Risk Factors for Metachronous Advanced Serrated Lesions

Risk Factors for Metachronous Advanced Serrated Lesions

Douglas K. Rex, MD, MASGE, reviewing Rouphael C, et al. Clin Gastroenterol Hepatol 2023 Aug 4.

Current recommended postpolypectomy surveillance intervals for patients with serrated lesions are based on limited evidence. This single-center study evaluated risk factors for metachronous advanced serrated lesions (mASLs; defined as sessile serrated lesions [SSLs] ≥10 mm, hyperplastic polyps [HPs] ≥10 mm, SSLs with dysplasia, or any traditional serrated adenoma [TSA]).

Among 4990 patients with a mean age of 61 years and median follow-up time of 3.7 years, the investigators discovered that female sex (hazard ratio [HR], 2.03) and active smoking (HR, 1.70) were associated with mASLs.

The 5-year cumulative incidence of mASLs among patients with any baseline SSLs, at least 3 SSLs, SSLs ≥10 mm, SSLs 6 to 9 mm, SSLs with low-grade dysplasia, and any TSA were 14%, 31%, 26%, 12%, 27%, and 18%, respectively. Larger SSLs at baseline were associated with a higher risk of mASLs, as were baseline HPs ≥10 mm.

Douglas K. Rex, MD, FASGE


These results generally support the recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer for postpolypectomy surveillance intervals in patients with baseline serrated lesions.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Rouphael C, El Halabi J, Bena J, McMichael J, Burke CA. Impact of clinical and endoscopic features on the development of metachronous colorectal advanced serrated lesions. Clin Gastroenterol Hepatol 2023 Aug 4. (Epub ahead of print) (https://doi.org/10.1016/j.cgh.2023.07.020)

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