Serrated polyposis syndrome: Diagnosis and management

Serrated polyposis syndrome is a clinical diagnosis characterized by a few large right-sided colorectal serrated polyps, multiple small serrated polyps, or a combination of both. Colorectal polyps and cancers develop via the methylator (or serrated) carcinogenic pathway. Patients with SPS have an increased risk of CRC compared to the general population throughout their lifetime and adequate surveillance and intervention are necessary. Cancer develops mainly via serrated polyp intermediates, but adenomas can also be present. The goals of management are to prevent the development of colorectal cancer and death from colorectal cancers. Colonoscopy beginning at age 40 at the latest, with polypectomy is the mainstay of clinical management. Surgery is utilized to treat colorectal cancer or decrease its risk. First-degree family members of patients with SPS are also at increased risk of colorectal cancer compared to the general population and increased colonoscopic screening is indicated.