First AD

Second AD

A 50-year-old man of average risk undergoes a first-time screening colonoscopy. A sub-centimeter polyp was found in the ascending colon and was removed. Histology revealed a sessile serrated adenoma.  

Sessile serrated adenomas (SSA) are precursors to colon cancer similar to tubular adenomas. However, they appear to follow a different pathway, which is not as well-defined as the traditional tubular adenoma to colon cancer pathway. The SSA-to-cancer pathway includes involvement of BRAF mutation and possibly microsatellite instability. According to the

 US Multisociety Task Force on Colorectal Cancer,

 SSAs should be managed currently in a manner similar to that for tubular adenomas-for 1 lesion smaller than 1 centimeter in diamter, surveillance is recommended in 5 years.

Gastrointestinal Disorders

Colorectal Cancer

Is a surveillance interval of 1 year, 3 years, 5, or 10 years recommended?  

Follow-up Colonoscopy: When Should This Patient Return?