Serrated colorectal lesions in patients with inflammatory bowel disease

The serrated neoplasia pathway is thought to account for up to 30% of sporadic colorectal cancer, but its role in inflammatory bowel disease (IBD)-related colorectal cancer is still not well elucidated. Hyperplastic polyps are not thought to impart an increased risk of colorectal cancer; however, sessile serrated adenomas/polyps and traditional serrated adenomas may have malignant potential. From the limited research currently available, this appears to hold true for IBD patients as well. IBD patients do not seem to be at a higher risk of typical serrated colorectal lesions than the general population, but it is still not known if they have a quicker progression to colorectal cancer. Serrated epithelial change is a newly described finding in patients with longstanding colitis that may increase the risk of colorectal cancer in IBD patients. Overall, serrated lesions are not uncommon in the IBD population, and further research is needed to understand the role that serrated lesions play in the development of colorectal cancer.