Histologic Proof of a Serrated Polyp–Colorectal Cancer Pathway

Histologic evidence supporting the development of colon cancer from sessile serrated polyp (SSP) is lacking.

In a single-center review of 2646 colorectal cancers, 33 lesions were identified with residual SSP. The majority of these lesions was located in the proximal colon (94%), was T stage 0, I, or II (69%), expressed mutant BRAF (94%), had loss of MLH1 (79%), and were interval cancers (67%). Forty-eight percent of lesions had dysplasia in the specimen in addition to the cancer in the SSP components.