Document Detail

Proximal and large hyperplastic and nondysplastic serrated polyps detected by colonoscopy are associated with neoplasia.
MedLine Citation:
PMID:  20633561     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: The family of serrated lesions includes hyperplastic polyps and sessile serrated adenomas without dysplasia, as well as traditional serrated adenoma with dysplasia. We investigated whether detection of proximal nondysplastic serrated polyps (ND-SP) at screening and surveillance colonoscopies is associated with advanced neoplasia.
METHODS: The study included 3121 asymptomatic patients (aged 50-75 years) who had screening colonoscopies; 1371 had subsequent surveillance. The proximal colon was defined as segments proximal to the descending colon. Large ND-SP were defined as ≥ 10 mm. We compared rates of detection of any neoplasia and advanced neoplasia at screening and surveillance colonoscopies (within 5.5 years) in patients with and without proximal or large ND-SP.
RESULTS: At baseline screening, 248 patients (7.9%) had at least 1 proximal ND-SP. They were more likely than patients with no proximal ND-SP to have advanced neoplasia (17.3% vs 10.0%; odds ratio [OR], 1.90; 95% confidence interval [CI], 1.33-2.70). Patients with large ND-SP (n = 44) were also more likely to have synchronous advanced neoplasia (OR, 3.37; 95% CI, 1.71-6.65). During surveillance, 39 patients with baseline proximal ND-SP and no neoplasia were more likely to have neoplasia compared with subjects who did not have polyps (OR, 3.14; 95% CI, 1.59-6.20). Among patients with advanced neoplasia at baseline, those with proximal ND-SP (n = 43) were more likely to have advanced neoplasia during surveillance (OR, 2.17; 95% CI, 1.03-4.59).
CONCLUSIONS: Detection of proximal and large ND-SP at a screening colonoscopy is associated with an increased risk for synchronous advanced neoplasia. Detection of proximal ND-SP in a baseline colonoscopy is associated with an increased risk for interval neoplasia during surveillance.
Mitchal A Schreiner; David G Weiss; David A Lieberman
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2010-07-13
Journal Detail:
Title:  Gastroenterology     Volume:  139     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2010-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1497-502     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
Portland VA Medical Center and Oregon Health and Science University, Portland, Oregon, USA.
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MeSH Terms
Adenoma / diagnosis*,  epidemiology
Colonic Neoplasms / diagnosis*,  epidemiology
Colonic Polyps / diagnosis*,  epidemiology
Colonoscopy / methods*
Diagnosis, Differential
Follow-Up Studies
Intestinal Mucosa / pathology*
Mass Screening / methods*
Middle Aged
Retrospective Studies
Severity of Illness Index
United States / epidemiology
Comment In:
Gastroenterology. 2010 Nov;139(5):1444-7   [PMID:  20875785 ]

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