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The (ir)relevance of the abandoned criterion II for the diagnosis of serrated polyposis syndrome: a retrospective cohort study

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Abstract

The World Health Organization (WHO) recently updated the diagnostic criteria for serrated polyposis syndrome (SPS). One of the three previous diagnostic criteria (criterion II2010) is now abandoned: ≥ 1 serrated polyp (SP) proximal to the sigmoid in a first-degree relative (FDR) of a patient with SPS. Individuals fulfilling this abandoned criterion now receive the same surveillance recommendations as all FDRs of patients with SPS. We aimed to compare the incidence of advanced neoplasia (AN) in FDRs with vs. without fulfillment of the abandoned criterion II2010. We retrospectively recruited FDRs of patients with SPS who underwent a colonoscopy, and stratified them according to fulfilment of criterion II2010 at baseline. Our primary and secondary outcomes were AN incidence during surveillance and at baseline, respectively. We included 224 FDRs of patients with SPS, of whom 36 (16%) fulfilled criterion II2010 at baseline. One hundred and five underwent surveillance after baseline. Criterion II2010-positive FDRs were at increased risk of AN, both during surveillance (hazard ratio 8.94, 95% CI 2.15–37.1, p = .003) as well as at baseline (adjusted odds-ratio 9.30, 95% CI 3.7–23.3, p < .001). FDRs of patients with SPS that underwent colonoscopy and fulfilled the abandoned criterion II2010 for SPS diagnosis were at increased risk of AN at baseline and during surveillance in this small, retrospective cohort study. Our results should be interpreted with caution but suggest that adherence to surveillance recommendations for all FDRs of patients with SPS is important, especially for those that would have fulfilled the now abandoned criterion II2010.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105, The Netherlands

    Arne G.C. Bleijenberg, Joep E.G. IJspeert, Maurits R. Visser & Evelien Dekker

  2. Digestive Disease Section, Hospital Universitario de Móstoles, Móstoles, Spain

    Daniel Rodríguez-Alcalde

  3. Gastroenterology Department, Hospital Clínic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain

    Sabela Carballal, Maria Pellise & Francesc Balaguer

  4. Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands

    Jan Jacob Koornstra

  5. The Polyposis Registry, St Mark’s Hospital, London, UK

    Salman A. Rana & Andrew Latchford

  6. Department of Surgery and Cancer, Imperial College London, London, UK

    Salman A. Rana & Andrew Latchford

Authors
  1. Arne G.C. Bleijenberg
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  2. Joep E.G. IJspeert
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  6. Maria Pellise
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  7. Jan Jacob Koornstra
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  11. Evelien Dekker
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Contributions

AGCB, JEGI, and ED: study conception & design. AGCB, JEGI, DR-A, SC, FB, JJK, and SAR: acquisition of data. AGCB: drafting of the manuscript and statistical analysis. All authors: analysis & interpretation of data, critical revision of the manuscript for intellectual content, technical & logistical support.

Corresponding author

Correspondence to Evelien Dekker.

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Conflict of interest

The author FB have endoscopic equipment on loan of Fujifilm, and he received an honorarium for consultancy from Sysmex, and speaker’s fee from Norgine. The author MP received research grant from Fujifilm, received consultancy fee from Norgine and speaker’s fee from Olympus, Norgine, Casen Recordati and Janssen. The author ED have endoscopic equipment on loan of Olympus and FujiFilm, receive a research grant from FujiFilm and he received a honorarium for consultancy from FujiFilm, Tillots and Olympus and a speakers’ fee from Olympus and Roche.

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Bleijenberg, A.G., IJspeert, J.E., Rodríguez-Alcalde, D. et al. The (ir)relevance of the abandoned criterion II for the diagnosis of serrated polyposis syndrome: a retrospective cohort study. Familial Cancer 19, 153–160 (2020). https://doi.org/10.1007/s10689-019-00156-2

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