Increased colorectal cancer risk during follow-up in patients with hyperplastic polyposis syndrome: a multicentre cohort study

Abstract

Increased colorectal cancer risk during follow-up in patients with hyperplastic polyposis syndrome: a multicentre cohort study Boparai, K.S.; Mathus-Vliegen, E.M.H.; Koornstra, J.J.; Nagengast, F.M.; van Leerdam, M.; van Noesel, C.J.M.; Houben, M.; Cats, A.; van Hest, L.P.; Fockens, P.; Dekker, E. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.

Phenotypic characterization and familial risk in hyperplastic polyposis syndrome

“…In our study, the analysis of larger lesions (28) showed that the majority were located in the proximal colon, in contrast to smaller polyps predominantly located in the rectum and the sigmoid, corroborating other publications [13,16]. One of the HPS characteristics is the simultaneous presence of different types of serrated and adenomatous polyps in the same patient [3,16,17]. However, we only found five cases of advanced lesions besides HP, which is probably due to the young age of our patients and the close follow-up with polypectomy.…”

“…The median number of polyps per patient varies in different studies: it was 16 in our study, which is in accordance with some authors [16,17] but is well below the average 90 polyps per patient documented by Ferrandez et al [23] Our findings are probably related to patients' age and the presence of CRC family history; in fact, Buchanan et al [20] pointed out the absence of CRC family history as an independent predictor of polyp density. Despite the predominance of small polyps, the presence of some larger lesions (high-risk lesions) is frequent.…”

“…An alternative sequence for CRC-the serrated pathway [12,19,20]-is widely accepted and stratification of serrated-risk lesions became an important issue [16]. With the expansion of knowledge in this area, the diagnostic criteria proposed by Jass and Burt will most likely be redefined [21].…”

“…HPS patients should undergo colonoscopic surveillance with polypectomy, but so far the frequency of this surveillance was not defined [14,16]. HPS patients with FDR, who seem to be at higher risk for HPS and CCR than the general population, [2,17], should also be included in surveillance programs.…”

Serrated polyposis syndrome: a silent killer when undetected

“…A recent large retrospective study demonstrated that, once cleared from all polyps and under close surveillance, CRC risk in these patients is only moderately increased [3]. However, most cases of SPS remain unrecognized and as a consequence patients do not receive proper surveillance intervals, significantly increasing their risk of developing CRC [4,5]. For this reason it is important that endoscopists become acquainted with the diagnosis, risk, and optimal treatment strategies for SPS [6].…”