Serrated Adenoma is a Risk Factor for Subsequent Adenomatous Polyps

Abstract

While SA are uncommon, they are commonly associated with colorectal cancer. Serrated adenomas appear to be found more commonly in the left colon and in older patients. This study found a significant association between SA and the subsequent development of adenomatous polyps. Further studies are needed to define appropriate preventive strategies for these patients.

Serrated Polyps and the Risk of Synchronous Colorectal Advanced Neoplasia: A Systematic Review and Meta-Analysis

“…A total of 68 English language abstracts that involved human subjects were retrieved, and 28 potentially relevant studies were reviewed ( 10,(11)(12)(13). Aft er exclusion of 15 studies that did not report the information of interest ( 12,21,(23)(24)(25)(28)(29)(30)32,33,(35)(36)(37)(38)(39) and 4 studies that had insuffi cient data for meta-analysis ( 13,22,31,41 ), our fi nal analysis included nine studies published between 2009 and 2014.…”

Hyperplastic Polyps: Are They Completely Innocent?

“…A small case-control study including 17 patients with SA and 17 controls found that the finding of an SA at baseline colonoscopy was associated with adenomatous polyps in subsequent examinations (24% vs 0%; P=0.01) [12]. • The presence of a proximal ND-SP and no neoplasia on index colonoscopy is associated with an increased risk of any adenoma during surveillance (OR, 3.14; 95% CI, 1.59-6.2)…”

“…The incidence of cancerous transformation of serrated polyps remains unknown and the hypothesis that the presence of serrated polyps constitutes a risk factor for CRC has been based on small studies until very recently ( Table 2) [12][13][14]46]. The first report showing a correlation between serrated polyps and development of adenomatous polyps in a large cohort was published in 2009 by Li et al [47].…”

“…These two somatic features, which can be traced from cancer to their serrated precursors, constitute the molecular basis of the "serrated pathway" [11•]. Finally, patients with serrated polyps have been recognized to be at risk for colorectal neoplasia [12][13][14]. The presence of large and proximal serrated polyps has been recently shown to constitute risk factors for CRC development, and this might have implication for surveillance [15•, 16•].…”

La fréquence des cancers coliques d’intervalle est-elle le seul critère pertinent pour la coloscopie ?

“…Leur implication est égale-ment démontrée pour les PFS proximaux, avec un RR de CCR plus marqué pour les PFS larges et proximaux (5,4 [2,4-10,1]) [37] ou de 3,4 (IC 95 % : [1,7]) pour les néoplasies avancées [38]. Cette dernière étude a surtout montré une augmentation plus marquée du risque de récidive de néoplasie (3,1 ; IC 95 % : [1,6-6,2]) ou de néoplasie avancée (2,2 ; IC 95 % : [1,01-4,6]) à 5,5 ans en présence de PFS à localisation proximale, alors que ce risque était déjà connu pour les PFT du côlon gauche [39].…”