Small and diminutive hyperplastic polyps in the proximal colon: Are they innocent or guilty of a crime?

Over the past 30 years, serrated polyps (SPs) of the colorectum have gained increasing attention in relation to colorectal cancer (CRC) prevention.1 Historically, this group of lesions was called "hyperplastic polyps" (HPs), which were considered innocuous, and the term "serrated" was used to describe the "saw-toothed" architecture in their crypt epithelium.2 The heterogeneity of SPs was not recognized until 1990, when Longacre and Fenoglio-Preiser3 proposed the term "serrated adenoma" (now termed "traditional serrated adenoma," or TSA) to describe a subgroup of SPs that not only share the serrated crypt architecture of HPs but also have cytologic dysplasia.

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