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 commissioned by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement.
Dr Colin Rees and colleagues provided clinical guidance until the evidence becomes available to support a formal guideline.
|The scope of the position statement included evidence that serrated lesions have premalignant potential|
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, 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 more than 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.
Dr Rees' team concludes, "We suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions that appear associated with a higher risk of future neoplasia or colorectal cancer should be offered a one-off colonoscopic surveillance examination at 3 years."