Serrated polyposis syndrome may go undiagnosed even in structured colorectal cancer screening programmes performed by endoscopists with otherwise good quality indices

Schramm, C; Janhsen, Katharina; Demir, Münevver; Nierhoff, Dirk; Goeser, Tobias; Steffen, H.

doi:10.1136/gutjnl-2017-315321

Cited by 2 publications

(4 citation statements)

References 6 publications

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“…The strengths of this study include that it is by far the largest study to specifically address the issue of underdiagnosis of SPS 1 5 6 7 8 9 10 , with outside medical records available in 92.6% of 229 patients referred for resection of a specific lesion and diagnosed with SPS. Limitations of the study include that it arises from a single center with the diagnosis of SPS largely made by a single expert endoscopist.…”

Section: Discussionmentioning

confidence: 99%

“…In our large single-center experience, no patient has developed CRC during surveillance [4]. Some evidence suggests SPS is underdiagnosed in the community [1,[5][6][7][8][9][10]. At our center, SPS cases are diagnosed in many cases in patients with polyps referred for endoscopic resection [6].…”

Section: Introductionmentioning

confidence: 98%

“…Some evidence suggests SPS is underdiagnosed in the community 1 5 6 7 8 9 10 . At our center, SPS cases are diagnosed in many cases in patients with polyps referred for endoscopic resection 6 .…”

Section: Introductionmentioning

confidence: 99%

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Frequency of serrated polyposis syndrome recognition by community endoscopists

McWhinney,

Lahr,

Rex

2023

Endosc Int Open

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Background and Aims: Some data indicate serrated polyposis syndrome (SPS) is underdiagnosed. We determined the frequency of SPS diagnosis by community endoscopists prior to referral to a tertiary center. Methods: We performed a retrospective analysis of a prospectively collected database of SPS patients at a tertiary academic hospital. There were 219 patients who were referred to our center for resection of one or more lesions detected at a prior colonoscopy and who had records available that allowed determination of whether SPS was diagnosed before referral. Results: Only 25/219 (11.7%) had a diagnosis or suspicion of a polyposis syndrome prior to referral, and only 12 patients (5.7%) had a specific SPS diagnosis made prior to referral. Among 187 patients diagnosed at our center, 39 had sufficient serrated lesions removed and documented in outside records to meet SPS criteria prior to referral, but the diagnosis was not made by the referring physician despite adequate numbers of lesions resected. The remaining cases required lesions removed at our center to meet SPS diagnostic criteria. Limitations were a single center, single expert endoscopist. Conclusions: SPS is the most common colorectal polyposis syndrome, but it remains underdiagnosed by community endoscopists. Underdiagnosis may contribute to post-colonoscopy colorectal cancer in patients with SPS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Frequency of serrated polyposis syndrome recognition by community endoscopists

McWhinney,

Lahr,

Rex

2023

Endosc Int Open

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“…The prevalence of SPS is estimated to be as high as 1: 127 and 1:238, respectively, in Spanish and Dutch screening cohorts (19). Studies have shown that diagnosis of SPS is missed in patients undergoing routine colonoscopy, suggesting that the actual prevalence could be higher than currently known (20)(21)(22). Patients with SPS have a substantial risk for development of metachronous advanced precancerous lesions (23).…”

Section: Discussionmentioning

confidence: 99%

Cancer Risk in Patients With and Relatives of Serrated Polyposis Syndrome and Sporadic Sessile Serrated Lesions

Kanth

Keener

et al. 2021

Am J Gastroenterol

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INTRODUCTION: Patients with serrated polyposis syndrome (SPS) and their first-degree relatives (FDRs) have increased colorectal cancer (CRC) risk. Patients with sporadic sessile serrated lesion (SSL) have risk for progression to CRC. Yet familial risks of common extracolonic cancers and even CRC in these cohorts are poorly understood. Our aim was to examine cancer risk for patients with SPS and sporadic SSL and their close and more distant relatives using a large population database. METHODS:Patients with SPS (n 5 59) from hereditary patient registries were eligible for study. Sporadic SSL (n 5 754) and sex-and age-matched normal colonoscopy controls (n 5 1,624) were selected from clinical data linked to the Utah Population Database. Cox models adjusting for the number of relatives, degree of relatedness, and person-years at risk were used to estimate CRC, extracolonic, and any-site adenocarcinoma/carcinoma cancer risk in patients and their relatives. RESULTS:Compared with controls, CRC risk was elevated 10-fold in patients with SPS (P 5 0.04) and 5-fold in their FDRs (P 5 0.001). Any-site adenoma/carcinoma risk was increased 2.6-fold in FDRs of patients with SPS. No elevated risks of other common extracolonic cancers were observed in SPS and family members. The FDRs, second-degree relatives, and third-degree relatives of patients with both SSL and adenomatous polyps exhibited a 50% increased CRC risk. DISCUSSION:Patients with SPS and their FDRs have an increased CRC risk, confirming other reports. Interestingly, patients with SSL were noted to have an increased risk of prostate cancer. Relatives of individuals with both sporadic SSL and adenomas, irrespective of size or dysplasia on examination, may have an elevated CRC risk, suggesting closer colonoscopy surveillance in this population.

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Serrated polyposis syndrome may go undiagnosed even in structured colorectal cancer screening programmes performed by endoscopists with otherwise good quality indices

Cited by 2 publications

References 6 publications

Frequency of serrated polyposis syndrome recognition by community endoscopists

Frequency of serrated polyposis syndrome recognition by community endoscopists

Cancer Risk in Patients With and Relatives of Serrated Polyposis Syndrome and Sporadic Sessile Serrated Lesions

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