Prevalence of preneoplastic serrated polyps in Hungary

Background: Due to their preneoplastic potential serrated polyps have been an area of intense focus for gastroenterologists over the past several years. At present „serrated polyp” is used as an umbrella term and includes sessile serrated adenomas (SSA), traditional serrated adenomas (TSA), and hyperplastic polyps (HP). It is now widely accepted that SSA and TSA are preneoplastic lesions and give rise to colorectal cancers (CRC). To date, the prevalence of preneoplastic serrated polyps has not been known in Hungary.

Objective: We aimed to define the prevalence and characterize the demographical features of TSA and SSA in two pathological cohorts.

Materials and methods: Pathologocal records were searched for „serrated polyps” in two Hungarian Pathology Departments: Department of Pathology, Sopron Elizabeth Teaching Hospital (between 2006 and 2010) and 1st Department of Pathology, Semmelweis University, Budapest (between 2011 and 2013).

Results: Altogether 34 cases were found in the two databases. In the 5-year Sopron cohort 26 patients were diagnosed with serrated polyps. Of them 11 were female and 16 were male, the mean age was 60.5 years (range: 36 – 77). In the 3-year Budapest cohort 6 patients (2 females and 4 males) were diagnosed with SSA and 2 patients (1 female, 1 male) with TSA, mean age was 57.5 years (range 48 – 72). All SSAs were observed in the proximal colon. No subsequent CRCs have been observed during the follow-up.

Conclusion: Prevalence of preneoplastic serrated polyps is significantly lower in Hungary than that observed in Western European and US centers. Awareness among gastroenterologists and pathologists should be raised of preneoplastic serrated lesions, as these lesions give rise to the majority of interval colorectal cancers. Further investigation is needed to better characterize the prevalence and natural history of this newly recognized colorectal lesions.