The clinical significance of serrated polyps

Am J Gastroenterol. 2011 Feb;106(2):229-40; quiz 241. doi: 10.1038/ajg.2010.429. Epub 2010 Nov 2.


Colorectal cancer (CRC) is a heterogeneous disorder than arises via multiple distinct pathways, such as the serrated pathway, in which serrated polyps (including variants of hyperplastic polyps) are the precursor lesions. Approximately 15-20% of all CRCs arise via the serrated pathway, and these serrated carcinomas are clinically, morphologically, and molecularly distinct from conventional CRCs. The prevention of serrated carcinomas represents an important clinical challenge. Gastroenterologists need to recognize and remove potential precursor lesions and implement a post-polypectomy surveillance program when appropriate. This article focuses on the characteristics and significance of clinically relevant serrated polyps and addresses implications for CRC prevention practices.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / prevention & control
  • Age Factors
  • Cell Transformation, Neoplastic
  • Colonic Polyps / genetics
  • Colonic Polyps / pathology*
  • Colonoscopy
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / prevention & control
  • CpG Islands / genetics
  • DNA Methylation
  • Disease Progression
  • Genes, Tumor Suppressor
  • Humans
  • Molecular Biology
  • Mutation
  • Precancerous Conditions / genetics
  • Precancerous Conditions / pathology*
  • Proto-Oncogene Proteins B-raf / genetics
  • Risk Factors


  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf