Associate Editor, Dr. Lisa Strate, highlights this article from the August issue “Presence of small sessile serrated polyps increases rate of advanced neoplasia upon surveillance compared with isolated low-risk tubular adenomas” by Joshua Melson, MD, Karen Ma, MD, Saba Arshad, MBBS, et al.
Large sessile serrated adenomas are associated with an increased risk of synchronous and metachronous advanced neoplasia. The association between small sessile serrated adenomas and risk of subsequent colorectal neoplasia is less clear. Understanding this association could impact recommendations for colon surveillance. In this study of nearly 800 patients with a colon adenoma and/or sessile serrated lesion on index colonoscopy, the risk of advanced neoplasia on surveillance colonoscopy was higher in patients with sessile serrated polyps than those without such lesions.
Figure 1. Flow diagram of patient exclusions (some patients met more than 1 exclusion criterion), resulting in 788 patients included in the study.
I recommend this article because it raises awareness of the unique significance of sessile serrated lesions in the colon.
Small sessile polyps may increase the risk of subsequent colorectal neoplasia. Although further study is needed, this study indicates that surveillance recommendations for small sessile serrated colon polyps may need to be reconsidered.
Read the article abstract here.
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