TY - JOUR T1 - Clinical risk factors of colorectal cancer in patients with serrated polyposis syndrome: a multicentre cohort analysis JF - Gut JO - Gut SP - 278 LP - 284 DO - 10.1136/gutjnl-2015-310630 VL - 66 IS - 2 AU - J E G IJspeert AU - S A Q Rana AU - N S S Atkinson AU - Y J van Herwaarden AU - B A J Bastiaansen AU - M E van Leerdam AU - S Sanduleanu AU - T M Bisseling AU - M C W Spaander AU - S K Clark AU - G A Meijer AU - N van Lelyveld AU - J J Koornstra AU - I D Nagtegaal AU - J E East AU - A Latchford AU - E Dekker AU - on behalf of the Dutch workgroup serrated polyps & polyposis (WASP) Y1 - 2017/02/01 UR - http://gut.bmj.com/content/66/2/278.abstract N2 - Objective Serrated polyposis syndrome (SPS) is accompanied by an increased risk of colorectal cancer (CRC). Patients fulfilling the clinical criteria, as defined by the WHO, have a wide variation in CRC risk. We aimed to assess risk factors for CRC in a large cohort of patients with SPS and to evaluate the risk of CRC during surveillance.Design In this retrospective cohort analysis, all patients with SPS from seven centres in the Netherlands and two in the UK were enrolled. WHO criteria were used to diagnose SPS. Patients who only fulfilled WHO criterion-2, with IBD and/or a known hereditary CRC syndrome were excluded.Results In total, 434 patients with SPS were included for analysis; 127 (29.3%) were diagnosed with CRC. In a per-patient analysis ≥1 serrated polyp (SP) with dysplasia (OR 2.07; 95% CI 1.28 to 3.33), ≥1 advanced adenoma (OR 2.30; 95% CI 1.47 to 3.67) and the fulfilment of both WHO criteria 1 and 3 (OR 1.60; 95% CI 1.04 to 2.51) were associated with CRC, while a history of smoking was inversely associated with CRC (OR 0.36; 95% CI 0.23 to 0.56). Overall, 260 patients underwent surveillance after clearing of all relevant lesions, during which two patients were diagnosed with CRC, corresponding to 1.9 events/1000 person-years surveillance (95% CI 0.3 to 6.4).Conclusion The presence of SPs containing dysplasia, advanced adenomas and/or combined WHO criteria 1 and 3 phenotype is associated with CRC in patients with SPS. Patients with a history of smoking show a lower risk of CRC, possibly due to a different pathogenesis of disease. The risk of developing CRC during surveillance is lower than previously reported in literature, which may reflect a more mature multicentre cohort with less selection bias. ER -