 While mutations in the gene PTEN were also thought to have caused juvenile polyposis syndrome, it is now thought that mutations in this gene cause a similar clinical picture to juvenile polyposis syndrome but are actually affected with Cowden syndrome or other phenotypes of the PTEN hamartoma tumor syndrome.People with juvenile polyps may require yearly upper and lower endoscopies with polyp excision and cytology.Their siblings may also need to be screened regularly.