The US Multi-Society Task Force on Colorectal Cancer has issued 11 consensus recommendations to improve the diagnosis and management of serrated polyposis syndrome (SPS), a condition associated with increased colorectal cancer risk that is frequently underrecognized. The guidance was developed by representatives of the ACG, AGA, and ASGE and published in Gastroenterology, The American Journal of Gastroenterology, and Gastrointestinal Endoscopy.
The task force recommends using the 2019 WHO diagnostic criteria and tracking the number, size, and location of serrated polyps across a patient’s lifetime. It emphasizes that all serrated polyp types count toward diagnosis, including hyperplastic polyps, sessile serrated lesions, and traditional serrated adenomas. Colonoscopies for patients with SPS should be performed by endoscopists with documented sessile serrated lesion detection rates of at least 6%.
For management, the guidance recommends colonoscopy every three to six months during the initial polyp-clearing phase, followed by surveillance every one to two years once target lesions are removed. Endoscopic management is preferred over surgery when feasible, with referral to advanced endoscopic resection specialists before surgery if the polyp burden is difficult to control. The task force also suggests screening first-degree relatives beginning at age 40 or earlier based on family history.
Why it matters: The recommendations highlight the importance of recognizing SPS, documenting cumulative polyp burden, and maintaining high serrated-lesion detection standards. They also provide a more structured approach to surveillance intervals and family screening, with implications for colonoscopy quality and colorectal cancer prevention.