- For patients with serrated polyposis syndrome (SPS), allowing some patients longer colonoscopic surveillance intervals does not correlate with greater advanced neoplasia (AN) risk.
- It might be safe to extend the surveillance interval to 2 years with this protocol.
- Patients fulfilling only WHO criterion III appeared to be at lower risk.
Why this matters
- Because of the link between SPS and higher colorectal cancer (CRC) risk, guidelines recommend stringent surveillance every 1-2 years.
- For most, this interval is closer to 1 year.
- Risk stratification might allow longer intervals.
- Median follow-up, 3.6 years.
- WHO criteria among patients:
- 36.5% (99) fulfilled criterion I;
- 36.5% (99) criterion III; and
- 27% (73) both.
- Cumulative 5-year incidences (95% CIs):
- CRC (2 patients): 1.3% (0%-3.2%).
- AN (98): 44% (37%-51%).
- AN risk with criterion III vs I: HR, 0.38 (P<.001 class="">
- AN with 2- vs 1-year interval: OR, 0.57 (P=.08).
- Prospective multicenter cohort study (n=271).
- Participants had SPS, WHO criteria I and/or III.
- Authors conducted protocolized surveillance colonoscopy every 1 vs 2 years based on previous polyp burden.
- Outcome: 5-year incidences of CRC, AN (comprising CRC, advanced serrated polyp, advanced adenoma) during surveillance.
- Funding: European governmental, nonprofit funds.
- Short follow-up.
- Few cancers.