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

Gao, Qin-Yan; Tsoi, Kelvin K.F.; Hirai, Hoyee W.; Wong, Martin C. S.; Chan, Francis K.L.; Wu, Justin Che Yuen; Lau, James Y.; Sung, Joseph J.Y.; Ng, Siew C.

doi:10.1038/ajg.2015.49

Cited by 75 publications

(65 citation statements)

References 54 publications

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“…Assuming an independent contribution of SSPs to FIT positivity, a lower prevalence of advanced adenomas would have been expected in subjects with SSPs. Contrary to this assumption, we found an increased prevalence of advanced adenomas in screenees detected with SSPs, which would confirm the association between SSPs and advanced adenomas already shown in primary screening settings,38 45 46 47 48 49 suggesting that these two lesions may share environmental or genetic risk factors.…”

Section: Discussionsupporting

confidence: 86%

Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

Zorzi

Senore

et al. 2016

Gut

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Section: Discussionsupporting

confidence: 86%

Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

Zorzi

Senore

et al. 2016

Gut

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“…This was supported by a recent systematic review and meta-analysis, by Gao et al, revealing a strong positive relationship between proximal SP and synchronous advanced neoplasia 16 .…”

Section: Introductionsupporting

confidence: 64%

Lifestyle Risk Factors for Serrated Colorectal Polyps: A Systematic Review and Meta-analysis

Bailie¹,

Loughrey²,

Coleman³

2017

Gastroenterology

142

127

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“…Up to now, these polyps were mainly differentiated into hyperplastic polyps and adenomas. In recent years, sessile and TSAs have been identified as separate lesions which may be precursor lesion in the so-called serrated and alternate pathways of colorectal carcinogenesis [3,20]. Therefore, correct diagnosis and differential diagnosis of serrated lesions (hyperplastic polyps, sessile and TSAs) is very important for further management including follow-up.…”

Section: Discussionmentioning

confidence: 99%

Impact of reassessment of colonic hyperplastic polyps by expert GI pathologists

Schachschal

Sehner

Choschzick

et al. 2016

Int J Colorectal Dis

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BACKGROUND: Recommended follow-up intervals after endoscopic removal of hyperplastic polyps (HP) and sessile serrated adenomas (SSA) differ because of assumed differences in biological behaviour. However, histopathologic differentiation is difficult, with higher SSA rates reported from specialist GI histopathologists. OBJECTIVE: The objective of this study was to clarify the relevance of histologic reassessment of HP. DESIGN AND SETTING: From a prospective screening colonoscopy study relevant serrated lesions (excluding distal small HP 5 mm) diagnosed by private practice pathologists were reassessed by four specialized GI pathologists PATIENTS: One thousand sixty-nine screening colonoscopies were performed in patients. MAIN OUTCOME MEASUREMENTS: In terms of main outcome measurements, there is a likelihood of changes of the HP diagnosis on reassessment, as well as interrater variability. RESULTS: SSA were initially diagnosed in 7 cases (0.7 %) and relevant HP in 83 (7.8 %; 101 lesions). Of the latter, the chance of a change in diagnosis from HP to SSA by any of the four specialist histopathologists was higher for larger (>5 mm) and right-sided lesions (19.1 vs 1.3 %, OR 18.4, p = 0.04) including a higher likelihood to change recommended follow-up intervals (32.1 vs 3.3 %, p < 0.01). However, follow-up intervals were determined by concomitant adenomas in 41 %. Interrater variability was also higher for these lesions (p = 0.04), with an overall kappa value of 0.48. However, this issue related to only 1.2 % of the 1069 study cases. LIMITATION: The limitations this study are the limited case number as well as limited retrospective assessment. CONCLUSIONS: Right-sided HP >5 mm had a higher chance of change in diagnosis to SSA; therefore, they should probably be treated like adenomas and be removed. However, reliable data for recommendations on follow-up intervals of HP or SSA will require follow-up studies. Abstract Background Recommended follow-up intervals after endoscopic removal of hyperplastic polyps (HP) and sessile serrated adenomas (SSA) differ because of assumed differences in biological behaviour. However, histopathologic differentiation is difficult, with higher SSA rates reported from specialist GI histopathologists.Objective The objective of this study was to clarify the relevance of histologic reassessment of HP.Design and setting From a prospective screening colonoscopy study relevant serrated lesions (excluding distal small HP ≤5 mm) diagnosed by private practice pathologists were reassessed by four specialized GI pathologists Patients One thousand sixty-nine screening colonoscopies were performed in patients.Main outcome measurements In terms of main outcome measurements, there is a likelihood of changes of the HP diagnosis on reassessment, as well as interrater variability.Results SSA were initially diagnosed in 7 cases (0.7 %) and relevant HP in 83 (7.8 %; 101 lesions). Of the latter, the chance of a change in diagnosis from HP to SSA by any of the four specialist histopathologists was hig...

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

Abstract: Our meta-analysis showed that serrated polyps are associated with a more than twofold increased risk of detection of synchronous advanced neoplasia. Individuals with proximal and large serrated polyps have the highest risk. These individuals deserve surveillance colonoscopy.

Cited by 75 publications

References 54 publications

Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

Lifestyle Risk Factors for Serrated Colorectal Polyps: A Systematic Review and Meta-analysis

Impact of reassessment of colonic hyperplastic polyps by expert GI pathologists

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