title: Screening, management and surveillance for the sessile serrated adenomas/polyps.
abstract: The incidence and mortality rates from right-sided colorectal cancers (CRCs) have not decreased, compared with the significant reduction of CRCs in the left colon in recent years. It is likely that a significant proportion of right-sided CRCs evolve from undetected sessile serrated adenomas/polyps (SSA/Ps) in the primary colonoscopy. Increasing evidences suggest that SSA/Ps are high-risk lesions, with 15% of the SSA/P patients developing subsequent CRCs or adenomas with high-grade dysplasia. However, there are many issues in the screening, management and surveillance of SSA/Ps. Based on new evidences, this review addresses major issues in the diagnostic criteria for the serrated polyps of the colorectum, new endoscopic techniques (high-resolution magnifying endoscopy, narrow-band imaging, autofluorescence imaging, confocal laser endoscopy, and endocytoscopy) for the realtime identification of SSA/Ps, and the management of SSA/Ps by endoscopic mucosal resection, endoscopic sub-mucosal dissection or surgical resection in practice.
authors.affiliation: Department of Gastroenterology, The Affiliated Hospital of Luzhou Medical College Sichuan, China, 646000.
authors.forename: Xiangsheng
authors.initials: X
authors.lastname: Fu
authors.affiliation: Department of Gastroenterology, The Affiliated Hospital of Luzhou Medical College Sichuan, China, 646000.
authors.forename: Ye
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: The Institute for Digestive Medicine, Nanfang Hospital, Southern Medical University Guangzhou, China, 510515.
authors.forename: Yali
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D003106:Colon / Q000473:pathology / Q000601:surgery; D003111:Colonic Polyps / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D003107:Colorectal Surgery; D019468:Disease Management; D055088:Early Detection of Cancer / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D062665:Epidemiological Monitoring; D006801:Humans; D015994:Incidence
keywords: Serrated polyp; management; screening; sessile serrated adenomas/polyps; surveillance