{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:08:31Z","timestamp":1790842111244,"version":"4.1.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>\n            Background Serrated polyposis syndrome (SPS) is the most prevalent colonic polyposis syndrome and is associated with an increased colorectal cancer risk. A recent study in resected appendices of SPS patients reported that 6\/23 (26.1\u200a%) of identified serrated polyps had histological dysplasia. We evaluated the prevalence and clinical relevance of appendiceal lesions in a large SPS cohort.<\/jats:p><jats:p>\n            Methods Prospective data from 2007 to 2020 for a cohort of 199 SPS patients were analyzed. Data were retrieved from endoscopy and pathology reports. Patients who underwent (pre)clearance colonoscopies, surveillance colonoscopies, or colorectal surgery including the appendix were separately evaluated for the presence of appendiceal lesions. The primary outcome was the prevalence of adenocarcinomas and serrated polyps\/adenomas with advanced histology in the surgery group.<\/jats:p><jats:p>\n            Results 171 patients were included, of whom 110 received endoscopic surveillance and 34 underwent surgery. Appendiceal lesion prevalence in the surgery group was 14\u200a\/34 (41.2\u200a%, 95\u200a%CI 24.7\u200a%\u201359.3\u200a%); none were advanced on histology. Detection rates in the (pre)clearance group were 1\u200a\/171 (0.6\u200a%, 95\u200a%CI 0.01\u200a%\u20133.2\u200a%) for advanced and 3\u200a\/171 (1.8\u200a%, 95\u200a%CI 0.04\u200a%\u20135.0\u200a%) for nonadvanced appendiceal lesions, all of which were sessile serrated lesions. During 522 patient-years of surveillance, no advanced appendiceal lesions were detected at endoscopy, and in 1\u200a\/110 patients (0.9\u200a%, 95\u200a%CI 0.02\u200a%\u20135.0\u200a%) was a nonadvanced lesion detected.<\/jats:p><jats:p>\n            Conclusion Appendiceal lesions are common in SPS patients. The discrepancy between the endoscopic detection rate of appendiceal lesions and the reported prevalence in surgically resected appendices suggests a substantial miss-rate of appendiceal lesions during colonoscopy. Advanced appendiceal lesions are however rare and no appendiceal adenocarcinomas occurred, implying limited clinical relevance of these lesions.<\/jats:p>","DOI":"10.1055\/a-2025-0845","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T23:48:16Z","timestamp":1677282496000},"page":"620-626","source":"Crossref","is-referenced-by-count":5,"title":["Appendiceal lesions in serrated polyposis patients are easily overlooked but only seldomly lead to colorectal cancer"],"prefix":"10.1055","volume":"55","author":[{"given":"David E. F. W. M.","family":"van Toledo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam University Medical Center, location Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joep E. G.","family":"IJspeert","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam University Medical Center, location Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne G. C.","family":"Bleijenberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam University Medical Center, location Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A. J.","family":"Bastiaansen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam University Medical Center, location Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carel J. M.","family":"van Noesel","sequence":"additional","affiliation":[{"name":"Department of Pathology, Amsterdam UMC, University of Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4363-0745","authenticated-orcid":false,"given":"Evelien","family":"Dekker","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam, The Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam University Medical Center, location Academic Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,2,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1136\/gutjnl-2015-310784","article-title":"Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview","volume":"66","author":"J EG IJspeert","year":"2017","journal-title":"Gut"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1016\/j.gie.2020.04.068","article-title":"The long-term outcomes and natural disease course of serrated polyposis syndrome: over 10 years of prospective follow-up in a specialized center","volume":"92","author":"A G Bleijenberg","year":"2020","journal-title":"Gastrointest Endosc"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1136\/gutjnl-2015-309647","article-title":"Colorectal cancer risk factors in patients with serrated polyposis syndrome: a large multicentre study","volume":"65","author":"S Carballal","year":"2016","journal-title":"Gut"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1055\/a-0965-0605","article-title":"Endoscopic management of polyposis syndromes: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"51","author":"M E van Leerdam","year":"2019","journal-title":"Endoscopy"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.pathol.2015.11.012","article-title":"Serrated lesions of the appendix in serrated polyposis patients","volume":"48","author":"M Bettington","year":"2016","journal-title":"Pathology"},{"key":"ref6","first-page":"231","article-title":"Is it time to consider prophylactic appendectomy in patients with serrated polyposis syndrome undergoing surveillance?","volume":"70","author":"O McKay","year":"2021","journal-title":"Gut"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"e373","DOI":"10.1093\/bjs\/znab305","article-title":"Incidental diagnosis of serrated polyp in the appendix warrants colonoscopy to screen for colorectal neoplasia","volume":"108","author":"Y J van Herwaarden","year":"2021","journal-title":"Br J Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1136\/jmedgenet-2019-106374","article-title":"Colorectal cancer genetic variants are also associated with serrated polyposis syndrome susceptibility","volume":"57","author":"C Arnau-Collell","year":"2020","journal-title":"J Med Genet"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1136\/gutjnl-2015-310630","article-title":"Clinical risk factors of colorectal cancer in patients with serrated polyposis syndrome: a multicentre cohort analysis","volume":"66","author":"J EG IJspeert","year":"2017","journal-title":"Gut"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.gie.2018.11.016","article-title":"Endoscopic control of polyp burden and expansion of surveillance intervals in serrated polyposis syndrome","volume":"90","author":"M E MacPhail","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1055\/a-0656-5557","article-title":"High incidence of advanced colorectal neoplasia during endoscopic surveillance in serrated polyposis syndrome","volume":"51","author":"D Rodr\u00edguez-Alcalde","year":"2019","journal-title":"Endoscopy"},{"key":"ref12","first-page":"24","volume-title":"Serrated polyposis","author":"C Rosty","year":"2019"},{"key":"ref13","volume-title":"WHO Classification of Tumours of the Digestive System","author":"I D Nagtegaal","year":"2019"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1002\/1097-0142(197605)37:5<2511::AID-CNCR2820370544>3.0.CO;2-L","article-title":"Epithelial neoplasms of the vermiform appendix (exclusive of carcinoid). II. Cystadenomas, papillary adenomas, and adenomatous polyps of the appendix","volume":"37","author":"M Wolff","year":"1976","journal-title":"Cancer"},{"key":"ref15","first-page":"265","article-title":"71,000 human appendix specimens. 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