High prevalence of serrated polyposis syndrome in FIT-based colorectal cancer screening programmes

Serrated polyposis syndrome (SPS) is a recently recognised high risk condition for colorectal cancer (CRC) characterised by the presence of large and/or multiple serrated polyps in the colon.1 ,2 The prevalence of SPS has been previously estimated out of CRC endoscopy-based screening programmes on average risk individuals; in this setting, the prevalence ranged from 0.033% (1/3000 sigmoidoscopies)3 to 0.055% (1/1818 colonoscopies).4 However, Biswas et al 5 recently published a higher prevalence based on a guaiac faecal  occult blood testing (gFOBT) CRC screening programme in the UK (NHS Bowel Cancer Screening Programme). In this programme, between April 2010 and January 2012, 5/755 (0.66%) patients attended for index screening colonoscopy after a positive gFOBT met the WHO criteria for SPS, which represented a 20-fold increase …