Table 1.

Scoring system related to the Spigelman classification to estimate the severity of duodenal adenomatous polyposis and the risk of duodenal cancer development. The number and size of the polyps, the histological characteristics and the degree of dysplasia are given a score between 0 and 3. The 4 scores are summed up and the overall score determines the Spigelman stage and the suggested follow-up

Score	Number of polyps	Size of polyps	Histological characteristics	Degree of dysplasia
0	0	No polyps	No adenomas	No dysplasia
1	1–4	1–4 mm	Tubular adenoma	Mild dysplasia
2	5–20	5–10 mm	Tubulovillous adenoma	Moderate dysplasia
3	>20	>10 mm	Villous adenoma	Severe dysplasia

Spigelman score	Spigelman stage	Suggested follow-up
0	0	Every 5 year
1 − 4	I	Every 5 year
5 + 6	II	Every 2 years
7 + 8	III	Every year
9 − 12	IV	Every 6 months