Skip to content
How It Works
Explore
Resources Ask a Question
Who It's For
Patients
Decode results, prep for appointments, weigh options.
Caregivers & advocates
Carry the research load for someone you love.
Providers & clinicians
Resources for patients in your practice.
Log In Ask a Question
PubMed This is a summary of 48 peer-reviewed journal articles Updated
Gastroenterology

Navigating Serrated Polyposis Syndrome (SPS)

At a Glance

Serrated Polyposis Syndrome (SPS) is a silent condition that increases the risk of colorectal cancer but causes no symptoms. Early diagnosis is a powerful tool, allowing patients to dramatically reduce their cancer risk through strict adherence to regular colonoscopy screenings and polyp removal.

Finding out you have Serrated Polyposis Syndrome (SPS) can be overwhelming. The term “syndrome” often sounds frightening, and hearing that you have an increased risk of colorectal cancer can cause significant anxiety [1]. However, this diagnosis is actually a powerful tool. By identifying this condition early, you and your medical team can take proactive steps to dramatically reduce your risk and manage your health effectively [2][3].

The Silent Condition

One of the most important things to know about SPS is that it is almost always “silent.” This means it typically causes zero symptoms—no pain, no changes in bathroom habits, and no bleeding [4]. Because there are no warning signs, you cannot rely on how you feel to know if polyps are growing. Sticking strictly to your regular screening schedule is your only way to catch and remove polyps before they become dangerous [5].

How to Use This Guide

This resource is designed to help you understand your diagnosis, decode your medical reports, and take control of your care. It is divided into five main sections. We recommend reading through them to build your knowledge so you can partner effectively with your medical team.

01

Managing Serrated Polyposis Syndrome: Your Roadmap to Prevention

Learn how to manage Serrated Polyposis Syndrome (SPS). Understand the 2019 WHO diagnostic criteria, the clearing phase, and colonoscopy screening guidelines.

02

The Science of SPS: Understanding the Serrated Pathway

Learn the science behind Serrated Polyposis Syndrome (SPS). Understand the serrated neoplasia pathway, BRAF mutations, CIMP, and if SPS is hereditary.

03

Decoding Your Pathology: Understanding SSLs, TSAs, and HPs

Learn how to read your Serrated Polyposis Syndrome (SPS) pathology report. Understand the differences between SSLs, TSAs, HPs, and what dysplasia means.

04

Standard of Care: From Clearance to Surveillance

Understand the standard of care for Serrated Polyposis Syndrome (SPS). Learn about the clearing phase, surveillance colonoscopies, and when surgery is needed.

05

Protecting Your Family: Risk and Screening for Relatives

Learn about colon cancer risks for first-degree relatives of Serrated Polyposis Syndrome (SPS) patients. Understand when to start colonoscopy screening.

Common questions in this guide

What are the symptoms of Serrated Polyposis Syndrome?
Serrated Polyposis Syndrome is almost always a silent condition, meaning it typically causes zero symptoms. Patients usually do not experience pain, changes in bowel habits, or bleeding, making regular screening essential.
How is Serrated Polyposis Syndrome treated and managed?
SPS is managed proactively through a strict, regular colonoscopy screening schedule. The primary goal is to find and remove polyps before they have the chance to develop into colorectal cancer.
Should I see a specialist for my SPS diagnosis?
Because SPS requires specialized management, it is highly recommended to work with a doctor experienced with the 2019 WHO diagnostic criteria. You may also benefit from a referral to an advanced endoscopy center and a consultation with a genetic counselor.
What should I do with my past colonoscopy records?
It is vital to collect all of your past colonoscopy and pathology reports and keep them in one organized file. This helps your gastroenterologist accurately track your polyp history and determine the best screening schedule for you.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Are you experienced with the 2019 WHO criteria for Serrated Polyposis Syndrome, or should I be referred to an advanced endoscopy center?
  2. 2.Who is the primary contact on my care team if I have questions between my regular colonoscopies?
  3. 3.Do you recommend that I speak with a genetic counselor based on my diagnosis?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (5)
  1. 1

    Risk of Colorectal Cancer in Serrated Polyposis Syndrome: A Systematic Review and Meta-analysis.

    Muller C, Yamada A, Ikegami S, et al.

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 2022; (20(3)):622-630.e7 doi:10.1016/j.cgh.2021.05.057.

    PMID: 34089849
  2. 2

    Reducing the polyp burden in serrated polyposis by serial colonoscopy: the impact of nationally coordinated community surveillance.

    Parry S, Burt RW, Win AK, et al.

    The New Zealand medical journal 2017; (130(1451)):57-67.

    PMID: 28253245
  3. 3

    Feasibility and Safety of Endoscopic Control for Patients with Serrated Polyposis Syndrome.

    Nakaoka M, Chiba H, Kobayashi M, et al.

    Digestive diseases (Basel, Switzerland) 2024; (42(1)):31-40 doi:10.1159/000534968.

    PMID: 37967542
  4. 4

    Optimal Endoscopic Treatment and Surveillance of Serrated Polyps.

    Gupta V, East JE

    Gut and liver 2020; (14(4)):423-429 doi:10.5009/gnl19202.

    PMID: 31581390
  5. 5

    Serrated Polyposis Syndrome with a Synchronous Colon Adenocarcinoma Treated by an Endoscopic Mucosal Resection.

    Lee SH, Lee SJ, Park SC, et al.

    The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 2020; (76(3)):159-163 doi:10.4166/kjg.2020.76.3.159.

    PMID: 32969364

This guide is for informational purposes only and does not replace professional medical advice. Always consult your gastroenterologist or care team to discuss your specific Serrated Polyposis Syndrome management plan.

Get notified when new evidence is published on Serrated polyposis syndrome.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.