The primary aim of this study is to determine the rate of total metachronous advanced neoplasia (TMAN) detection after index detection of serrated lesions (SL) \[sessile serrated polyps (SSPs), traditional serrated adenomas (TSAs)\], and metachronous high-risk adenoma (HRA) after index detection of high-grade dysplasia (HGD).
We will use the database of patients diagnosed with SL or HGD at index colonoscopy with a delay in surveillance and determine the risk of advanced lesions (especially high-risk lesion and CRC detection) of these delayed colonoscopies. The aim is to determine the effects of breach of continuity of care in these patients.
Patients 45-80 who underwent colonoscopy from 2009 to 2022 at the Montreal University Hospital Center (CHUM) with 1+ SL or HGD detected at index colonoscopy and lacking follow-up within or beyond the surveillance interval recommended by 2020 USMSTF guidelines.
1) Patients with a diagnosis of inflammatory bowel disease;
2) Hereditary CRC syndromes;
3) CRC at index colonoscopy;
4) Serrated polyposis syndrome;
Single group
Standard Colonoscopy
Diagnostic testStandard colonoscopy: All optically diagnosed polyps will be removed and sent to the CHUM pathology laboratory for histopathological evaluation according to institutional standards.
Rate of TMAN detection after index detection of serrated lesions
the rate of total metachronous advanced neoplasia (TMAN) detection after index detection of serrated lesions \[sessile serrated polyps (SSPs), traditional serrated adenomas (TSAs)\]
Rate of metachronous high-risk adenoma (HRA) after index detection of high-grade dysplasia (HGD)
the rate of metachronous high-risk adenoma (HRA) after index detection of high-grade dysplasia (HGD)
Rate of T-MAN detection for concomitant index SSP+low-risk adenoma (LRA); index SSP+ high-risk adenoma (HRA); index SSP alone
The rate of T-MAN detection for concomitant index SSP+low-risk adenoma (LRA); index SSP+ high-risk adenoma (HRA); index SSP alone
Rate of T-MAN detection according to number, size, location, and dysplasia status of index SSPs
The rate of T-MAN detection according to number, size, location, and dysplasia status of index SSPs
Rate of metachronous HRA detection for index HGD alone
The rate of metachronous HRA detection for index HGD alone
Rate of metachronous HRA detection for index HGD according to number, size, location, of index HGD
The rate of metachronous HRA detection for index HGD according to number, size, location, of index HGD
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