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There is now strong evidence for an alternative pathway of colorectal carcinogenesis implicating hyperplastic polyps and serrated adenomas. This article briefly reviews the evidence for this serrated pathway, provides diagnostic criteria for clinically significant hyperplastic polyps and allied serrated polyps, and suggests how this information may be translated into safe, effective guidelines for colonoscopy-based colon cancer prevention. Consideration also is given to the definition and management of hyperplastic polyposis syndrome. The currently proposed management plan for serrated polyps is tentative because of incomplete knowledge of the nature and behavior of these polyps. This article highlights key areas warranting further research.

Original publication

DOI

10.1016/j.gtc.2007.12.014

Type

Journal article

Journal

Gastroenterol Clin North Am

Publication Date

03/2008

Volume

37

Pages

25 - v

Keywords

Adenoma, Colonic Neoplasms, Colonic Polyps, Colonoscopy, DNA, Neoplasm, Diagnosis, Differential, Genetic Predisposition to Disease, Humans, Molecular Biology, Oncogenes, Prognosis, Severity of Illness Index