Mo1147 Longitudinal Follow-Up of Proximal Hyperplastic or Serrated Polyps

Abstract

Introduction: Current guidelines recommend a 3-5 year follow up after removal of a sessile serrated adenoma (SSA) but the appropriate follow up of other types of proximal hyperplastic polyps (HP's) is unknown. The goal of the present study is to better characterize the natural history of HP's in the proximal colon and to define subgroups that may justify earlier follow up. Methods: Using the endoscopic and pathology databases at an academic medical center, we identified all patients diagnosed between 2005-2013 with SSA or HP in the proximal colon, defined as cecum to splenic flexure, who returned for repeat colonoscopies. With this cohort we measured the frequency of diagnosis in follow up colonoscopies for up to 5 years of proximal HP's and proximal SSAs, as well as the proportion with lesions > 1 cm and/or containing dysplasia. Results: A total of 42 patients met the inclusion criteria. The mean age was 62.6 years 48% were female, and median interval between first and second colonoscopy was 364 days. At the index colonoscopy, 55% of total patients had HP's, 36% had SSA's, 5% had both, and 5% had serrated adenoma. In addition, 40% had a concurrent finding of one or more tubular adenomas. At subsequent colonoscopy, 13 patients (31%) had recurrent findings proximal HP's and/or proximal SSA's, among which 46% were > 1 cm and/or contained dysplasia. No patient was diagnosed with colon cancer or has serrated adenoma in follow up. Conclusion: A substantial percentage of patients with proximal colon hyperplastic polyps or sessile serrated adenomas that are removed develop advanced pathology on follow up colonoscopy within 5 years or less. This data supports a shorter surveillance interval for patients with HP or SSAs of the right colon.