Long-Term Incidence of Advanced Colorectal Neoplasia in Patients With Serrated Polyposis Syndrome

Aims Serrated polyposis syndrome (SPS) implies an increased risk of colorectal cancer (CRC), so intensive endoscopic surveillance has been recommended. Although a low incidence of CRC has been described under follow-up, few studies have evaluated long-term risk of developing advanced colorectal neoplasia in these patients.

Methods From March 2013 to October 2020, individuals who fulfilled WHO (2010) criteria I and/or III for SPS were retrospective and prospectively 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 SPS diagnosis and those with any interval between colonoscopies >3.5 years. We defined advanced neoplasia as advanced serrated lesion (≥10 mm and/or with dysplasia), advanced adenoma or CRC.

Results We recruited 129 patients, 11 (8.5 %) of whom presented CRC, all prevalent. One hundred and nine started endoscopic surveillance every 1-3 years, 53 (48.6 %) women, with a mean age at SPS diagnosis of 59.4 years (SD=8.9). Eighteen (16.5 %), 61 (56.0 %) and 30 (27.5 %) individuals fulfilled criterion I, III and both, respectively. We performed 342 colonoscopies (median = 3, IQR=2-4), with a median follow-up after colonic clearance of 5.0 years (IQR=3.3-7.2) and a median interval between them of 1.8 years (IQR=1.6-2.1). Five-year cumulative incidences of advanced serrated lesion and advanced adenoma were 17.2 % (95 %CI 9.4-25.0) and 6.8 % (95 %CI 1.5-12.1), respectively. Regarding advanced neoplasia, 5-year cumulative incidences were 21.6 % (95 %CI 13.1-30.1) globally, and 5.6 % (95 %CI 0-16.1), 10.8 % (95 %CI 2.7-19.0) and 50.8 % (95 %CI 30.6-71.1) in patients who fulfilled criterion I, III and both, respectively. No CRC was diagnosed and only 1 (0.9 %) patient underwent surgery, because of an unresectable polyp.

Conclusions During follow-up of our cohort of patients with SPS, no CRC was diagnosed and only one required surgery. Long-term cumulative incidence of advanced colorectal neoplasia was lower than expected according to previous studies.

Citation: Rodríguez-Alcalde D, Castillo-López G, López-Vicente J¹ et al. eP249 LONG-TERM INCIDENCE OF ADVANCED COLORECTAL NEOPLASIA IN PATIENTS WITH SERRATED POLYPOSIS SYNDROME. Endoscopy 2021; 53: S179.

Publication History

Article published online:
19 March 2021