Prevalence and characteristics of sessile serrated lesions with dysplasia in Dutch fecal immunochemical test-positive screenees.
[BACKGROUND AND STUDY AIMS] Sessile serrated lesions (SSLs) with dysplasia (SSLDs) are considered high-risk polyps.
- p-value P<0.001
APA
van Roermund NS, Angerilli V, et al. (2026). Prevalence and characteristics of sessile serrated lesions with dysplasia in Dutch fecal immunochemical test-positive screenees.. Endoscopy. https://doi.org/10.1055/a-2847-3376
MLA
van Roermund NS, et al.. "Prevalence and characteristics of sessile serrated lesions with dysplasia in Dutch fecal immunochemical test-positive screenees.." Endoscopy, 2026.
PMID
41946470
Abstract
[BACKGROUND AND STUDY AIMS] Sessile serrated lesions (SSLs) with dysplasia (SSLDs) are considered high-risk polyps. We aimed to provide robust epidemiologic data on SSLDs over time in FIT-positive screenees.
[PATIENTS AND METHODS] All colonoscopy and pathology data of FIT-positive screenees in the Dutch colorectal cancer screening program (2014-2023) were analyzed. Prevalence of SSLs and SSLDs in FIT-positive screenees was calculated, along with the number needed to scope (NNS). Dysplasia rate within SSLs was calculated over time. Multivariate logistic regression was used to evaluate influence of age and sex on SSLD prevalence, and to assess patient and polyp characteristics associated with dysplasia at polyp level.
[RESULTS] Among 516.193 FIT-positive screenees a total of 1.033.298 polyps were removed, including 76.771 SSLs of which 7.019 (9%) exhibited dysplasia. Overall prevalence was 9.7% (9.6-9.8) for SSLs and 1.1% (1.1-1.1) for SSLDs. NNS to detect a SSL decreased over time, from 13 (2014-2018) to 9 (2019-2023), while NNS for SSLD remained stable at 90. The proportion of SSLs with dysplasia declined from 17.5% in 2014 to 6.6% in 2023. Increasing age was associated with a higher SSLD prevalence (OR per year 1.03; CI95% 1.03-1.04) and dysplasia was more frequent in larger polyps (P<0.001); however, 64% of SSLDs were <10mm in size.
[CONCLUSIONS] This study shows a 1.1% (1.1-1.1) prevalence of SSLD in FIT-positive screenees, offering valuable reference data. The finding that most SSLDs (64%) are small underscores the need to carefully assess small serrated polyps for dysplasia to ensure appropriate resection.
[PATIENTS AND METHODS] All colonoscopy and pathology data of FIT-positive screenees in the Dutch colorectal cancer screening program (2014-2023) were analyzed. Prevalence of SSLs and SSLDs in FIT-positive screenees was calculated, along with the number needed to scope (NNS). Dysplasia rate within SSLs was calculated over time. Multivariate logistic regression was used to evaluate influence of age and sex on SSLD prevalence, and to assess patient and polyp characteristics associated with dysplasia at polyp level.
[RESULTS] Among 516.193 FIT-positive screenees a total of 1.033.298 polyps were removed, including 76.771 SSLs of which 7.019 (9%) exhibited dysplasia. Overall prevalence was 9.7% (9.6-9.8) for SSLs and 1.1% (1.1-1.1) for SSLDs. NNS to detect a SSL decreased over time, from 13 (2014-2018) to 9 (2019-2023), while NNS for SSLD remained stable at 90. The proportion of SSLs with dysplasia declined from 17.5% in 2014 to 6.6% in 2023. Increasing age was associated with a higher SSLD prevalence (OR per year 1.03; CI95% 1.03-1.04) and dysplasia was more frequent in larger polyps (P<0.001); however, 64% of SSLDs were <10mm in size.
[CONCLUSIONS] This study shows a 1.1% (1.1-1.1) prevalence of SSLD in FIT-positive screenees, offering valuable reference data. The finding that most SSLDs (64%) are small underscores the need to carefully assess small serrated polyps for dysplasia to ensure appropriate resection.