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British Society of Gastroenterology position statement on serrated polyps in the colon and rectum

East, James E., Atkin, Wendy S., Bateman, Adrian C., Clark, Susan K., Dolwani, Sunil, Ket, Shara N., Leedham, Simon J., Phull, Perminder S., Rutter, Matt D., Shepherd, Neil A., Tomlinson, Ian and Rees, Colin J. 2017. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum. Gut 66 (7) , pp. 1181-1196. 10.1136/gutjnl-2017-314005

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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
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: 31 Jul 2017 11:56
URI: http://orca-mwe.cf.ac.uk/id/eprint/100180

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