# Serrated polyposis syndrome

Source: https://onco.cc/terms/serrated-polyposis-syndrome/  
OnCo record `serrated-polyposis-syndrome` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Serrated polyposis syndrome means having many serrated polyps in the bowel, a type that can turn into cancer, and it raises bowel cancer risk for the person and their close relatives. Clearing the polyps and then yearly colonoscopy is recommended, and close relatives are offered a colonoscopy at 40.

## Summary

Diagnosed on the WHO 2019 criteria; no single causative gene has been found and inheritance is not Mendelian, though first-degree relatives have a raised colorectal cancer risk and rare RNF43 and GREM1 variants are reported. It overlaps with MUTYH-associated polyposis, hereditary mixed polyposis and attenuated FAP, which have to be excluded. Prevalence reached 1 in 100 in one FIT-based screening cohort.

BSG 2020: yearly colonoscopy once all lesions over 5 mm are cleared, extending to two-yearly if no polyp of 10 mm or more is found (strong recommendation); first-degree relatives offered colonoscopy at 40 or ten years before the index case's diagnosis, then five-yearly. With this surveillance at academic centres, colorectal cancer was diagnosed at 1.9 per 1,000 patient-years of follow-up.

## Fields

- Kind: Term
- Last checked: 2026-11-04
- Also known as: hyperplastic polyposis syndrome; serrated polyposis
- Tags: gap-fill; hereditary

## Notes

- Orphanet ORPHA:157798, listed in the inherited digestive cancer-predisposing branch. Recorded with the hereditary syndromes because of the family risk, not because a gene is known.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Serrated_polyposis_syndrome
- Monahan, Gut 2020: BSG, ACPGBI and UKCGG guidelines for the management of hereditary colorectal cancer: https://doi.org/10.1136/gutjnl-2019-319915
- Orphanet ORPHA:157798: https://www.orpha.net/en/disease/detail/157798

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Serrated adenocarcinoma of the colon and rectum](https://onco.cc/cancers/colorectal-serrated-adenocarcinoma/)
- terms: [Colonoscopy](https://onco.cc/terms/colonoscopy/), [Hereditary cancer syndromes](https://onco.cc/terms/hereditary-cancer-syndromes/), [Serrated pathway](https://onco.cc/terms/serrated-pathway/), [Surveillance intervals after polypectomy](https://onco.cc/terms/colonoscopy-surveillance-intervals/)

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