Su1710 Large Proximal Serrated Lesions Are Associated with High Incidence of Synchronous and Metachronous Serrated Lesions and Neoplasia

Serrated lesions are increasingly recognized as precursors to colorectal cancer (CRC). The serrated pathway to colorectal cancer is genetically distinct from the traditional adenoma pathway. This accounts for their progression to dysplasia then carcinoma, but may also reflect a unique genetic predisposition for serrated lesion patients to develop premalignant synchronous and metachronous polyps. While recent surveillance guidelines reflect the malignant potential of serrated lesions, it is unclear how surveillance guidelines consider prevalence of synchronous and metachronous lesions. We hypothesized that large (≥10mm) proximal colon serrated lesions are highly associated with both synchronous and metachronous lesions.