Prevalence and predictive factors of colorectal sessile serrated lesions in younger individuals

Introduction Sessile serrated lesions (SSLs) are obscured lesions predominantly at right sided colon and associated with interval colorectal cancer. However, the prevalence and risk factors among younger individuals remain unclear. Methods This retrospective study enrolled individuals who underwent index colonoscopy. The primary outcomes were SSL prevalence between younger (<50 years) and older (≥50 years) groups, whereas the secondary outcomes included clinically significant serrated polyps (CSSPs). Multivariable logistic regression was employed to identify predictors. Results Of the 9854 eligible individuals, 4712 (47.8%) were categorized into the younger age group. Individuals in the younger age group exhibited a lower prevalence of adenomas (22.6% vs. 46.2%, P < 0.001) and right-sided adenomas (11.2% vs. 27.2%, P < 0.001) compared with their older counterparts. However, both groups exhibited a similar prevalence of SSLs (7.2% vs. 6.5%, P = 0.157) and CSSP (10.3% vs. 10.3%, P = 0.956). Multivariable analysis results revealed that age = 40–49 years (odds ratio [OR] = 1.81, 95% confidence interval [CI] = 1.01–3.23), longer withdrawal time (OR = 1.18, 95% CI = 1.15 – 1.21 per minute increment), and endoscopist performance (OR = 3.35, 95% CI = 2.44 – 4.58) were independent predictors of SSL detection in the younger age group. No significant correlation was observed between adenoma and SSL detection rates among endoscopists. Conclusion SSLs are not uncommon among younger individuals. Moreover, diligent effort and expertise are of paramount importance in SSL detection. Future studies should explore the clinical significance of SSLs in younger age individuals.