Relationship of colonoscopy-detected serrated polyps with synchronous advanced neoplasia in average-risk individuals

Cristina Álvarez; Montserrat Andreu; Antoni Castells; Enrique Quintero; Luis Bujanda; Joaquín Cubiella; Dolores Salas; Ángel Lanas; Fernando Carballo; Juan Diego Morillas; Cristina Hernández; Rodrigo Jover; Cristina Sarasqueta; José M. Enriquéz-Navascués; Vicent Hernández; Pamela Estévez; Ramiro Macenlle; Teresa Sala; Francesc Balaguer; Maria Pellisé; Leticia Moreira; Inés Gil; Antonio Peris; Francisca González-Rubio; Ángel Ferrández; Carmen Poves; Marta Ponce; Jaume Grau; Anna Serradesanferm; Akiko Ono; José Cruzado; Francisco Pérez-Riquelme; Inmaculada Alonso-Abreu; Marta Carrillo-Palau; Cecilio Santander; José Díaz Tasende; Alberto Herreros; Guillermo Cacho; Luis Eugenio Barranco; Xavier Bessa

doi:10.1016/j.gie.2013.03.003

Relationship of colonoscopy-detected serrated polyps with synchronous advanced neoplasia in average-risk individuals

Cristina Álvarez, Montserrat Andreu, Antoni Castells, Enrique Quintero, Luis Bujanda, Joaquín Cubiella, Dolores Salas, Ángel Lanas, Fernando Carballo, Juan Diego Morillas, Cristina Hernández, Rodrigo Jover, Cristina Sarasqueta, José M. Enriquéz-Navascués, Vicent Hernández, Pamela Estévez, Ramiro Macenlle, Teresa Sala, Francesc Balaguer, Maria PelliséLeticia Moreira, Inés Gil, Antonio Peris, Francisca González-Rubio, Ángel Ferrández, Carmen Poves, Marta Ponce, Jaume Grau, Anna Serradesanferm, Akiko Ono, José Cruzado, Francisco Pérez-Riquelme, Inmaculada Alonso-Abreu, Marta Carrillo-Palau, Cecilio Santander, José Díaz Tasende, Alberto Herreros, Guillermo Cacho, Luis Eugenio Barranco, Xavier Bessa

Department of Medicine

Research output: Contribution to journal › Article › Research › peer-review

58 Citations (Scopus)

Abstract

Background: Serrated cancers account for 10% to 20% of all colorectal cancers (CRC) and more than 30% of interval cancers. The presence of proximal serrated polyps and large (≥10 mm) serrated polyps (LSP) has been correlated with colorectal neoplasia. Objective: To evaluate the prevalence of serrated polyps and their association with synchronous advanced neoplasia in a cohort of average-risk population and to assess the efficacy of one-time colonoscopy and a biennial fecal immunochemical test for reducing CRC-related mortality. This study focused on the sample of 5059 individuals belonging to the colonoscopy arm. Design: Multicenter, randomized, controlled trial. Setting: The ColonPrev study, a population-based, multicenter, nationwide, randomized, controlled trial. Patients: A total of 5059 asymptomatic men and women aged 50 to 69 years. Intervention: Colonoscopy. Main Outcome Measurements: Prevalence of serrated polyps and their association with synchronous advanced neoplasia. Results: Advanced neoplasia was detected in 520 individuals (10.3%) (CRC was detected in 27 [0.5%] and advanced adenomas in 493 [9.7%]). Serrated polyps were found in 1054 individuals (20.8%). A total of 329 individuals (6.5%) had proximal serrated polyps, and 90 (1.8%) had LSPs. Proximal serrated polyps or LSPs were associated with male sex (odds ratio [OR] 2.08, 95% confidence interval [CI], 1.76-4.45 and OR 1.65, 95% CI, 1.31-2.07, respectively). Also, LSPs were associated with advanced neoplasia (OR 2.49, 95% CI, 1.47-4.198), regardless of their proximal (OR 4.15, 95% CI, 1.69-10.15) or distal (OR 2.61, 95% CI, 1.48-4.58) locations. When we analyzed subtypes of serrated polyps, proximal hyperplasic polyps were related to advanced neoplasia (OR 1.61, 95% CI, 1.13-2.28), although no correlation with the location of the advanced neoplasia was observed. Limitations: Pathology criteria for the diagnosis of serrated polyps were not centrally reviewed. The morphology of the hyperplasic polyps (protruded or flat) was not recorded. Finally, because of the characteristics of a population-based study carried out in average-risk patients, the proportion of patients with CRC was relatively small. Conclusion: LSPs, but not proximal serrated polyps, are associated with the presence of synchronous advanced neoplasia. Further studies are needed to determine the risk of proximal hyperplastic polyps.

