East, James E., Atkin, Wendy S., Bateman, Adrian C., Clark, Susan K., Dolwani, Sunil ![]() |
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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 reevaluated 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).
Item Type: | Article |
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Date Type: | Publication |
Status: | Published |
Subjects: | R Medicine > R Medicine (General) |
Publisher: | BMJ Publishing |
ISSN: | 0017-5749 |
Funders: | British Society of Gastroenterology |
Date of First Compliant Deposit: | 28 April 2017 |
Date of Acceptance: | 3 April 2017 |
Last Modified: | 03 May 2023 10:46 |
URI: | https://orca.cardiff.ac.uk/id/eprint/100180 |
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