{
  "abstract": "Serrated polyposis syndrome (SPS) is the most common colorectal polyposis syndrome, characterised by multiple serrated lesions in the colon and carries an elevated risk of colorectal cancer (CRC). Serrated lesions can be categorised into hyperplastic polyps, sessile serrated polyps (SSLs) and traditional serrated adenomas (TSAs)—with SSLs and TSAs recognised as pre-malignant lesions and contributing up to a third of sporadic CRCs via the serrated neoplasia pathway. SPS remains underdiagnosed due to the subtle endoscopic appearance and historical misclassification of these lesions.Advancements in colonoscopy, including high-definition imaging and chromoendoscopy, as well as extended withdrawal times and polyp classification systems, have significantly improved the detection of these challenging lesions. Cold snare polypectomy is the recommended technique for most non-dysplastic serrated lesions <10 mm due to its safety and efficacy. For larger or dysplastic lesions, endoscopic mucosal resection is the preferred technique and may be performed cold, hot or underwater. However, evidence regarding optimal resection techniques specific to serrated lesions remains limited.SPS and post-polypectomy surveillance strategies vary internationally and are largely based on expert opinion. All guidelines recommend annual surveillance in SPS patients following polyp clearance, although recent data suggest that biennial colonoscopy may be sufficient, thereby potentially reducing patient and procedural burden.This review highlights the ongoing challenges in diagnosing and managing SPS and serrated lesions and underscores the need for further research to guide best practices in detection, resection and surveillance, with the ultimate goal of reducing CRC incidence.",
  "authors": [
    {
      "affiliations": [
        "Gastroenterology, St George’s University Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Umang Qazi"
    },
    {
      "affiliations": [
        "Gastroenterology, St George’s University Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Kevin Jacob"
    },
    {
      "affiliations": [
        "Gastroenterology, St George’s University Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Gareth Sadler"
    },
    {
      "affiliations": [
        "Histopathology, St George’s University Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Heung Chong"
    },
    {
      "affiliations": [
        "Gastroenterology, St George’s University Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Kesavan Kandiah"
    }
  ],
  "title": "Serrated polyposis syndrome: what you need to know",
  "uid": "c8fbd63b-2acb-52fb-bf56-ecb33b498962"
}