British Society of Gastroenterology position statement on serrated polyps in the colon and rectum

James E. East*, Wendy S. Atkin, Adrian C. Bateman, Susan K. Clark, Sunil Dolwani, Shara N. Ket, Simon J. Leedham, Perminder S. Phull, Matt D. Rutter, Neil A. Shepherd, Ian Tomlinson, Colin J. Rees

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

200 Citations (Scopus)

Abstract

Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations - serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. Key recommendation: we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years (weak recommendation, low quality evidence, 90% agreement).

Original languageEnglish
Pages (from-to)1181-1196
Number of pages16
JournalGut
Volume66
Issue number7
Early online date27 Apr 2017
DOIs
Publication statusPublished - 1 Jul 2017

Bibliographical note

Publisher Copyright:
© 2017 Published by the BMJ Publishing Group Limited.

Keywords

  • COLONIC NEOPLASMS
  • COLONOSCOPY
  • COLORECTAL CANCER
  • HISTOPATHOLOGY
  • POLYPOSIS

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