OncologyPrevalence and characteristics of serrated lesions of the colorectum in Italy: A multicentre prospective cohort study

BackgroundSerrated lesions are recognized as important contributors to colorectal cancer incidence. We aimed to prospectively assess the prevalence of serrated lesions and identify potential predictors of these lesions during colonoscopy in an Italian population.MethodsProspective cross sectional study involving 8 endoscopy units from February 1st to July 31st 2012.ResultsOut of 2468 colonoscopies, 886 precancerous lesions were detected in 567 patients. Of these, 173 SELs were diagnosed in 148 patients (140 serrated/hyperplastic polyps and 33 serrated adenomas). Prevalence was 7% (173/2468). Serrated lesions accounted for 19.5% of all precancerous lesions. Serrated polyps were prevalent in the left colon (42.1%) and serrated adenomas in the proximal colon (54.5%). Independent clinical predictors of serrated lesions were patient age (OR 0.98 [0.97-1.00]) and post-polypectomy surveillance (OR 1.87 [1.24-2.82]). Endoscopic predictors were right colon location (OR 2.65 [1.63-4.30] vs. rectum; and 1.53 [1.03-2.26] vs. left colon), polypoid shape (OR 0.41 [027-0.64]) and size <6 mm (OR 0.49 [0.33-0.72] vs. 6-10 mm; and 0.14 [0.07-0.28] vs. >10 mm). There was no independent predictor of serrated adenoma.ConclusionIn our Italian study population, the prevalence of colorectal serrated lesions was 7%. Their diagnosis is associated with younger age and surveillance colonoscopy, right-sided colorectal location, non-polypoid shape and size <6 mm.