Long-Term Incidence of Advanced Colorectal Neoplasia in Patients with Serrated Polyposis Syndrome: Experience in a Single Academic Centre

• Published in: Cancers Vol. 13; no. 5; p. 1066
• Main Authors: Rodríguez-Alcalde, Daniel, Castillo-López, Guillermo, López-Vicente, Jorge, Hernández, Luis, Lumbreras-Cabrera, Mercedes, Moreno-Sánchez, Diego
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 03-03-2021; MDPI
• Subjects: Adenoma; Colonoscopy; Colorectal cancer; Colorectal carcinoma; Dysplasia; Endoscopy; Patients; Polyposis; Polyps; Surgery; Surveillance; Tumors; colorectal cancer; serrated polyp; serrated polyposis syndrome; advanced colorectal neoplasia
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13051066

Serrated polyposis syndrome (SPS) implies a slightly elevated risk of colorectal cancer (CRC) during endoscopic follow-up, but its natural course is still not well known. The main objective of this study was to describe the long-term risk of developing advanced neoplasia (AN) in these patients. Until October 2020, individuals who fulfilled 2010 WHO criteria I and/or III for SPS were retrospectively recruited. We selected those under endoscopic surveillance after resection of all lesions >3 mm in a high-quality colonoscopy. We excluded patients with total colectomy at diagnosis and those with any interval between colonoscopies >3.5 years. We defined AN as advanced serrated polyp (≥10 mm and/or with dysplasia), advanced adenoma, or CRC. In 109 patients, 342 colonoscopies were performed (median = 3, median interval = 1.8 years) during a median follow-up after colonic clearance of 5.0 years. Five-year cumulative incidences of AN were 21.6% globally, and 5.6%, 10.8%, and 50.8% in patients who fulfilled criterion I, III, and both, respectively (
< 0.001). No CRC was diagnosed and only 1 (0.9%) patient underwent surgery. In conclusion, cumulative incidences of AN could be lower than previously described, at least in patients who fulfil the 2010 WHO criterion III alone. Therefore, low-risk individuals might benefit from less stringent surveillance.