Traditional serrated adenomas associated with risk of subsequent high-risk polyps and colorectal cancer
INTRODUCTION: - Traditional serrated adenoma (TSA) is a rare yet established precursor to colorectal cancer (CRC). The risk of colorectal neoplasia after TSA removal remains unclear. - METHODS: - We identified participants without polyps or with TSAs during index colonoscopy from the Mass Gener...
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| Auteurs principaux: | , , , , , , |
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| Format: | Article (Journal) |
| Langue: | anglais |
| Publié: |
March 2026
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| In: |
The American journal of gastroenterology
Year: 2026, Volume: 121, Numéro: 3, Pages: 767-775 |
| ISSN: | 1572-0241 |
| DOI: | 10.14309/ajg.0000000000003588 |
| Accès en ligne: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.14309/ajg.0000000000003588 Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/ajg/fulltext/2026/03000/traditional_serrated_adenomas_associated_with_risk.27.aspx 
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| Notes sur l'auteur: | Yufeng Chen, MD, PhD, Georgios Polychronidis, MD, Yueyang Zhang, MBBS, BS, Jiaxian Shen, PhD, Yujia Lu, MS, Mengxi Du, PhD, MPH and Mingyang Song, MD, ScD |
| Résumé: | INTRODUCTION: - Traditional serrated adenoma (TSA) is a rare yet established precursor to colorectal cancer (CRC). The risk of colorectal neoplasia after TSA removal remains unclear. - METHODS: - We identified participants without polyps or with TSAs during index colonoscopy from the Mass General Brigham Colonoscopy Cohort (2007-2023). Participants were prospectively followed for recurrence of high-risk polyps and incidence of CRC. We used the time-varying multivariable-adjusted Cox proportional hazards model to estimate the risk of CRC and high-risk polyps associated with baseline diagnosis of TSAs. - RESULTS: - We identified 109,218 participants without polyps and 252 with TSAs, of whom 35,124 (32%) and 139 (55%) had undergone a follow-up colonoscopy, respectively. TSAs were predominantly located in the distal colon (35%) and rectum (38%), with approximately half sized <10 mm. TSAs tended to demonstrate as a single lesion (84%) but coexist with other types of polyps (70%). Compared with participants without polyps, those with TSAs had higher risk of developing high-risk polyps, high-risk adenomas, high-risk serrated polyps, and CRC, with the hazard ratio (95% confidence interval) of 3.31 (2.35-4.66), 3.07 (2.12-4.44), 6.66 (3.79-11.71), and 7.23 (2.23-23.44), respectively. The risk elevation of high-risk polyps peaked at 3 years post-TSA removal (hazard ratio = 10.85, 95% confidence interval, 6.36-18.52). Among recurrent polyps after TSA removal, 54% (52/96) occurred in the proximal colon and 69% (66/96) was serrated polyps. - DISCUSSION: - Patients with TSA removal had an elevated risk of colorectal neoplasia, particularly within 3 years after TSA removal, supporting the current US recommendations for a surveillance colonoscopy at 3 years. |
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| Description: | Online veröffentlicht: 10. Juni 2025 Gesehen am 12.06.2026 |
| Description matérielle: | Online Resource |
| ISSN: | 1572-0241 |
| DOI: | 10.14309/ajg.0000000000003588 |