American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the maximum number of serrated polyps required for a diagnosis of serrated polyposis syndrome without a family history?

1. 3 serrated polyps

2. 5 serrated polyps

3. 10 serrated polyps

4. 20 serrated polyps

The correct answer is: 5 serrated polyps

The diagnosis of serrated polyposis syndrome is established based on specific criteria, which include the number of serrated polyps found in an individual. According to the most recent guidelines, an individual can be diagnosed with serrated polyposis syndrome if they have at least five serrated polyps of any type, with at least two of these being larger than 1 cm. This criterion is particularly relevant for cases without a known family history of colorectal cancer syndromes. The rationale behind this specific number is tied to the increased risk associated with having multiple serrated polyps, which can indicate a pathway to colorectal cancer. The definition aims to identify high-risk patients who may benefit from intensified surveillance and management. Identifying and understanding these criteria is critical in guiding colonoscopy screening recommendations and determining appropriate follow-up interventions.