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Original article
Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview
  1. J E G IJspeert1,
  2. R Bevan2,
  3. C Senore3,
  4. M F Kaminski4,5,
  5. E J Kuipers6,
  6. A Mroz7,
  7. X Bessa8,
  8. P Cassoni9,
  9. C Hassan10,
  10. A Repici11,
  11. F Balaguer12,
  12. C J Rees2,
  13. E Dekker1
  1. 1 Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  2. 2 Department of Gastroenterology and Hepatology, South Tyneside District Hospital, South Shields, UK
  3. 3 Department of Gastroenterology and Hepatology, Piemonte Reference Centre for Epidemiology and Cancer Prevention, Turin, Italy
  4. 4 Department of Gastroenterological Oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Medical Centre for Postgraduate Education, Warsaw, Poland
  5. 5 Institute of Health and Society, University of Oslo, Oslo, Norway
  6. 6 Department of Gastroenterology and Hepatology, Erasmus Medical Centre, Rotterdam, The Netherlands
  7. 7 Department of Gastroenterology, Hepatology and Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland
  8. 8 Department of Gastroenterology, Digestive Service, Hospital del Mar de Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
  9. 9 Department of Medical Sciences, University of Turin, Turin, Italy
  10. 10 Department of Gastroenterology and Hepatology, ‘Nuovo regina Margherita’ Hospital, Rome, Italy
  11. 11 Department of Gastroenterology and Hepatology, Humanitas Research Hospital, Humanitas University, Milan, Italy
  12. 12 Department of Gastroenterology, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
  1. Correspondence to Dr Evelien Dekker, Department of Gastroenterology and Hepatology, Academic Medical Centre, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands; e.dekker{at}


Objective The role of serrated polyps (SPs) as colorectal cancer precursor is increasingly recognised. However, the true prevalence SPs is largely unknown. We aimed to evaluate the detection rate of SPs subtypes as well as serrated polyposis syndrome (SPS) among European screening cohorts.

Methods Prospectively collected screening cohorts of ≥1000 individuals were eligible for inclusion. Colonoscopies performed before 2009 and/or in individuals aged below 50 were excluded. Rate of SPs was assessed, categorised for histology, location and size. Age–sex–standardised number needed to screen (NNS) to detect SPs were calculated. Rate of SPS was assessed in cohorts with known colonoscopy follow-up data. Clinically relevant SPs (regarded as a separate entity) were defined as SPs ≥10 mm and/or SPs >5 mm in the proximal colon.

Results Three faecal occult blood test (FOBT) screening cohorts and two primary colonoscopy screening cohorts (range 1.426–205.949 individuals) were included. Rate of SPs ranged between 15.1% and 27.2% (median 19.5%), of sessile serrated polyps between 2.2% and 4.8% (median 3.3%) and of clinically relevant SPs between 2.1% and 7.8% (median 4.6%). Rate of SPs was similar in FOBT-based cohorts as in colonoscopy screening cohorts. No apparent association between the rate of SP and gender or age was shown. Rate of SPS ranged from 0% to 0.5%, which increased to 0.4% to 0.8% after follow-up colonoscopy.

Conclusions The detection rate of SPs is variable among screening cohorts, and standards for reporting, detection and histopathological assessment should be established. The median rate, as found in this study, may contribute to define uniform minimum standards for males and females between 50 and 75 years of age.


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