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Serrated polyposis syndrome/hyperplastic polyposis syndrome
Serrated polyposis syndrome/hyperplastic polyposis syndrome Appointments 216.444.7000 AP P OI NT M E NT S & L OCAT I ONS CONT ACT US
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Serrated polyposis syndrome (SPS), also formerly called hyperplastic polyposis syndrome, is a condition that is characterized by serrated polyps in the colon and/or rectum. Serrated polyps are a type of growth that are defined by their saw tooth, or serrated appearance under the microscope. They can often be difficult to distinguish from other types of polyps in the colon and the only way to determine the type of polyp is by removing them and examining them under a microscope. There are different types of serrated polyps including hyperplastic polyps, sessile serrated polyps, and serrated adenomas. SPS is defined and diagnosed by the certain criteria defined by the World Health Organization. People with SPS have an increased risk of developing colorectal cancer and should undergo colonoscopy every year once a diagnosis is made.
How is SPS diagnosed? SPS is a condition that is defined by the World Health Organization based on findings during endoscopic evaluation of the colon and rectum and confirmed with pathological examination of the polyps seen during colonoscopy. A patient meeting any one of the following criteria is diagnosed with SPS: 1. The presence of 20 or more serrated polyps located anywhere in the colon 2. The presence of 5 or more serrated polyps proximal to the splenic flexure, at least 2 equal to or greater than 1 cm in size 3. The presence of any serrated polyp in the colon in a patient with a family history of SPS
What causes SPS? SPS results from a tendency to develop serrated polyps in the colon and/or rectum. The exact cause is unknown. Although SPS is believed to be hereditary, no genetic defect has been identified to cause SPS. This means that there is no genetic test that can diagnose SPS.
What are the cancer risks associated with SPS? People with SPS have an increased risk of developing colorectal cancer. About 25-40% of people with SPS will develop colorectal cancer. There are not any other cancer risks that have definitively been established to be associated with SPS and screening of other organs is not recommended.
What are the symptoms of SPS? Symptoms are generally caused by the polyps or cancer that develop and are not specific to serrated polyps or to SPS. Common symptoms include bleeding, pain, diarrhea, or constipation. Patients may not have any symptoms. If you have any of the above symptoms, you should be evaluated by a physician.
Is my family at risk for getting SPS? Various studies have suggested that SPS can be inherited, but the inheritance pattern is unknown. Therefore, it is advised that first-degree relatives (i.e., parents, siblings and children) of someone with SPS have an increased risk of developing SPS also.
How is SPS treated? There is no cure for SPS. The treatment is directed at curing symptoms and removing polyps or cancers that are caused by SPS. This entails undergoing a yearly colonoscopy with removal of the polyps. If the polyps cannot be safely or completely removed, or if a cancer is found, surgery is recommended. The usual approach to a colon cancer is to remove the entire colon and reconnect the small bowel to the rectum. The entire colon and rectum is at risk to developing these polyps and cancer and thus any remaining colon or rectum still needs to be evaluated by endoscopy every year.
Where Can I Find More Information? Rex DK, Ahnen DJ, Baron JA, Batts KP, Burke CA, et al. Serrated Lesions of the Colorectum: Review and Recommendations From and Expert Panel. Am J Gastroenterol. 2012 Jun 19. doi: 10.1038/ajg.2012.161. [Epub ahead of print];PMID: 22710576 Burke CA, Snover DC.Sessile serrated adenomas and their pit patterns: we must first see the forest through the trees. Am J Gastroenterol. 2012 Mar;107(3):470-2. PMID: 22388025 Vu HT, Lopez R, Bennett A, Burke CA. Individuals with sessile serrated polyps express an aggressive colorectal phenotype. Dis Colon Rectum. 2011;54(10):1216-23. PMID: 21904135
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© Copyright 1995-2018 The Cleveland Clinic Foundation. All rights reserved. This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
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