Article Text

PDF
PTH-039 Prevalence of sessile serrated adenomas/polyps in distal colon during screening colonoscopy/flexible sigmoidoscopy: a single bowel cancer screening experience from uk
  1. R Rameshshanker1,
  2. F Purchiaroni,
  3. W Ana,
  4. S Thomas-Gibson,
  5. A Rajendran,
  6. BP Saunders,
  7. Z Tsiamoulos
  1. Wolfson Unit for Endoscopy, St Mark’s Hospital, London, UK

Abstract

Introduction Sessile Serrated Adenomas/Polyps (SSA/P) are responsible for nearly 20% of colo rectal cancer (CRC). Despite the utility of novel image enhancing techniques including narrow band imaging it is difficult to differentiate hyperplastic (HP) polyps from SSA/Ps. Vast proportion of endoscopists leave the diminutive and possibly small HP polyps in situ in the recto sigmoid area (diagnose and disregard approach). Hence there is a possibility of leaving SSA/P in the recto sigmoid region which could potentially lead to CRC later in life.

Aim To estimate the prevalence of SSA/P in recto sigmoid colon at screening colonoscopy and flexible sigmoidoscopy (FS).

Method Patients aged >55 years underwent a screening colonoscopy (n=500) or a flexible sigmoidoscopy (n=500) at our institution between August 2014 and April 2015 were included. Data collected from 500 consecutive patients who underwent a colonoscopy or a FS. Demographic, procedural and polyp data were retrieved from our endoscopy database.

Results 99.6% of (498/500) colonoscopy and 97.6% of flexible sigmoidoscopy procedures were completed. Screening colonoscopy detected 1006 polyps and FS detected 249 polyps. Polyp size ranged between 1–80 mm (colonoscopy mean size 6 mm, SD 7.2 mm; FS mean 3.4 mm, SD 3.9 mm). While colonoscopy detected 43 SSA/Ps (4.3%), FS detected only 6 SSA/Ps (2.4%) which equates to an overall prevalence of 3.9% (49/1255). Image 1 summarises the SSA/Ps prevalence by colonic segment. In recto sigmoid there were 21 SSA/Ps detected and resected which equals to a 3.9% of all recto sigmoid polyps. All SSA/Ps detected in this segment were less than 10 mm in size (range 2–10 mm). Only one of the SSA/P had dysplasia (4.7%). Prevalence of SSA/Ps in proximal colon was 4.8%.

Conclusion Our cohort showed a slightly higher prevalence of SSA/Ps in rectum and sigmoid colon. Therefore, it becomes clinically relevant to differentiate SSA/Ps from HP polyps in recto sigmoid before adapting a diagnose and disregard approach for small (<9 mm) hyperplastic looking polyps in this location.

Disclosure of Interest None Declared

  • adenoma
  • Advanced adenoma
  • sessile serrated polyps

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.