Possible Red Flag to Predict Colorectal Cancer Identified

Large serrated polyps may be a useful sign for clinicians to predict CRC risk

MONDAY, Nov. 22 (HealthDay News) -- Large serrated polyps (LSPs) discovered during a colonoscopy are associated with an increased risk of colorectal cancer (CRC) -- proximal CRC in particular, according to research published in the November issue of Gastroenterology.

Sakiko Hiraoka, M.D., of the Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences in Japan, and colleagues conducted a large, multicenter database study that included 10,199 patients who had undergone their first colonoscopy between June 2005 and May 2008. LSPs were defined as those at least 10 mm in size.

The researchers found advanced neoplasia in 15.4 percent of patients, CRC in 6.9 percent, and LSPs in 1.4 percent. Multivariate analysis showed that the odds ratio (OR) of LSPs associated with advanced neoplasia was 4.01, versus the 3.34 OR for LSPs associated with CRC. The researchers noted that the presence of LSPs was the strongest risk factor for CRC, especially proximal CRC (OR, 4.79). Also, proximal and protruded LSPs were found to be the strongest risk factors for proximal CRC (ORs, 5.36 and 9.00, respectively).

"Patients with LSPs require meticulous follow-up with colonoscopy, and prospective observation of these patients may reveal novel findings regarding development of proximal CRC or CRC with microsatellite instability," the authors write.

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