Serrated polyposis syndrome (SPS), previously known as hyperplastic polyposis syndrome, is a disorder characterized by the appearance of serrated polyps in ...SerratedpolyposissyndromeFromWikipedia,thefreeencyclopediaJumptonavigationJumptosearchSerratedpolyposissyndromeOthernamesHyperplasticpolyposissyndrome(former)SpecialtyGastroenterologySymptomsAsymptomaticComplicationsColorectalcancer(15-30%)[1]Usualonset55yearsofage(average)[2]TypesDistalandproximalCausesEnvironmentalandgeneticfactorsRiskfactorsSmoking,Lymphoma[3]DiagnosticmethodColonoscopyTreatmentSurveillancecolonoscopyPolypectomySurgeryFrequency0.03-0.5%.[1]Serratedpolyposissyndrome(SPS),previouslyknownashyperplasticpolyposissyndrome,isadisordercharacterizedbytheappearanceofserratedpolypsinthecolon.Whileserratedpolyposissyndromedoesnotcausesymptoms,theconditionisassociatedwithahigherriskofcolorectalcancer(CRC).ThelifelongriskofCRCisbetween25and40%.SPSisthemostcommonpolyposissyndromeaffectingthecolon,butisunderrecognizedduetoalackofsystemiclongtermmonitoring.[4]Diagnosisrequirescolonoscopy,andisdefinedbythepresenceofeitheroftwocriteria:≥5serratedlesions/polypsproximaltotherectum(all≥5mminsize,withtwolesions≥10mm),or>20serratedlesions/polypsofanysizedistributedthroughoutthecolonwith5proximaltotherectum.[5]AfamilyhistoryofSPSandsmokingtobaccoareassociatedwithahigherriskofserratedpolyposissyndrome,whereastheuseofaspirinandNonsteroidalanti-inflammatorydrug(NSAIDs)areassociatedwithalowerrisk.WhilethereareseveralgeneticabnormalitiesassociatedwithSPS,includingRNF43,BRAF,abnormalCpGislandmethylatorphenotype,andmicrosatelliteinstability.However,mostindividualswiththesyndromedonothaveanassociatedgermlinemutation.ThetypesofpolypsfoundinSPSincludesessileserratedadenomas/polyps,traditionalserratedadenomas,andhyperplasticpolyps.SPSoccursin2phenotypes:proximalanddistal.ProximalSPShasagreaterriskofCRCthandistalSPS.Thevastmajorityofcasesmaybemanagedwithcolonoscopywithremovalpolyps(polypectomy).Polypremovalisrecommendedtodecre