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Predictors for dMMR colorectal cancer in patients with serrated lesions and polyps – A register-based cohort study
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Predictors for dMMR colorectal cancer in patients with serrated lesions and polyps – A register-based cohort study
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Journal Article
Predictors for dMMR colorectal cancer in patients with serrated lesions and polyps – A register-based cohort study
2024
Overview
Serrated lesions and polyps (SP) are precursors of up to 30 % of colorectal cancers (CRC) through the serrated pathway. This often entails early BRAF mutations and MLH1 hypermethylation leading to mismatch repair deficient (dMMR) CRC. We investigated predictors of dMMR CRC among patients with co-occurrence of CRC and SP to increase our knowledge on the serrated pathway.
We used data from The Danish Pathology Registry and Danish Colorectal Cancer Groups Database from the period 2010–2021 to investigate risk factors for development of dMMR CRC. We used logistic regression models to identify difference in risk factors of developing dMMR CRC in comparison to CRC with proficient MMR (pMMR).
We included 3273 patients with a median age of 70.7 years [64.3,76.4] of which 1850 (56.5 %) were male. dMMR CRC was present in 592 patients (18.1 %), with loss of MLH1/PMS2 being most common. The risk of dMMR CRC was significantly higher in females OR 3.47 [2.87;4.20]. When adjusting for age, SP subtype, conventional adenomas (CA), anatomical location and lifestyle factors, female sex remained the strongest predictor OR 2.84 [2.27;3.56]. The presence of sessile serrated lesions with or without dysplasia was related to higher risk OR 1.60 [1.11;2.31] and OR 1.42 [1.11;1.82] respectively, while conventional adenomas constituted a lower risk OR 0.68 [0.55;0.84].
In conclusion we found several predictors of whom female sex had the strongest correlation with dMMR CRC in patients with SP.
•Female sex is the strongest predictor for dMMR colorectal cancer in patients with serrated lesions and polyps.•Sessile serrated lesions with and without dysplasia are correlated to at higher risk of dMMR colorectal cancer.•Conventional adenomas are correlated to a lower risk of dMMR colorectal cancer.
Publisher
Elsevier Ltd,Elsevier Limited
Subject
/ Age
/ Aged
/ Alcohol
/ Colonic Polyps - epidemiology
/ Colorectal Neoplasms - epidemiology
/ Colorectal Neoplasms - genetics
/ Colorectal Neoplasms - pathology
/ Colorectal serrated lesions and polyps
/ Female
/ Females
/ Humans
/ Lesions
/ Male
/ Mutation
/ MutL Protein Homolog 1 - genetics
/ Patients
/ Polyps
/ Surgeons
/ Surgery
/ Tumors
