Increased Risk of Colorectal Cancer Development among Patients with Serrated Polyps

作者：Henrik Toft Sørensen, Stanley R. Hamilton, Trine Frøslev, E.E. Torlakovic, Mogens Vyberg, Lise Pedersen, Dale C. Snover, Stephen Jacques Hamilton-Dutoit, Rune Erichsen, John A. Baron · 发表于：Carolina Digital Repository (University of North Carolina at Chapel Hill) · 年份：2023 · DOI：10.17615/bzah-zn76 · 被引用次数：9 · 研究领域：Colorectal Cancer Surgical Treatments、Gastric Cancer Management and Outcomes、Colorectal Cancer Screening and Detection

Background & Aims Sessile serrated adenomas/polyps (SSA/Ps) and traditional serrated adenomas (TSAs) are now distinguished from hyperplastic polyps and recognized as precursors to colorectal cancer (CRC). We studied CRC risks associated with serrated polyps. Methods By using Danish databases (1977-2009), we conducted a nationwide population-based, case-control study nested within individuals who had received colonoscopies (n = 272,342), and identified 2045 CRC cases and 8105 CRC-free individuals (controls). For each case and control, we identified the first colorectal polyp(s) that underwent a biopsy or were excised during or after the initial colonoscopy, and obtained tissue blocks for hyperplastic lesions. Four expert pathologists reviewed these lesions using current terminology for serrated polyps. We used logistic regression to compute odds ratios (ORs) to associate the risk of CRC with polyp type and estimated the absolute risks by multiplying the risk in patients with no polyps by these ORs. Results Seventy-nine cases and 142 controls had SSA/Ps (OR, 3.07; 95% confidence interval [CI], 2.30-4.10). SSA/Ps with cytology markers of dysplasia were associated with a particularly high OR (4.76; 95% CI, 2.59-8.73). Women with SSA/P had a higher risk for CRC than men with SSA/P (OR for women, 5.05; 95% CI, 3.05-8.37 vs OR for men, 2.18; 95% CI, 1.24-3.82); patients with SSA/P proximal to the splenic flexure had the highest risk for CRC (OR, 12.42; 95% CI, 4.88-31.58). The OR fo...