title: Prevalence of serrated polyps and association with synchronous advanced neoplasia in screening colonoscopy.
abstract: OBJECTIVE
  Serrated polyps of the large intestine comprise a heterogeneous group of lesions with distinct histological and malignant features. The aim of the study was to estimate the prevalence of serrated polyp subtypes in a cohort of individuals undergoing screening colonoscopy, and to identify associations between the detection of serrated polyp subtypes and advanced neoplasia.
  
  
  METHODS
  Data on serrated polyps, adenomas, and cancers were collected from participants of a randomized screening trial that compared colonoscopy with computed tomography colonography. Only data from participants in the colonoscopy arm were used. Logistic regression analyses were performed to identify associations between patients' age, sex, and prevalence of the different types of serrated polyps and to identify associations between the detection of these polyps and advanced neoplasia (defined as an adenoma ≥ 10 mm, villous component, high grade dysplasia or colorectal cancer).
  
  
  RESULTS
  A total of 1426 screen-naïve individuals (51 % male) with a median age of 60 years (IQR 55 - 65) were included. The prevalence of hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), and traditional serrated adenomas (TSAs) was 23.8 %, 4.8 %, and 0.1 %, respectively. SSA/Ps comprised 7.3 % of all polyps. No differences based on age or sex were observed in the prevalence of SSA/Ps. Proximal and large (≥ 10 mm) hyperplastic polyps, as well as proximal and large (≥ 10 mm) SSA/Ps, were associated with synchronous advanced neoplasia.
  
  
  CONCLUSIONS
  Serrated polyps, including SSA/Ps, were frequently encountered in routine screening colonoscopies. Large and proximal hyperplastic polyps, as well large and proximal SSA/Ps, were associated with advanced neoplasia.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Yark
authors.initials: Y
authors.lastname: Hazewinkel
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: de Wijkerslooth
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Stoop
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Bossuyt
authors.affiliation: Department of Pathology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Katharina
authors.initials: K
authors.lastname: Biermann
authors.affiliation: Department of Pathology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: van de Vijver
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Monique E
authors.initials: ME
authors.lastname: van Leerdam
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: Dekker
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology*; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology*; D003111:Colonic Polyps / Q000453:epidemiology* / Q000473:pathology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence