P-052 Sessile Serrated Adenoma Prevalence in Inflammatory Bowel Disease Patients Is Independent of Age

Abstract

Sessile serrated adenomas (SSA) are pre-neoplastic lesions that is felt to represent a carcinogenic sequence distinct from that of conventional adenomas and dysplasia-associated lesions or masses (DALMs). SSA can occur in the general population, as well as, in inflammatory bowel disease (IBD) patients. However, the risk for SSA in IBD patients has not been characterized. This study evaluated the prevalence of SSA in IBD patients. A retrospective chart review was performed using electronic health records. Patients included were those who presented to an urban academic medical center during a one-year period for IBD surveillance colonoscopy. Patients were excluded if the colonoscopy report could not be matched to an outpatient medical record. Data regarding patients' age, demographics, IBD history, and colonoscopic and pathologic findings were collected. A database was created using Microsoft Excel maintaining patient confidentiality. Identifying information was excluded to ensure anonymity. Statistical analysis was performed using Fisher's Exact Test, with statistical significance set at P < 0.05. There were 136 patients who received IBD surveillance colonoscopy; 58 (42.6%) with Crohn's disease and 78 (57.4%) with ulcerative colitis. Among them, 74 (54.4%) were <50 years old and 62 (45.6%) were >50 years old. Sporadic adenomas included sessile serrated, tubular, villous, and tubulovillous histologies. Twelve patients (6 Crohn's, 6 ulcerative colitis) had sporadic adenomas, resulting in an adenoma detection rate of 8.8%. Five of the patients were >50 years and 7 were <50 years. There was no significant difference in the rate of sporadic adenomas based upon disease type (P = 0.7613) or age (P = 1.0000). Eight (5.8%) of the patients (3 Crohn's, 5 ulcerative colitis) had SSAs, 5 of whom were <50 years and 3 were >50 years. There was no significant difference in the rate of SSA based upon disease type (P = 1.000) or age (P = 0.7273). The prevalence of sessile serrated adenomas in the general population increases with age. However, there have been limited studies focused on the rate of SSAs in patients with inflammatory bowel disease. This study revealed an adenoma detection rate of 8.8% with sessile serrated adenomas occurring in 5.9%. There was no significant difference in the rate of SSAs based upon disease type or age. The similarity in SSA rates across ages in IBD patients may suggest that an IBD-related physiologic pathway may result in early SSA formation. Alternatively, as the sessile serrated pathway is distinct from that of conventional adenomas, age may exert less influence on the development of SSA than it does the sporadic adenomas. Because the average-risk screening colonoscopy population is predominantly >50 years old, this is difficult to ascertain. Although this is a small, single institution study, the similar prevalence of SSA in younger and older IBD patients raises interesting questions about the nature of these lesions both in IBD patients and in the general population.