Serrated polyposis syndrome is diagnosed on the cumulative number of serrated polyps over all colonoscopies, along with their size and location — not on a single examination. A patient with a few sessile serrated lesions each time may meet criteria only when the reports are added together.
When reviewing a patient with serrated lesions, look back through previous colonoscopy and pathology reports and total them. Proximal location and size of 10 mm or more add weight. Record the running count in the report so the next endoscopist sees it.
- Total serrated polyps across all previous colonoscopies when assessing a patient.
- Record the cumulative count, sizes and locations in each report.
- Note proximal and larger serrated lesions particularly.
- Check whether first-degree relatives have been offered screening once the syndrome is diagnosed.
Why it matters
The syndrome is missed when each colonoscopy is judged on its own.
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