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DOI: 10.1055/s-0045-1806150
Risk Factors Associated with Serrated Adenomas in a Screening Colonoscopy Cohort in Northwest Africa
Aims Serrated polyps are an increasingly recognized precursor to colorectal cancer, but their epidemiology is not well characterized in North African populations. This study aimed to evaluate the prevalence and risk factors associated with serrated adenomas in a cohort undergoing screening colonoscopy in northwest Africa.
Methods A prospective cohort study was conducted among 2,359 patients undergoing outpatient colonoscopy at a tertiary care center in northwest Africa. Adenoma detection rates were compared across experience levels, and multivariate analysis was performed to adjust for confounding factors including bowel preparation quality and use of high-definition colonoscopes.
Results Most patients underwent colonoscopy for diagnostic purposes (72.9%), with 9.8% for screening and 17.3% for surveillance. Constipation was the main indication, accounting for 21.6% of cases. The cohort included 1,175 men (49.8%) and 1,184 women (50.2%), with a sex ratio M/F of 0.98. Within the population, 271 (11.5%) were smokers and 89 (3.8%) were alcohol consumers. 163 (6.9%) patients were on anticoagulation or antiplatelet therapy, with documentation of anticoagulation management for 28 patients who underwent polypectomy. Serrated polyps were detected in 2% of all colonoscopies and 0.95% of proximal colonoscopies. The detection rate for advanced adenomas was 4.6%. Multivariate analysis showed that a history of hypertension (OR=2.14, 95% CI 1.54-2.98, p<0.001), use of antihypertensive medication (OR=1.92, 95% CI 1.33-2.77, p<0.001), and use of antiplatelet drugs (OR=1.81, 95% CI 1.21-2.71, p=0.004) were significantly associated with the presence of serrated lesions.
Conclusions The prevalence of serrated polyps in this North African cohort is lower than reported in Western populations. However, patients with hypertension, on antihypertensive medications, and on antidiabetic drugs appear to have an increased risk of harbouring serrated adenomas. Heightened awareness and surveillance may be warranted in these high-risk groups.
Publication History
Article published online:
27 March 2025
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