II. Epidemiology

  1. Prevalence: one in 2000 to 3000
  2. Diagnosed on average by age 62 years
  3. Colorectal Cancer present at time of polyposis diagnosis in 25-70%

III. Diagnosis

  1. Five of more Sessile Serrated Adenomatous Polyps proximal to sigmoid and two or more polyps >1 cm OR
  2. Any number of Sessile Serrated Adenomatous Polyps proximal to sigmoid and affected first degree relatives OR
  3. More than 20 Sessile Serrated Adenomatous Polyps of any size throughout the colon

IV. Management: Colorectal Cancer Screening

  1. Start screening at at age 40 years, or 10 years earlier than youngest relative
    1. Repeat Colonoscopy every 5 years in those with Family History until polyp is found
  2. Once serrated polyps are found
    1. Repeat Colonoscopy annually to clear all polyps
    2. Colectomy indications
      1. Colorectal Cancer diagnosis
      2. Polypectomy cannot control polyps
  3. Monitoring after colon resection
    1. Endoscopy of Rectum and residual colon every 6-12 months

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