Original language	English
Journal	Gastrointestinal Endoscopy
Volume	78
Issue number	2
DOIs	https://doi.org/10.1016/j.gie.2013.03.003
Publication status	Published - 1 Jan 2013

Keywords

CIMP
colorectal cancer
CpG island methylation phenotype
CRC
high degree of microsatellite instability
HP
hyperplastic polyp
large serrated polyp
LSP
MSI-H
sessile serrated adenoma
SSA
traditional serrated adenoma
TSA

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.gie.2013.03.003

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Álvarez, C., Andreu, M., Castells, A., Quintero, E., Bujanda, L., Cubiella, J., Salas, D., Lanas, Á., Carballo, F., Morillas, J. D., Hernández, C., Jover, R., Sarasqueta, C., Enriquéz-Navascués, J. M., Hernández, V., Estévez, P., Macenlle, R., Sala, T., Balaguer, F., ... Bessa, X. (2013). Relationship of colonoscopy-detected serrated polyps with synchronous advanced neoplasia in average-risk individuals. Gastrointestinal Endoscopy, 78(2). https://doi.org/10.1016/j.gie.2013.03.003

@article{009f06dd057a4ff085c64678ae937efb,

title = "Relationship of colonoscopy-detected serrated polyps with synchronous advanced neoplasia in average-risk individuals",

abstract = "Background: Serrated cancers account for 10% to 20% of all colorectal cancers (CRC) and more than 30% of interval cancers. The presence of proximal serrated polyps and large (≥10 mm) serrated polyps (LSP) has been correlated with colorectal neoplasia. Objective: To evaluate the prevalence of serrated polyps and their association with synchronous advanced neoplasia in a cohort of average-risk population and to assess the efficacy of one-time colonoscopy and a biennial fecal immunochemical test for reducing CRC-related mortality. This study focused on the sample of 5059 individuals belonging to the colonoscopy arm. Design: Multicenter, randomized, controlled trial. Setting: The ColonPrev study, a population-based, multicenter, nationwide, randomized, controlled trial. Patients: A total of 5059 asymptomatic men and women aged 50 to 69 years. Intervention: Colonoscopy. Main Outcome Measurements: Prevalence of serrated polyps and their association with synchronous advanced neoplasia. Results: Advanced neoplasia was detected in 520 individuals (10.3%) (CRC was detected in 27 [0.5%] and advanced adenomas in 493 [9.7%]). Serrated polyps were found in 1054 individuals (20.8%). A total of 329 individuals (6.5%) had proximal serrated polyps, and 90 (1.8%) had LSPs. Proximal serrated polyps or LSPs were associated with male sex (odds ratio [OR] 2.08, 95% confidence interval [CI], 1.76-4.45 and OR 1.65, 95% CI, 1.31-2.07, respectively). Also, LSPs were associated with advanced neoplasia (OR 2.49, 95% CI, 1.47-4.198), regardless of their proximal (OR 4.15, 95% CI, 1.69-10.15) or distal (OR 2.61, 95% CI, 1.48-4.58) locations. When we analyzed subtypes of serrated polyps, proximal hyperplasic polyps were related to advanced neoplasia (OR 1.61, 95% CI, 1.13-2.28), although no correlation with the location of the advanced neoplasia was observed. Limitations: Pathology criteria for the diagnosis of serrated polyps were not centrally reviewed. The morphology of the hyperplasic polyps (protruded or flat) was not recorded. Finally, because of the characteristics of a population-based study carried out in average-risk patients, the proportion of patients with CRC was relatively small. Conclusion: LSPs, but not proximal serrated polyps, are associated with the presence of synchronous advanced neoplasia. Further studies are needed to determine the risk of proximal hyperplastic polyps.",

keywords = "CIMP, colorectal cancer, CpG island methylation phenotype, CRC, high degree of microsatellite instability, HP, hyperplastic polyp, large serrated polyp, LSP, MSI-H, sessile serrated adenoma, SSA, traditional serrated adenoma, TSA",

