Prevalence of serrated polyps and their association with synchronous colorectal advanced adenomas

Abstract

Background – Serrated lesions are the precursors of up to one-third of colorectal cancer (CRC) cases and share molecular and epi-demiological features with interval CRC. Previous studies have reported wide variation in serrated polyp prevalence and diverse magnitude of its relationship with synchronous advanced adenomas. Objective – De-scribe the prevalence of serrated polyps and evaluate their association with synchronous advanced adenomas. Methods – The study is a ret-rospective analysis of 1208 colonoscopies performed in patients aged 45 to 75, predominantly for CRC screening. Data on the prevalence of serrated polyps subsets and advanced adenomas were collected, and multivariate analysis were performed to identify the association between serrated polyps and synchronous advanced adenomas. Results – The prevalence of clinically significant serrated polyps (CSSP), large serrated polyps (LSP), and sessile serrated adenomas (SSA) were 11.3%, 6%, and 3.7%. CSSP were associated with synchronous advanced adenomas (OR 2.121, 95%CI 1.321–3.406), regardless of proximal (OR 2.966, 95%CI 1.701–5.170) or distal (OR 1.945, 95%CI 1.081–3.499) location, while LSP (OR 2.872, 95%CI 1.425–5.787) and SSA (OR 5.032, 95%CI 2.395–10.576) were associated with proximal advanced adenomas. Conclusion – The prevalence of CSSP and advanced adenomas were alike. CSSP is a risk factor for advanced adenomas, and the strength of this association is stronger for proximal advanced adenomas. LSP and SSA are associated with proximal advanced adenomas.