British Society of Gastroenterology position statement on serrated polyps in the colon and rectum
File(s)
Author(s)
Type
Journal Article
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).
Date Issued
2017-04-27
Date Acceptance
2017-04-03
Citation
Gut, 2017, 66 (7), pp.1181-1196
ISSN
0017-5749
Publisher
BMJ Publishing Group
Start Page
1181
End Page
1196
Journal / Book Title
Gut
Volume
66
Issue
7
Copyright Statement
© 2017 The Authors.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sponsor
Cancer Research UK
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000402730000004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
A16894
Subjects
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
HAMPSHIRE COLONOSCOPY REGISTRY
HIGH-DEFINITION COLONOSCOPY
INFLAMMATORY-BOWEL-DISEASE
CANCER SCREENING-PROGRAM
MICROSATELLITE-UNSTABLE ADENOCARCINOMAS
SYNCHRONOUS ADVANCED NEOPLASIA
ADVANCED COLORECTAL NEOPLASIA
ENDOSCOPIC MUCOSAL RESECTION
ISLAND METHYLATOR PHENOTYPE
AVERAGE-RISK INDIVIDUALS
Publication Status
Published