Serrated pathway: Alternative route to colorectal cancer

Table 2 Colonoscopic management and surveillance strategies for serrated polyps based on experts’ opinion and current literature[28,34,51,63]

Serrated polyp	Intervention	Surveillance interval
Hyperplastic polyp in the rectosigmoid	No surveillance recommended	Screening colonoscopy at 10 yr
SSA without dysplasia	Endoscopic resection (EMR)	< 3 lesions, < 1 cm: 5 yr
		≥ 3 lesions, ≥ 1 cm: 3 yr
SSA with dysplasia	Endoscopic resection (EMR)	Complete: 2-6 mo
		Incomplete: Segmental colectomy
TSA	Endoscopic resection (cold-snare)	Complete: 3 yr
		Incomplete: Segmental colectomy
Serrated polyposis	Endoscopic resection	Follow-up colonoscopy at 6-12 mo
		Children: screening at an age 10 yr younger than index case
Serrated polyposis in first-degree relative	Screening at an age 10 yr younger	Follow-up colonoscopy at 12 mo

SSA: Sessile serrated adenoma; TSA: Traditional serrated adenoma; EMR: Endoscopic mucosal resection.