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Endoscopy
DOI: 10.1055/a-2324-6262
Original article

Sessile serrated lesion prevalence and factors associated with their detection: a post-hoc analysis of a multinational randomized controlled trial from Asia

Chin Kimg Tan 
1   Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore (Ringgold ID: RIN26674)
2   Medicine Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore (Ringgold ID: RIN569261)
,
Sho Suzuki 
3   Gastroenterology and Hepatology, International University of Health and Welfare School of Medicine, Narita, Japan (Ringgold ID: RIN38259)
,
Tiing Leong Ang
1   Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore (Ringgold ID: RIN26674)
2   Medicine Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore (Ringgold ID: RIN569261)
,
Xuan Han Koh
4   Health Services Research, Changi General Hospital, Singapore, Singapore (Ringgold ID: RIN26674)
,
Lai Mun Wang
5   Laboratory Medicine, Changi General Hospital, Singapore, Singapore (Ringgold ID: RIN26674)
6   Pathology Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore (Ringgold ID: RIN569261)
,
Satimai Aniwan
7   Center of Excellence in Endoscopy for Gastrointestinal Oncology, Chulalongkorn University Department of Internal Medicine, Bangkok, Thailand (Ringgold ID: RIN625863)
,
Han-Mo Chiu
8   Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan (Ringgold ID: RIN38006)
,
Kannikar Laohavichitra
9   Rajavithi Digestive Endoscopy Center, Rajavithi Hospital, Bangkok, Thailand (Ringgold ID: RIN54781)
,
Sakkarin Chirapongsathorn
10   Gastroenterology and Hepatology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand (Ringgold ID: RIN37680)
,
Takeshi Yamamura 
11   Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Chen Ya Kuo
12   Gastroenterology, Fu Jen Catholic University Hospital, New Taipei City, Taiwan (Ringgold ID: RIN485856)
,
Naohisa Yoshida 
13   Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan (Ringgold ID: RIN12898)
,
Takahito Takezawa
14   Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan (Ringgold ID: RIN12838)
,
Rungsun Rerknimitr 
7   Center of Excellence in Endoscopy for Gastrointestinal Oncology, Chulalongkorn University Department of Internal Medicine, Bangkok, Thailand (Ringgold ID: RIN625863)
,
Hideki Ishikawa
15   Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan (Ringgold ID: RIN12898)
,
Takuji Gotoda
16   Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
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Abstract

Background Sessile serrated lesions (SSLs) are associated with an increased risk of colorectal cancer. Data on the prevalence of SSLs in Asia are limited. We performed this study to estimate the prevalence of SSLs in Asia and to explore endoscopic factors that are associated with SSL detection.

Methods This is a post-hoc analysis of a multicenter randomized controlled trial from four Asian countries/regions that compared adenoma detection rates using linked-color imaging (LCI) and white-light imaging. Colonoscopies were performed in an average-risk population for screening, diagnostic examination, or polyp surveillance. Patients with SSLs were compared against those without SSLs to evaluate for possible predictors of SSL detection using Firth’s logistic regression.

Results 2898 participants (mean age 64.5 years) were included in the analysis. The estimated prevalence of SSLs was 4.0% (95%CI 3.4%–4.8%), with no sex or age group differences. On multivariable analysis, use of LCI (adjusted odds ratio [aOR] 1.63, 95%CI 1.10–2.41), experienced endoscopists (aOR 1.94, 95%CI 1.25–3.00), use of transparent cap (aOR 1.75, 95%CI 1.09–2.81), and longer withdrawal time (aOR 1.06, 95%CI 1.03–1.10) were independently associated with SSL detection. Synchronous adenoma detection (aOR 1.89, 95%CI 1.20–2.99) was also predictive of SSL detection.

Conclusion The prevalence of SSLs in Asia is 4.0%. Use of LCI or a transparent cap, greater endoscopist experience, and longer withdrawal time were all associated with increased SSL detection.

Supplementary Material



Publication History

Received: 15 October 2023

Accepted after revision: 18 April 2024

Article published online:
10 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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