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Did you know? The cancer risk of serrated polyposis syndrome is as high as 40%!
Serrated polyposis syndrome (SPS), formerly known as hyperproliferative polyposis syndrome, is a disease characterized by the appearance of serrated polyps in the colon. Although serrated polyposis syndrome causes no obvious symptoms, the condition is associated with a significantly increased risk of colorectal cancer (CRC), with a lifetime cancer risk of 25% to 40%. This figure has many people wondering, is this condition underestimated?
Serlated polyp syndrome is the most common polyp syndrome affecting the colon, but is often overlooked due to a lack of systematic long-term surveillance.
Diagnosis and Causes
To diagnose serrated polyposis syndrome, a colonoscopy is required. Criteria for diagnosis include the presence of five or more serrated lesions/polyps near the rectum (all ≥5 mm in size and two ≥10 mm), or more than 20 serrated lesions in any part of the colon. Among these lesions, we can find flat serrated adenomas and hyperplastic polyps. A characteristic of these lesions is that they are often easily overlooked.
Pathophysiology
SPS is not caused by a single genetic mutation. Several genetic abnormalities associated with this syndrome include BRAF gene mutations and an abnormal CpG island methylation phenotype. In addition, health history and smoking habits of a large family are also considered risk factors, while use of aspirin and nonsteroidal anti-inflammatory drugs may reduce the risk.
Treatment Options
Colonoscopy is the mainstay of treatment for SPS. This not only allows polyps to be identified, but also enables polyp removal. Repeat colonoscopies are generally recommended every to three years to prevent the development of colon cancer.
If the polyps are relatively few, a colonoscopy may be sufficient for removal. If the polyps are large or growing rapidly, surgery may be needed.
Prognosis and Risks
Overall, individuals with serrated polyposis syndrome face a risk of colon cancer of approximately 19.9%. The risk of cancer varies based on age, polyp burden, and atypia in histology. Aggressive endoscopic surveillance can reduce the risk of progression to cancer.
Epidemiology
Exact data on the overall prevalence of SPS remain uncertain, but it is estimated to be approximately 1 case per 100,000 people. The disease affects men and women equally, and most patients diagnosed are between the ages of 40 and 60.
Serted polyp syndrome is key to combating the risk of colon cancer, yet many people know little about it. Is this putting a premium on regular screening?
Based on the above information, serrated polyp syndrome and its association with colorectal cancer cannot be ignored. Prevention and early detection are key to improving patient survival, but do we truly understand and act on all the risks and treatments of this disease?
