Sessile serrated adenomas may have low risk of malignant progression in young patients
Sessile serrated adenomas (SSAs) appear to have a prolonged dwell time and are unlikely to develop into cancer, especially in young patients, a study suggests.
Researchers examined two separate cohorts consisting of a consecutive series of patients who underwent outpatient colonoscopy (polyp cohort; mean age 58 years; 50.6 percent female) and a consecutive series of patients who contributed resection specimens for colorectal carcinoma (CRC; cancer cohort; mean age 69 years; 46.8 percent female).
SSA prevalence by age was compared against the ages of patients with BRAF-mutated CRC. Results showed that the prevalence of SSAs in the polyp cohort was 20.1 percent, and the rate was similar across age groups. On the other hand, BRAF-mutated CRCs in the cancer cohort were very rare (3.8 percent) in patients aged <50 years and uncommon (9.3 percent) in those aged <60 years, but increased to 39.8 percent in older patients (age >80 years).
The present data demonstrate a high prevalence of SSAs in young patients, but a distinct lack of BRAF-mutated carcinomas in patients aged <60 years, suggesting that the risk of malignant progression for sporadic SSAs in young patients is low, researchers said.
However, researchers warned that young patients with serrated polyposis syndrome are of course at a greater risk of developing CRC and require very close surveillance. Patients with multiple SSAs but who do not meet the criteria for serrated polyposis syndrome should also be followed closely as polyp counts are usually considered to be cumulative over time.