Unifying Concepts

WHO Criteria for Diagnosis of Serrated Polyposis Syndrome (SPS)

Serrated polyposis syndrome (SPS) (previously hyperplastic polyposis) is defined by number and size of serrated polyps in the colon and rectum, but the definition is purely arbitrary and there is no known genotype.
SPS is associated with a high risk of colorectal cancer, not only in the affected patient, but also family members. The carcinogenesis can be rapid, with several series describing interval cancers occurring quickly.

The diagnosis of serrated polyposis syndrome (SPS) is currently met by fulfilling one of three criteria established by the World Health Organization (WHO):

  1. ≥5 serrated lesions proximal to the sigmoid colon of which (2 must be ≥1 cm in diameter)
  2. >20 serrated polyp lesions throughout the colon
  3. Any serrated lesion proximal to the sigmoid colon in someone with a first-degree relative with SPS

Small numbers of adenomas are a frequent occurrence in SPS and colorectal cancer in SPS is not confined to the serrated pathway.



  1. Soons E, Bisseling TM, van der Post RS, Nagtegaal ID, Hazewinkel Y, van Kouwen MCA, Siersema PD. The Workgroup Serrated Polyps and Polyposis (WASP) classification for optical diagnosis of colorectal diminutive polyps with iScan and the impact of the revised World Health Organization (WHO) criteria. United European Gastroenterol J. 2021 Sep 3;9(7):819–28. [Medline]
  2. Lee J, Bae JH, Chung SJ, Kang HY, Kang SJ, Kwak MS, Seo JY, Song JH, Yang SY, Yang JI, Lim SH, Yim JY, Lim JH, Chung GE, Jin EH, Choi JM, Han YM, Kim JS. Impact of comprehensive optical diagnosis training using Workgroup serrAted polypS and Polyposis classification on detection of adenoma and sessile serrated lesion. Dig Endosc. 2021 May 21. [Medline]
  3. Dekker E, Bleijenberg A, Balaguer F; Dutch-Spanish-British Serrated Polyposis Syndrome collaboration. Update on the World Health Organization Criteria for Diagnosis of Serrated Polyposis Syndrome. Gastroenterology. 2020 May;158(6):1520-1523. [Medline]


Created Sep 22, 2021


  • Language:

  • Users Online

  • Medical Disclaimer

    El contenido de este sitio web son solo para fines informativos y no reemplazan la consulta con un profesional médico.
  • Recent Posts

  • Categories

  • Copyright by