The natural course of serrated lesions: a difficult enigma to resolve

To the editor, The serrated pathway is an established sequence to colorectal cancer (CRC), but little is known about the exact malignant potential of serrated polyps (SPs). Therefore, we have read with great interest the article by Holme et al1 who evaluated the long-term risk of CRC in individuals with large (≥10 mm) SPs as well as the natural course of these lesions. Based on their results, the authors state that the increased CRC risk for individuals with large SPs may not be due to the malignant growth of the SP itself, but rather to an overall field effect in patients with these lesions. However, this statement warrants careful interpretation as we believe that both the timeframe and study design imply a major negative effect on the external validity of this study. First of all, the long-term risk for CRC is assessed after an initial screening sigmoidoscopy performed...

Source: Gut - May 8, 2015 Category: Gastroenterology Authors: IJspeert, J. E. G., Bastiaansen, B. A. J., Fockens, P., Dekker, E. Tags: PostScript Source Type: research