BACKGROUND AND AIMS: Sessile serrated adenomas (SSAs) are recognised as precursors to microsatellite unstable adenocarcinomas. This study attempts to estimate the progression rate of SSAs based upon the epidemiology of a large cohort as well as identify relationships to other colorectal polyps. METHODS: Pathological reports generated at Caris Diagnostics from 290 810 colonoscopic specimens on 179 111 patients were analysed using computerised algorithms. RESULTS: SSAs with or without dysplasia/carcinoma (SSA+/-) were identified in 2416 specimens from 2139 patients (54% women). The distribution of SSA+/- was: right-sided (81.2%); left-sided (11.2%); both right- and left-sided (3.2%); not specified (4.3%). There were 1816 (85%) patients without dysplasia (SSA-), 257 (12%) with low-grade dysplasia (SSA-LD), 45 (2%) with high-grade dysplasia (SSA-HD) and 21 (1%) with adenocarcinoma (SSA-CA). The difference in median age between almost all groups was significant (SSA-=61 years versus SSA-LD=66 years (p<0.001) vs SSA-HD=72 years (p=0.002) vs SSA-CA=76 years (p=0.07, NS)). Women comprised 53% of the SSA- group (968/1816), 57% of the SSA-LD group (147/257), 69% of the SSA-HD group (31/45) and 76% of the SSA-CA group (16/21), being more likely to have high-grade dysplasia (OR 1.94, 95% CI 1.03 to 3.67) and adenocarcinoma (OR 2.80, 95% CI 1.02 to 7.68). CONCLUSIONS: 1.7% of patients with mucosal polyps had SSAs (with and without dysplasia), more commonly in women and primarily in the right colon. Dysplasia or carcinoma was identified in 15% of patients and significantly disproportionately among women. Based on significant age differences between groups, there appears to be a stepwise progression of dysplasia and carcinoma in SSAs over 10 to 15 years, a period two to three times longer than that for conventional adenomas.
BACKGROUND AND AIMS: Sessile serrated adenomas (SSAs) are recognised as precursors to microsatellite unstable adenocarcinomas. This study attempts to estimate the progression rate of SSAs based upon the epidemiology of a large cohort as well as identify relationships to other colorectal polyps. METHODS: Pathological reports generated at Caris Diagnostics from 290 810 colonoscopic specimens on 179 111 patients were analysed using computerised algorithms. RESULTS: SSAs with or without dysplasia/carcinoma (SSA+/-) were identified in 2416 specimens from 2139 patients (54% women). The distribution of SSA+/- was: right-sided (81.2%); left-sided (11.2%); both right- and left-sided (3.2%); not specified (4.3%). There were 1816 (85%) patients without dysplasia (SSA-), 257 (12%) with low-grade dysplasia (SSA-LD), 45 (2%) with high-grade dysplasia (SSA-HD) and 21 (1%) with adenocarcinoma (SSA-CA). The difference in median age between almost all groups was significant (SSA-=61 years versus SSA-LD=66 years (p<0.001) vs SSA-HD=72 years (p=0.002) vs SSA-CA=76 years (p=0.07, NS)). Women comprised 53% of the SSA- group (968/1816), 57% of the SSA-LD group (147/257), 69% of the SSA-HD group (31/45) and 76% of the SSA-CA group (16/21), being more likely to have high-grade dysplasia (OR 1.94, 95% CI 1.03 to 3.67) and adenocarcinoma (OR 2.80, 95% CI 1.02 to 7.68). CONCLUSIONS: 1.7% of patients with mucosal polyps had SSAs (with and without dysplasia), more commonly in women and primarily in the right colon. Dysplasia or carcinoma was identified in 15% of patients and significantly disproportionately among women. Based on significant age differences between groups, there appears to be a stepwise progression of dysplasia and carcinoma in SSAs over 10 to 15 years, a period two to three times longer than that for conventional adenomas.
Authors: Xinwei Hua; Polly A Newcomb; Jessica Chubak; Rachel C Malen; Rebecca Ziebell; Aruna Kamineni; Lee-Ching Zhu; Melissa P Upton; Michelle A Wurscher; Sushma S Thomas; Hana Newman; Sheetal Hardikar; Andrea N Burnett-Hartman Journal: Cancer Causes Control Date: 2020-05-01 Impact factor: 2.506
Authors: Ronald G Racho; Murli Krishna; Susan G Coe; Colleen S Thomas; Julia E Crook; Nancy N Diehl; Michael B Wallace Journal: Dig Dis Sci Date: 2017-04-25 Impact factor: 3.199
Authors: A Chino; N Yamamoto; Y Kato; K Morishige; H Ishikawa; T Kishihara; J Fujisaki; Y Ishikawa; Y Tamegai; M Igarashi Journal: Int J Colorectal Dis Date: 2015-10-29 Impact factor: 2.571
Authors: Manish K Gala; Yusuke Mizukami; Long P Le; Kentaro Moriichi; Thomas Austin; Masayoshi Yamamoto; Gregory Y Lauwers; Nabeel Bardeesy; Daniel C Chung Journal: Gastroenterology Date: 2014-02 Impact factor: 22.682