Prevalence of sessile serrated lesions more than 6% among veterans after positive FIT
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Key takeaways:
- The overall prevalence of sessile serrated lesions was 6.1% in FIT-positive individuals.
- Older age, BMI above 25 and smoking status were predictors of sessile serrated lesions.
VANCOUVER, British Columbia — Predictors of sessile serrated lesions among veterans who underwent colonoscopy within 12 months of a positive fecal immunochemical test included older age, obesity and smoking, according to a presenter.
“It is estimated that approximately 20% to 30% of all colorectal cancers arise from serrated lesions in a pathway that’s distinct from the traditional adenoma carcinoma sequence,” Natalie Wilson, MD, a third-year resident at the University of Minnesota, said at the ACG Annual Scientific Meeting. “While the adenoma detection rate in FIT-positive individuals has been estimated to be about 45% in men and 35% in women, the prevalence of sessile serrated lesions in FIT-positive individuals is not well-studied.”
Using data from the Veterans Health Administration, Wilson and colleagues identified 51,526 veterans (mean age, 62.5 years; 93.5% men) who underwent colonoscopy within 12 months of a positive FIT test between January 2015 and April 2023.
In addition to determining the prevalence of sessile serrated lesions (SSLs) in FIT-positive individuals — based on the finding of at least one clinically significant SSL during colonoscopy — researchers also aimed to identify demographics and risk factors linked to detection of SSLs.
According to results, the prevalence of SSLs in FIT-positive individuals was 6.1% — 5.3% in women and 6.5% in men.
Multivariate analysis showed that predictors of SSLs included age 70 to 79 years (OR = 1.264; 95% CI, 1.051-1.519), BMI above 25 kg/m2 (25-30 kg/m2: OR = 1.168; 95% CI, 1.0397-1.312; 30-35 kg/m2: OR = 1.315; 95% CI, 1.162-1.487; and > 35 kg/m2: OR = 1.363; 95% CI, 1.189-1.563) and smoking status (OR = 1.393; 95% CI, 1.283-1.513).
Conversely, Black race (OR = 0.493; 95% CI, 0.44-0.553) was associated with lower detection of SSLs.
Study limitations included lack of data on lesion size or location and the inclusion of only veterans in the study population, most of whom were men, Wilson noted.
“With the uptick in the use of noninvasive colorectal cancer screening strategies, these findings can be used to determine quality benchmarks for SSL detection rates moving forward,” Wilson concluded.
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Wilson N, et al. Sessile serrated lesion detection rate in individuals with positive fecal immunochemical test undergoing colonoscopy: Results from a large nationwide veterans affairs database. Presented at: ACG Annual Scientific Meeting; Oct. 20-25, 2023; Vancouver, British Columbia (hybrid meeting).
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