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News

Colorectal cancer risk in patients with serrated polyposis syndrome

The most recent issue of Gut identifies clinical risk factors of colorectal cancer in patients with serrated polyposis syndrome.

News image

Serrated polyposis syndrome is accompanied by an increased risk of colorectal cancer. 

Patients fulfilling the clinical criteria, as defined by the WHO, have a wide variation in colorectal cancer risk. 

Dr Evelien Dekker and colleagues assessed risk factors for colorectal cancer in a large cohort of patients with serrated polyposis syndrome, and evaluated the risk of colorectal cancer during surveillance.

In this retrospective cohort analysis, all patients with serrated polyposis syndrome from 7 centers in the Netherlands, and 2 in the UK were enrolled. 

Patients with a history of smoking show a lower risk of colorectal cancer
Gut
WHO criteria were used to diagnose serrated polyposis syndrome. 

Patients who only fulfilled WHO criterion-2, with IBD and/or a known hereditary colorectal cancer syndrome were excluded.

In total, the team included 434 patients with serrated polyposis syndrome, of whom 29% were diagnosed with colorectal cancer. 

The research team noted that ≥1 serrated polyp with dysplasia, ≥1 advanced adenoma, and the fulfilment of both WHO criteria 1 and 3 were associated with colorectal cancer, while a history of smoking was inversely associated with colorectal cancer. 

The researchers found that overall, 260 patients underwent surveillance after clearing of all relevant lesions, during which 2 patients were diagnosed with colorectal cancer, corresponding to 2 events per 1000 person-years surveillance.

Dr Dekker's team concludes, "The presence of serrated polyps containing dysplasia, advanced adenomas and/or combined WHO criteria 1 and 3 phenotype is associated with colorectal cancer in patients with serrated polyposis syndrome."

"Patients with a history of smoking show a lower risk of colorectal cancer, possibly due to a different pathogenesis of disease."

"The risk of developing colorectal cancer during surveillance is lower than previously reported in literature, which may reflect a more mature multicentre cohort with less selection bias."

Gut 2017;66:278-284
10 January 2017

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