CC BY-NC-ND 4.0 · Endoscopy 2024; 56(07): 494-502
DOI: 10.1055/a-2272-1911
Original article

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

Jen-Hao Yeh
1   Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (Ringgold ID: RIN38023)
2   Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da DaChang Hospital, I-Shou University, Kaohsiung, Taiwan
Chih-Wen Lin
3   Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
Po-Jen Hsiao
2   Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da DaChang Hospital, I-Shou University, Kaohsiung, Taiwan
Daw-Shyong Perng
3   Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
Jen-Chieh Chen
4   Department of Health Examination, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
Kuo-Tung Hung
2   Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da DaChang Hospital, I-Shou University, Kaohsiung, Taiwan
Chia-Chang Hsu
4   Department of Health Examination, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
Chia-Chi Chen
5   Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
Yu-Peng Liu
1   Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (Ringgold ID: RIN38023)
6   Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (Ringgold ID: RIN38023)
Yi-Chia Lee
7   Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Jaw-Yuan Wang
1   Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (Ringgold ID: RIN38023)
8   Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
9   Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan (Ringgold ID: RIN38023)
› Author Affiliations
Supported by: National Science and Technology Council MOST 111-2314-B-037-070-MY3,NSTC 112-2314-B-037-050-MY3,NSTC 112-2314-B-037-090
Supported by: Ministry of Health and Welfare 12D1-IVMOHW02
Supported by: Kaohsiung Medical University KMU-TC112A04,KMUH-SH11207,KMUH112-2M27,KMUH112-2M28,KMUH112-2M29,KMUH112-2R37,KMUH112-2R38,KMUH112-2R39
Supported by: E-Da Hospital EDAHS112014,EDAHS112029,EDDHP112001


Background Sessile serrated lesions (SSLs) are obscured lesions predominantly in the right-sided colon and associated with interval colorectal cancer; however, their prevalence and risk factors among younger individuals remain unclear.

Methods This retrospective study enrolled individuals who underwent index colonoscopy. The primary outcome was the SSL prevalence in the younger (<50 years) and older (≥50 years) age groups, while 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 lower prevalences 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=0.16) and CSSPs (10.3% vs. 10.3%;P=0.96). Multivariable analysis revealed that age 40–49 years (odds ratio [OR] 1.81, 95%CI 1.01–3.23), longer withdrawal time (OR 1.17, 95%CI 1.14–1.20, 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 individuals of younger age.

Supplementary Material

Publication History

Received: 15 October 2023

Accepted after revision: 16 February 2024

Accepted Manuscript online:
20 February 2024

Article published online:
04 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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