WHO Criteria for Serrated Polyposis Are Too Restrictive

The diagnosis of serrated polyposis syndrome (SPS) is currently met by fulfilling one of three criteria established by the World Health Organization (WHO):

1. ≥5 serrated lesions proximal to the sigmoid colon of which (2 must be ≥1 cm in diameter)

2. >20 serrated polyp lesions throughout the colon

3. Any serrated lesion proximal to the sigmoid colon in someone with a first-degree relative with SPS

Because the genetic basis of SPS is not established, the WHO criteria have not been validated.

In a retrospective analysis, researchers in Spain compared the prevalence and incidence of cancer between a cohort of SPS patients and a cohort of patients with multiple serrated polyps (MSP) who did not meet WHO SPS criteria. MSP patients had a lifetime cumulative nu…