Serrated polyps–a concealed but prevalent precursor of colorectal cancer

Henrik Thorlacius, Yoji Takeuchi, Takashi Kanesaka, Otto Ljungberg, Noriya Uedo, E. Tóth

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Serrated polyps have long been considered to lack malignant potential but accumulating data suggest that these lesions may cause up to one-third of all sporadic colorectal cancer. Serrated polyps are classified into three subtypes, including sessile serrated adenomas/polyps (SSA/Ps), traditional serrated adenomas (TSAs), and hyperplastic polyps (HPs). SSA/P and TSA harbour malignant potential but TSA represents only 1–2%, wheras SSA/P constitute up to 20% of all serrated lesions. HPs are most common (80%) of all serrated polyps but are considered to have a low potential of developing colorectal cancer. Due to their subtle appearence, detection and removal of serrated polyps pose a major challenge to endoscopists. Considering that precancerous serrated polyps are predominately located in the right colon could explain why interval cancers most frequently appear in the proximal colon and why colonoscopy is less protective against colon cancer in the proximal compared to the distal colon. Despite the significant impact on colorectal cancer incidence, the aetiology, incidence, prevalence, and natural history of serrated polyps is incompletely known. To effectively detect, remove, and follow-up serrated polyps, endoscopists and pathologists should be well-informed about serrated polyps. This review highlights colorectal serrated polyps in terms of biology, types, diagnosis, therapy, and follow-up.

Original languageEnglish
Pages (from-to)654-661
Number of pages8
JournalScandinavian Journal of Gastroenterology
Volume52
Issue number6-7
DOIs
Publication statusPublished - Jul 3 2017

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Polyps
Colorectal Neoplasms
Adenoma
Colon
Incidence
Colonoscopy
Natural History
Colonic Neoplasms
Adenocarcinoma

Keywords

  • colonoscopy
  • Colorectal cancer
  • hyperplastic
  • malignant
  • polyps

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Serrated polyps–a concealed but prevalent precursor of colorectal cancer. / Thorlacius, Henrik; Takeuchi, Yoji; Kanesaka, Takashi; Ljungberg, Otto; Uedo, Noriya; Tóth, E.

In: Scandinavian Journal of Gastroenterology, Vol. 52, No. 6-7, 03.07.2017, p. 654-661.

Research output: Contribution to journalReview article

Thorlacius, Henrik ; Takeuchi, Yoji ; Kanesaka, Takashi ; Ljungberg, Otto ; Uedo, Noriya ; Tóth, E. / Serrated polyps–a concealed but prevalent precursor of colorectal cancer. In: Scandinavian Journal of Gastroenterology. 2017 ; Vol. 52, No. 6-7. pp. 654-661.
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