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The association between colorectal sessile serrated adenomas/polyps and subsequent advanced colorectal neoplasia.

Authors
  • Burnett-Hartman, Andrea N1, 2
  • Chubak, Jessica3, 4
  • Hua, Xinwei5, 4
  • Ziebell, Rebecca3
  • Kamineni, Aruna3
  • Zhu, Lee-Ching3
  • Upton, Melissa P6
  • Malen, Rachel C5
  • Hardikar, Sheetal5, 7
  • Newcomb, Polly A5, 4
  • 1 Kaiser Permanente Colorado Institute for Health Research, 2550 S. Parker Rd, Aurora, CO, USA. [email protected]
  • 2 Fred Hutchinson Cancer Research Center, Seattle, WA, USA. [email protected]
  • 3 Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
  • 4 University of Washington, School of Public Health, Seattle, WA, USA.
  • 5 Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
  • 6 University of Washington, School of Medicine, Seattle, WA, USA.
  • 7 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
Type
Published Article
Journal
Cancer Causes & Control
Publisher
Springer-Verlag
Publication Date
Sep 01, 2019
Volume
30
Issue
9
Pages
979–987
Identifiers
DOI: 10.1007/s10552-019-01205-y
PMID: 31290073
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Colorectal cancer (CRC) screening guidelines recommend increased surveillance of individuals with sessile serrated adenomas/polyps (SSA/Ps), but there is uncertainty about the risk associated with SSA/Ps. We aimed to determine the association between SSA/Ps and subsequent advanced colorectal neoplasia. This case-control study included Kaiser Permanente Washington (KPWA) members who received an index colonoscopy between 1/1/1998 and 12/31/2007, and had hyperplastic polyps (HPs) or SSA/Ps but no conventional adenomas according to study pathologist histologic review. Subsequent pathology reports and biopsies through 1/1/2013 were reviewed for advanced colorectal neoplasia. We linked to the Seattle-Puget Sound Surveillance Epidemiology and End Results (SEER) registry to identify additional CRC cases. We used generalized estimating equations with a logit link to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for advanced colorectal neoplasia, comparing those with SSA/Ps to those with HPs. There were 161 individuals with index SSA/Ps, 548 with HPs, and 918 subsequent endoscopies included in analyses. Of those with index SSA/Ps, 19 had subsequent advanced colorectal neoplasia; 39 with HPs had subsequent advanced colorectal neoplasia. Compared to those with HPs, those with SSA/Ps were not statistically significantly more likely to have subsequent advanced colorectal neoplasia (adjusted OR 1.79; CI 0.98-3.28). Polyp size ≥ 10 mm, right colon location, and the presence of multiple serrated polyps were also not associated with advanced colorectal neoplasia. Our results suggest that there is not a strong association between SSA/Ps and subsequent advanced colorectal neoplasia during the 5 years following SSA/P removal.

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