Serrated Polyposis Syndrome in a Single-Center 10-Year Experience

Abstract

Aims: Serrated polyposis syndrome is a disease that is often missed in the clinical setting and is associated with colorectal cancer. We investigated the prevalence of SPS and the association between colorectal or other cancers in a 10-year, retrospective data analysis. Methods: We reviewed complete colonoscopy data obtained from January 2005 through January 2015 at a health-screening centre. Serrated polyposis syndrome was defined on the basis of the criteria established by the 2010 World Health Organization. Results: Of a total of 53.842 consecutive subjects who underwent complete colonoscopy, 12 (0.022%) patients had serrated polyposis syndrome. All of these cases were under-recognized by the endoscopist or referring physician. The mean patient age was 58.6 years; 67% of the patients were men and 33% were women. No serrated polyposis syndrome patients had a first-degree relative with serrated polyposis syndrome, and no serrated polyposis syndrome patients had colorectal cancer. Two cases (17%) had extra-colonic cancers (prostate cancer and thyroid cancer). Eight cases (67%) had a family history of cancer (stomach, breast, lung, pancreas, prostate and colorectal cancer). Conclusion: Serrated polyposis syndrome was a rare condition in a 10-year database, and it was diagnosed late in all cases. Serrated polyposis syndrome may be associated with an increased risk of extra-colonic cancer.

Keywords

• Serrated polyposis syndrome, prevalence, cancer, colonoscopy

Kaynakça

1. 1. Jung KW, Won YJ, Kong HJ, Oh CM, Seo HG, Lee JS. Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2010. Cancer Res Treat 2013;45:1-14.
2. 2. Jung KW, Won YJ, Kong HJ, Oh CM, Cho H, Lee DH, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 2015;47:127-41.
3. 3. Snover D, Ahnen D, Burt R, Odze R. Serrated polyps of the colon and rectum and serrated polyposis. WHO classification of tumours of the digestive system, 4th ed. IARC: Lyon; 2010:160-5.
4. 4. Boparai KS, Mathus-Vliegen EM, Koornstra JJ, Nagengast FM, Van Leerdam M, Van Noesel CJ, et al. Increased colorectal cancer risk during follow-up in patients with hyperplastic polyposis syndrome: a multicentre cohort study. Gut 2010;59:1094-100.
5. 5. Kalady MF, Jarrar A, Leach B, LaGuardia L, O'Malley M, Eng C, et al. Defining phenotypes and cancer risk in hyperplastic polyposis syndrome. Dis Colon Rectum 2011;54:164-70.
6. 6. Kim HY, Kim SM, Seo JH, Park EH, Kim N, Lee DH. Age-specific prevalence of serrated lesions and their subtypes by screening colonoscopy: a retrospective study. BMC Gastroenterol 2014;14:82.
7. 7. Lockett MJ, Atkin WS. Hyperplastic polyposis (HPP): Prevalence and cancer risk. Gastroenterology 2001;120(Suppl 1):A742.
8. 8. Miwata T, Hiyama T, Oka S, Tanaka S, Shimamoto F, Arihiro K, et al. Clinicopathologic features of hyperplastic/serrated polyposis syndrome in Japan. J Gastroenterol Hepatol 2013;28:1693-8.

9. 9. van Herwaarden YJ, Verstegen MH, Dura P, Kievit W, Drenth JP, Dekker E, et al. Low prevalence of serrated polyposis syndrome in screening populations: a systematic review. Endoscopy 2015;47:1043-9.
10. 10. Kahi CJ, Li X, Eckert GJ, Rex DK. High colonoscopic prevalence of proximal colon serrated polyps in average-risk men and women. Gastrointest Endosc 2012;75:515-20.
11. 11. Hazewinkel Y, de Wijkerslooth TR, Stoop EM, Bossuyt PM, Biermann K, van de Vijver MJ, et al. Prevalence of serrated polyps and association with synchronous advanced neoplasia in screening colonoscopy. Endoscopy 2014;46:219-24.
12. 12. Orlowska J, Kiedrowski M, Kaminski F, Regula J, Butruk E. Hyperplastic polyposis syndrome in asymptomatic patients: the results from the colorectal-cancer screening program. Virchows Archiv; 2009: SPRINGER 233 SPRING ST, NEW YORK, NY 10013 USA.
13. 13. Biswas S, Ellis AJ, Guy R, Savage H, Madronal K, East JE. High prevalence of hyperplastic polyposis syndrome (serrated polyposis) in the NHS bowel cancer screening programme. Gut 2013;62:475.
14. 14. Moreira L, Pellisé M, Carballal S, Bessa X, Ocaña T, Serradesanferm A, et al. High prevalence of serrated polyposis syndrome in FIT-based colorectal cancer screening programmes. Gut 2013;62:476-7.
15. 15. Higuchi T, Jass JR. My approach to serrated polyps of the colorectum. J Clin Pathol 2004;57:682-6.
16. 16. Edelstein DL, Cruz-Correa M, Soto-Salgado M, Axilbund JE, Hylind LM, Romans K, et al. Risk of Colorectal and Other Cancers in Patients With Serrated Polyposis. Clin Gastroenterol Hepatol 2015;13:1697-9.
17. 17. Kalady MF, Jarrar A, Leach B, LaGuardia L, O'Malley M, Eng C, et al. Defining phenotypes and cancer risk in hyperplastic polyposis syndrome. Dis Colon Rectum 2011;54:164-70.
18. 18. Jasperson KW, Kanth P, Kirchhoff AC, Huismann D, Gammon A, Kohlmann W, et al. Serrated polyposis: colonic phenotype, extracolonic features, and familial risk in a large cohort. Dis Colon Rectum 2013;56:1211-6.
19. 19. Hazewinkel Y, Reitsma JB, Nagengast FM, Vasen HF, van Os TA, van Leerdam ME, et al. Extracolonic cancer risk in patients with serrated polyposis syndrome and their first-degree relatives. Fam Cancer 2013;12:669-73.