author = "Cristina {\'A}lvarez and Montserrat Andreu and Antoni Castells and Enrique Quintero and Luis Bujanda and Joaqu{\'i}n Cubiella and Dolores Salas and {\'A}ngel Lanas and Fernando Carballo and Morillas, {Juan Diego} and Cristina Hern{\'a}ndez and Rodrigo Jover and Cristina Sarasqueta and Enriqu{\'e}z-Navascu{\'e}s, {Jos{\'e} M.} and Vicent Hern{\'a}ndez and Pamela Est{\'e}vez and Ramiro Macenlle and Teresa Sala and Francesc Balaguer and Maria Pellis{\'e} and Leticia Moreira and In{\'e}s Gil and Antonio Peris and Francisca Gonz{\'a}lez-Rubio and {\'A}ngel Ferr{\'a}ndez and Carmen Poves and Marta Ponce and Jaume Grau and Anna Serradesanferm and Akiko Ono and Jos{\'e} Cruzado and Francisco P{\'e}rez-Riquelme and Inmaculada Alonso-Abreu and Marta Carrillo-Palau and Cecilio Santander and {D{\'i}az Tasende}, Jos{\'e} and Alberto Herreros and Guillermo Cacho and Barranco, {Luis Eugenio} and Xavier Bessa",

year = "2013",

month = jan,

day = "1",

doi = "10.1016/j.gie.2013.03.003",

language = "English",

volume = "78",

journal = "Gastrointestinal Endoscopy",

issn = "0016-5107",

publisher = "Mosby Inc.",

number = "2",

}

Álvarez, C, Andreu, M, Castells, A, Quintero, E, Bujanda, L, Cubiella, J, Salas, D, Lanas, Á, Carballo, F, Morillas, JD, Hernández, C, Jover, R, Sarasqueta, C, Enriquéz-Navascués, JM, Hernández, V, Estévez, P, Macenlle, R, Sala, T, Balaguer, F, Pellisé, M, Moreira, L, Gil, I, Peris, A, González-Rubio, F, Ferrández, Á, Poves, C, Ponce, M, Grau, J, Serradesanferm, A, Ono, A, Cruzado, J, Pérez-Riquelme, F, Alonso-Abreu, I, Carrillo-Palau, M, Santander, C, Díaz Tasende, J, Herreros, A, Cacho, G, Barranco, LE & Bessa, X 2013, 'Relationship of colonoscopy-detected serrated polyps with synchronous advanced neoplasia in average-risk individuals', Gastrointestinal Endoscopy, vol. 78, no. 2. https://doi.org/10.1016/j.gie.2013.03.003

TY - JOUR

T1 - Relationship of colonoscopy-detected serrated polyps with synchronous advanced neoplasia in average-risk individuals

AU - Álvarez, Cristina

AU - Andreu, Montserrat

AU - Castells, Antoni

AU - Quintero, Enrique

AU - Bujanda, Luis

AU - Cubiella, Joaquín

AU - Salas, Dolores

AU - Lanas, Ángel

AU - Carballo, Fernando

AU - Morillas, Juan Diego

AU - Hernández, Cristina

AU - Jover, Rodrigo

AU - Sarasqueta, Cristina

AU - Enriquéz-Navascués, José M.

