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The World Health Organization (WHO) defines serrated polyposis syndrome (SPS) as presence of at least five serrated polyps located proximally to the sigmoid colon, two of which are >10 mm; any number of serrated polyps located proximally to the sigmoid colon in an individual who has a first-degree relative with SPS; or at least 20 serrated polyps of any size distributed throughout the colon. SPS is associated with increased risk for colorectal cancer (CRC), and frequent surveillance is recommended. However, the WHO definition is largely empirical, and a previous study showed that the risk for CRC in persons with multiple serrated polyps who do not meet SPS criteria is similar compared with risk in those with SPS (NEJM JW Gastroenterol Jun 2…