Increased Risk of Colorectal Cancer in Individuals With a History of Serrated Polyps

Li, Dan; Liu, Liyan; Fevrier, Helene; Alexeeff, Stacey; Doherty, Amanda R.; Raju, Menaka; Amsden, Laura; Lee, Jeffrey K.; Levin, Theodore R.; Corley, Douglas A.; Herrinton, Lisa J.

doi:10.1053/j.gastro.2020.04.004

Cited by 33 publications

(25 citation statements)

References 21 publications

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“…Since many are located in the right colon and are less likely to bleed, they will not be detected in a screening programme based on FOBT or sigmoidoscopy [27,29]. However, they are important to detect, since patients with detected serrated lesions have an increased risk for CRC after more than three years [30].…”

Section: Colorectal Adenomasmentioning

confidence: 99%

Aspects of colorectal cancer screening, methods, age and gender

Hultcrantz

2020

J. Intern. Med.

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Colorectal cancer (CRC) is, besides breast, prostate, lung and skin cancers, the most common cancer worldwide and is suitable for screening. The incidence of CRC varies considerably in different parts of the world: in well-developed countries, the incidence is between 30 and 70 per 100 000 inhabitants, whereas in less-developed countries such as sub-Saharan Africa, it is 10-20/100 000 inhabitants. Women have a lower incidence of CRC, which is usually one-third of total incidence. Several studies have shown that it is possible to decrease mortality from CRC with about 20%, which is evidenced through the data from countries with screening programmes. Though the method of choice to identify blood samples in faecal matter is under debate, the most feasible way is to perform colonoscopy. Other methods include more advanced faecal analyses, testing for mutations from CRC, sigmoidoscopy, CT colonoscopy or optical colonoscopy. Colonoscopy is in most countries not available in sufficient amount and has to be carried out with great accuracy; otherwise, lesions will be missed to identify, thus leading to complications. Gender is an issue in CRC screening, as women have about 20% fewer colorectal adenomas and CRCs, but they also have more right-sided lesions, which are more difficult to detect with tests for faecal blood since they create less blood in faeces. Thus, other strategies may have to be developed for women in order for screening to have the same effect. It is essential to introduce colorectal cancer screening in all countries together with other clinical pieces of advice such as information on smoking, obesity and exercise in order to reduce one of the most dangerous cancers.

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Section: Colorectal Adenomasmentioning

confidence: 99%

Aspects of colorectal cancer screening, methods, age and gender

Hultcrantz

2020

J. Intern. Med.

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“…Previous studies have investigated an association between serrated polyps and the risk of synchronous and metachronous advanced colonic neoplasia. [13][14][15][16][17][18][19][20][21][22][23][24] However, few of them have addressed the risk of metachronous lesions in the presence of adenoma and SSL, and individuals with no polyps rather than those within a similar adenoma risk group were set up as the comparative group in the majority of these studies. [20][21][22] Melson et al 20 reported that the presence of SSL was associated with an approximately two-fold increased risk of metachronous advanced neoplasia, compared with isolated adenoma.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have investigated an association between serrated polyps and the risk of synchronous and metachronous advanced colonic neoplasia 13–24 . However, few of them have addressed the risk of metachronous lesions in the presence of adenoma and SSL, and individuals with no polyps rather than those within a similar adenoma risk group were set up as the comparative group in the majority of these studies 20–22 .…”

Section: Introductionmentioning

confidence: 99%

Sessile serrated lesions in patients with adenoma on index colonoscopy do not increase metachronous advanced adenoma risk

Hong

Kim

Lee

et al. 2021

Digestive Endoscopy

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Objectives Post‐polypectomy surveillance intervals should be determined based on index colonoscopy findings. However, the risk of metachronous lesions, resulting from the coexistence of adenoma and sessile serrated lesions (SSLs), has rarely been addressed. We evaluated the impact of synchronous SSL on the risk of metachronous lesions within similar adenoma risk groups. Methods We retrieved individuals with one or more adenomas on index colonoscopy in a single‐center retrospective cohort and stratified them into four groups depending on the presence of SSL and low‐risk/high‐risk adenoma (LRA/HRA). Participants who underwent surveillance colonoscopies at least 12 months apart were included. We compared the risks of metachronous lesions including HRA, advanced adenoma (AA), or SSL within similar adenoma risk groups according to the presence of SSL. Results Overall 4493 individuals were included in the analysis. The risk of metachronous HRA/AA was not significantly higher in the adenoma with SSL group compared with the adenoma without SSL group, irrespective of LRA (HRA, 6/86 vs. 231/3297, P = 1.00; AA, 0/86 vs. 52/3297, P = 0.64) or HRA (HRA, 11/64 vs. 240/1046, P = 0.36; AA, 3/64 vs. 51/1046, P = 1.00). However, the risk of metachronous SSL in individuals with synchronous SSL was higher than that in those without SSL for both LRA (15/86 vs. 161/3297, P < 0.001) and HRA groups (11/64 vs. 61/1046, P = 0.002). Conclusion The presence of synchronous SSL did not increase the risk of metachronous HRA/AA, compared with isolated adenoma, but increased the risk of metachronous SSL.

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“…Although viewed as a single disease, from the molecular and morphological point of view, CRC is a heterogeneous disease that is believed to arise mainly from two different types of precursor lesions: adenoma and serrated polyps [ 7 , 8 ]. In the classic sequence of adenoma to carcinoma progression model, the development of colorectal cancer originates from aberrant crypts, progressing to early adenoma, advanced adenoma, and subsequently carcinoma [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Somatic targeted mutation profiling of colorectal cancer precursor lesions

et al. 2022

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Background Most colorectal cancers (CRC) arise from precursor lesions. This study aimed to characterize the mutation profile of colorectal cancer precursor lesions in a Brazilian population. Methods In total, 90 formalin-fixed paraffin-embedded colorectal precursor lesions, including 67 adenomas, 7 sessile serrated lesions, and 16 hyperplastic polyps, were analyzed by next-generation sequencing using a panel of 50 oncogenes and tumor suppressor genes. The genetic ancestry of the patients was estimated. Results Somatic driver mutations were identified in 66.7% of cases, including alterations in APC (32.2%), TP53 (20.0%), KRAS (18.9%), BRAF (13.3%) and EGFR (7.8%). Adenomas displayed a higher number of mutations, mainly in APC, compared to serrated polyps (73.1% vs. 47.8%, p = 0.026). Advanced adenomas had a significantly higher frequency of mutation in KRAS and a high overall mutation rate than early adenomas (92.9% vs. 59%, p = 0.006). A high degree of ancestry admixture was observed in the population studied, with a predominance of European components (mean of 73%) followed by African (mean of 11.3%). No association between genetic ancestry and type of lesions was found. The mutation profile of Brazilian colorectal precursor lesions exhibits alteration in APC, KRAS, TP53, and BRAF at different frequencies according to lesion type. Conclusions These results bestow the knowledge of CRC's biologic history and support the potential of these biomarkers for precursor lesions detection in CRC screening of the Brazilian population.

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Increased Risk of Colorectal Cancer in Individuals With a History of Serrated Polyps

Cited by 33 publications

References 21 publications

Aspects of colorectal cancer screening, methods, age and gender

Aspects of colorectal cancer screening, methods, age and gender

Sessile serrated lesions in patients with adenoma on index colonoscopy do not increase metachronous advanced adenoma risk

Somatic targeted mutation profiling of colorectal cancer precursor lesions

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