and current guidelines are based largely on expert opinion. In this review, we outline the current taxonomy, epidemiology, and management of SPs with an emphasis on the clinical and public health impact of these lesions.

Keywords: serrated polyp, sessile serrated adenoma, sessile serrated polyp, traditional serrated adenoma, hyperplastic polyp, epidemiology, colonoscopy

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