Serrated polyposis is common and often missed, a US task force warns

The edition in brief

The US Multi-Society Task Force on Colorectal Cancer has issued a review and consensus statement on serrated polyposis syndrome, the commonest polyposis syndrome and one frequently unrecognised. Diagnosis rests on WHO criteria counting the size, cumulative number and location of serrated polyps across colonoscopies; management is meticulous clearing and frequent surveillance, with surgery for cancer or unmanageable polyp burden; germline testing is not routinely indicated; and first-degree relatives need screening colonoscopy. A Dutch nationwide cohort of 8,914 patients treated for Barrett-related dysplasia or adenocarcinoma found 90% had no prior surveillance endoscopy, as did 65% of those treated endoscopically. A phase 2a trial in 60 women with polycystic ovary syndrome and MASLD found saroglitazar 4 mg reduced MRI liver fat by about 15% against a 2% rise on placebo over 24 weeks. A meta-analysis of 12 studies found early liver transplantation for alcohol-related liver disease gave survival similar to standard listing, with a non-significant signal towards more relapse. The FDA approved a supplement for etanercept, which is not used in inflammatory bowel disease. The pearl covers PCOS in young women with steatosis.