title: [Serrated polyps and their association with synchronous advanced colorectal neoplasia].
abstract: BACKGROUND
  Large serrated polyps (SP), proximal SP, SP with dysplasia and the presence of multiple sessile serrated adenomas/polyps (SSA/P), which we refer to as SP with increased risk of metachronous lesions (SPIRML), have been associated with an increased risk of advanced colon lesions on follow-up. It is unclear, however, whether SPIRML are also associated with an increased risk of synchronous advanced colorectal neoplasia (ACN).
  
  
  OBJECTIVE
  The aim of this study was to estimate the prevalence of SPIRML and to evaluate the association between SPIRML and synchronous ACN.
  
  
  METHODS
  A cross-sectional population-based study in all patients (1,538) with histological diagnosis of SP obtained from colonoscopies, sigmoidoscopies and colonic surgery performed in Navarra Health Service hospitals (Spain) in 2011. Demographic parameters and synchronous colonic lesions (adenomas, advanced adenomas [AA] and ACN) were analyzed.
  
  
  RESULTS
  One fourth of the sample (384 patients) presented SPIRML. These were older patients, with a slight predominance of women, and with no differences in body mass index (BMI) compared to patients without SPIRML. In the univariate analysis, patients with SPIRML showed an increased risk of adenoma, AA and ACN. In the multivariate analysis, the SPIRML group had a higher risk of synchronous AA and ACN (odds ratio [OR]: 2.38 [1.77-3.21] and OR: 2.29 [1.72-3.05], respectively); in the case of ACN, this risk was statistically significant in both locations (proximal or distal), with OR slightly higher for the proximal location. Different subtypes of SPIRML had a higher risk of AA and synchronous NA.
  
  
  CONCLUSIONS
  SPIRML were common in patients with SP, and their presence was associated with an increased risk of synchronous ACN.
authors.affiliation: Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España. Electronic address: jurmanf@yahoo.es.
authors.forename: Jesús
authors.initials: J
authors.lastname: Urman
authors.affiliation: Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Gomez
authors.affiliation: Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Basterra
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España; Servicio de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: María Del Rosario
authors.initials: MD
authors.lastname: Mercado
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España; Servicio de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Montes
authors.affiliation: Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España; Servicio de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Marisa
authors.initials: M
authors.lastname: Gómez Dorronsoro
authors.affiliation: Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Maitane
authors.initials: M
authors.lastname: Garaigorta
authors.affiliation: Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: María
authors.initials: M
authors.lastname: Fraile
authors.affiliation: Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: Eva
authors.initials: E
authors.lastname: Rubio
authors.affiliation: Servicio de Anatomía Patológica, Hospital Reina Sofía, Tudela, Navarra, España.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Aisa
authors.affiliation: Navarrabiomed-Fundación Miguel Servet, Pamplona, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España.
authors.forename: Arkaitz
authors.initials: A
authors.lastname: Galbete
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000473:pathology; D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000453:epidemiology* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Adenoma avanzado de colon; Adenoma de colon; Advanced adenoma; Advanced colorectal neoplasia; Colonic adenoma; Colonic neoplasms; Colonic polyps; Cross-sectional studies; Estudio transversal; Neoplasia avanzada de colon; Neoplasia de colon; Pólipos de colon; Pólipos serrados; Serrated polyps