Large Serrated Polyps Indicate a Greater Risk of Advanced Metachronous Colorectal Neoplasia than High-Grade Adenomas (original) (raw)

Background: The risk of developing total metachronous advanced neoplasia (TMAN) in patients with index serrated lesions (SL) or adenoma with high-grade dysplasia (HGD) is unknown. We evaluated this risk in patients with either HGD, SL <10 mm or SL ≥10 mm at index colonoscopy, who underwent surveillance colonoscopies. Methods: This retrospective cohort study evaluated all consecutive patients (n = 2477) diagnosed between 2010 and 2019 with colorectal HGD, SL <10 mm or SL ≥10 mm. We excluded patients aged <45 or >75 years or those who had inflammatory bowel disease, hereditary colorectal cancer (CRC) syndromes, previous or synchronous CRC, or no follow-up colonoscopy. Descriptive variables were compared using analysis of variance or Pearson chi-squared tests. Multivariate Cox regressions were used to compare the risk of TMAN between the HGD, SL <10 mm and SL ≥10 mm groups. Results: Overall, 585 patients (mean age 63 years; 55% male; mean follow-up 3.67 years) were inclu...