Traditional serrated adenomas (TSA) and the company they keep: TSA presence predicts advanced neoplasm states.

BACKGROUND: The association of TSAs with metachronous neoplasms is well established and suggests that TSAs would also have an association with synchronous neoplasms. METHODS: We compared odds ratios and rates of synchronous neoplasms found in colonoscopies with and without TSAs. RESULTS: There was a mean of 2.44 neoplasms among TSA cases in comparison with 1.72 in non-TSA cases. The odds ratio for advanced neoplasia was highest among cases with one or more TSAs relative to cases with one or more HPs (7.54 [CI, 4.23-13.44]) when compared with adenomas (1.95 [CI, 1.75-2.17]) and SSPs (2.98 [CI, 2.54-3.5]). CONCLUSIONS: In this study population, there is a 7-fold higher risk of synchronous advanced neoplasms among cases with one or more TSAs.