AU - Hernández, Vicent

AU - Estévez, Pamela

AU - Macenlle, Ramiro

AU - Sala, Teresa

AU - Balaguer, Francesc

AU - Pellisé, Maria

AU - Moreira, Leticia

AU - Gil, Inés

AU - Peris, Antonio

AU - González-Rubio, Francisca

AU - Ferrández, Ángel

AU - Poves, Carmen

AU - Ponce, Marta

AU - Grau, Jaume

AU - Serradesanferm, Anna

AU - Ono, Akiko

AU - Cruzado, José

AU - Pérez-Riquelme, Francisco

AU - Alonso-Abreu, Inmaculada

AU - Carrillo-Palau, Marta

AU - Santander, Cecilio

AU - Díaz Tasende, José

AU - Herreros, Alberto

AU - Cacho, Guillermo

AU - Barranco, Luis Eugenio

AU - Bessa, Xavier

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Background: Serrated cancers account for 10% to 20% of all colorectal cancers (CRC) and more than 30% of interval cancers. The presence of proximal serrated polyps and large (≥10 mm) serrated polyps (LSP) has been correlated with colorectal neoplasia. Objective: To evaluate the prevalence of serrated polyps and their association with synchronous advanced neoplasia in a cohort of average-risk population and to assess the efficacy of one-time colonoscopy and a biennial fecal immunochemical test for reducing CRC-related mortality. This study focused on the sample of 5059 individuals belonging to the colonoscopy arm. Design: Multicenter, randomized, controlled trial. Setting: The ColonPrev study, a population-based, multicenter, nationwide, randomized, controlled trial. Patients: A total of 5059 asymptomatic men and women aged 50 to 69 years. Intervention: Colonoscopy. Main Outcome Measurements: Prevalence of serrated polyps and their association with synchronous advanced neoplasia. Results: Advanced neoplasia was detected in 520 individuals (10.3%) (CRC was detected in 27 [0.5%] and advanced adenomas in 493 [9.7%]). Serrated polyps were found in 1054 individuals (20.8%). A total of 329 individuals (6.5%) had proximal serrated polyps, and 90 (1.8%) had LSPs. Proximal serrated polyps or LSPs were associated with male sex (odds ratio [OR] 2.08, 95% confidence interval [CI], 1.76-4.45 and OR 1.65, 95% CI, 1.31-2.07, respectively). Also, LSPs were associated with advanced neoplasia (OR 2.49, 95% CI, 1.47-4.198), regardless of their proximal (OR 4.15, 95% CI, 1.69-10.15) or distal (OR 2.61, 95% CI, 1.48-4.58) locations. When we analyzed subtypes of serrated polyps, proximal hyperplasic polyps were related to advanced neoplasia (OR 1.61, 95% CI, 1.13-2.28), although no correlation with the location of the advanced neoplasia was observed. Limitations: Pathology criteria for the diagnosis of serrated polyps were not centrally reviewed. The morphology of the hyperplasic polyps (protruded or flat) was not recorded. Finally, because of the characteristics of a population-based study carried out in average-risk patients, the proportion of patients with CRC was relatively small. Conclusion: LSPs, but not proximal serrated polyps, are associated with the presence of synchronous advanced neoplasia. Further studies are needed to determine the risk of proximal hyperplastic polyps.

AB - Background: Serrated cancers account for 10% to 20% of all colorectal cancers (CRC) and more than 30% of interval cancers. The presence of proximal serrated polyps and large (≥10 mm) serrated polyps (LSP) has been correlated with colorectal neoplasia. Objective: To evaluate the prevalence of serrated polyps and their association with synchronous advanced neoplasia in a cohort of average-risk population and to assess the efficacy of one-time colonoscopy and a biennial fecal immunochemical test for reducing CRC-related mortality. This study focused on the sample of 5059 individuals belonging to the colonoscopy arm. Design: Multicenter, randomized, controlled trial. Setting: The ColonPrev study, a population-based, multicenter, nationwide, randomized, controlled trial. Patients: A total of 5059 asymptomatic men and women aged 50 to 69 years. Intervention: Colonoscopy. Main Outcome Measurements: Prevalence of serrated polyps and their association with synchronous advanced neoplasia. Results: Advanced neoplasia was detected in 520 individuals (10.3%) (CRC was detected in 27 [0.5%] and advanced adenomas in 493 [9.7%]). Serrated polyps were found in 1054 individuals (20.8%). A total of 329 individuals (6.5%) had proximal serrated polyps, and 90 (1.8%) had LSPs. Proximal serrated polyps or LSPs were associated with male sex (odds ratio [OR] 2.08, 95% confidence interval [CI], 1.76-4.45 and OR 1.65, 95% CI, 1.31-2.07, respectively). Also, LSPs were associated with advanced neoplasia (OR 2.49, 95% CI, 1.47-4.198), regardless of their proximal (OR 4.15, 95% CI, 1.69-10.15) or distal (OR 2.61, 95% CI, 1.48-4.58) locations. When we analyzed subtypes of serrated polyps, proximal hyperplasic polyps were related to advanced neoplasia (OR 1.61, 95% CI, 1.13-2.28), although no correlation with the location of the advanced neoplasia was observed. Limitations: Pathology criteria for the diagnosis of serrated polyps were not centrally reviewed. The morphology of the hyperplasic polyps (protruded or flat) was not recorded. Finally, because of the characteristics of a population-based study carried out in average-risk patients, the proportion of patients with CRC was relatively small. Conclusion: LSPs, but not proximal serrated polyps, are associated with the presence of synchronous advanced neoplasia. Further studies are needed to determine the risk of proximal hyperplastic polyps.

KW - CIMP

KW - colorectal cancer

KW - CpG island methylation phenotype

KW - CRC

KW - high degree of microsatellite instability

KW - HP

KW - hyperplastic polyp

KW - large serrated polyp

KW - LSP

KW - MSI-H

KW - sessile serrated adenoma

KW - SSA

KW - traditional serrated adenoma

KW - TSA

U2 - 10.1016/j.gie.2013.03.003

DO - 10.1016/j.gie.2013.03.003

M3 - Article

SN - 0016-5107

VL - 78

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

IS - 2

ER -

Relationship of colonoscopy-detected serrated polyps with synchronous advanced neoplasia in average-risk individuals

Abstract

Keywords

UN SDGs

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