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

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2017 04 East et al., Gut BSG Position statement on serrated polyps.pdfPublished version5.72 MBAdobe PDFView/Open
Title: British Society of Gastroenterology position statement on serrated polyps in the colon and rectum
Authors: East, JE
Atkin, WS
Bateman, AC
Clark, SK
Dolwani, S
Ket, SN
Leedham, SJ
Phull, PS
Rutter, MD
Shepherd, NA
Tomlinson, I
Rees, CJ
Item 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).
Issue Date: 27-Apr-2017
Date of Acceptance: 3-Apr-2017
URI: http://hdl.handle.net/10044/1/50540
DOI: https://dx.doi.org/10.1136/gutjnl-2017-314005
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/
Sponsor/Funder: Cancer Research UK
Funder's Grant Number: A16894
Keywords: 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
COLONIC NEOPLASMS
COLONOSCOPY
COLORECTAL CANCER
HISTOPATHOLOGY
POLYPOSIS
Adenoma
Adenomatous Polyposis Coli
Benchmarking
Biomarkers
Cell Transformation, Neoplastic
Colitis
Colonic Polyps
Colonoscopy
CpG Islands
DNA
DNA Methylation
Feces
Humans
Parasympatholytics
Polyps
Precancerous Conditions
Rectal Diseases
Terminology as Topic
Watchful Waiting
1103 Clinical Sciences
1114 Paediatrics And Reproductive Medicine
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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