Age-specific prevalence of serrated lesions and their subtypes by screening colonoscopy: a retrospective study

Abstract

BackgroundSerrated lesions of the colorectum as categorized by pathology include hyperplastic polyps, sessile serrated adenomas without dysplasia, and traditional serrated adenomas with dysplasia. The aim of this study was to investigate the prevalence of various subtypes of serrated lesions by age.MethodsIn this study, 28,544 consecutive asymptomatic patients (aged 22–88 years) were evaluated during health check-ups involving colonoscopies performed by gastroenterologists at a single institution from 2005 to 2012.ResultsThe adenoma detection rate during colonoscopies for patients aged ≥50 years was 31.8% (25.0–35.8%). The serrated lesion detection rate for patients aged ≥50 years was 15.3% (10.5–19.6%). Serrated lesions were detected in 15.1% of all patients with subtype prevalences of 14.7% for hyperplastic polyps, 0.5% for sessile serrated adenomas, and 0.1% for traditional serrated adenomas. The prevalence of conventional adenomas increased sharply with age (5.0% in patients aged 20–29 years, 10.9% in those aged 30–39 years, 21.8% in those aged 40–49 years, 29.5% in those aged 50–59 years, 36.9% in those aged 60–69 years, and 40.7% in those aged ≥70 years) (trend P = 0.027). In contrast, the prevalence of serrated lesions increased only slightly with age (10.0% in patients aged 20–29 years, 11.8% in those aged 30–39 years, 14.8% in those aged 40–49 years, 15.3% in those aged 50–59 years, 16.8% in those aged 60–69 years, and 16.4% in those aged ≥70 years) (trend P = 0.036).ConclusionsThe screening colonoscopy detection rate of serrated lesions, including sessile serrated adenomas and traditional serrated adenomas, appears to be relatively high among young patients aged <50 years.

Nonsteroidal anti‐inflammatory drugs but not aspirin are associated with a lower risk of post‐colonoscopy colorectal cancer

“…The current subgroup analysis also shows that the beneficial effect of NSAIDs was observed in both sex, but may be higher in females. However, it was only significant among those aged 60 years or above, which may be explained by lower burden of both adenomatous and serrated polyps in younger patients, and hence a lower risk of missed colonic polyps or incomplete resection of lesions. The beneficial effect of NSAIDs was also limited to nondiabetic patients and those without the history of colonic polyps.…”

Sessile serrated adenomas versus conventional adenomas. Different polyps in different populations?

“…It has been presented from previous studies that serrated lesion development slightly increases with age [11][12][13], and in a recent study from Kim et al in 2014, it was concluded that SSA/Ps tend to occur more frequently in younger patients (<50) than conventional adenomas [12]. In our study, it was found that age is a risk factor for developing SSA/Ps especially after the age of 50 comparing to normal population and also that SSA/Ps seem to have their peak incidence 10 years earlier than that of conventional adenomas [51-60 p=0.001 and 61-70 (p=0.001), respectively].…”

Genome Scale Epigenetic Profiling Reveals Five Distinct Subtypes of Colorectal Cancer

“…This is also consistent with our animal model for serrated neoplasia where we observe a slow accumulation of DNA methylation changes over time, however these are dramatically accelerated by mutating BRAF, congruent with development of serrated neoplasia (32). This may explain why BRAF mutant sessile serrated adenomas are often identified in younger patients, despite the cancers arising from them occurring primarily in older patients (12, 33, 34). Understanding the role of age-related methylation might inform surveillance for younger patients with sessile serrated adenomas.…”