Analyses of individuals with serrated polyposis, i.e. incidence of multiple sessile serrated adenomas simultaneously, have identified germline alterations in genes including ATM, RBL1, XAF1, PIF1, TELO2, and RNF43, which are involved in OIS through roles in DNA repair, cell cycle, apoptosis, genome stability, and Wnt regulation [93]. The gene discussed is RNF43; the disease is adenoma.