Are We Missing Proximal Serrated Polyps?

Sessile serrated polyps (SSPs) arise primarily in the proximal colon and are thought to be precursors to colorectal cancers characterized as having a CpG island methylator phenotype. Recent studies suggest that SSPs are missed more frequently than conventional adenomas during colonoscopy (Clin Gastroenterol Hepatol 2011; 9:42). To investigate this issue further, researchers assessed whether colonoscopic findings of conventional advanced adenomas or SSPs were less likely in patients who had previously undergone endoscopy than in those who had not.

This case-control study included 213 patients with advanced adenomas, 172 patients with SSPs, and 1704 controls (patients with no colorectal pathology or with only nonadvanced adenomas or hyperplast…