P3649 - Prevalence and Detection Rates of Serrated Polyps and Sessile Serrated Lesions in Average Risk Persons With Positive Fecal Immunohistochemical Test Undergoing Colonoscopy: A Systematic Review and Meta-Analysis

Fouad Jaber, MD, MS¹, Mohammad Jaber, MD², Saqr Alsakarneh, MD¹, Tala Alsharaeh, MD³, Abdelrahman Mohamed Mahmoud, MD⁴, Anas Alselek, MD⁵, Yazan Abboud, MD⁶, Mouhand F.H. Mohamed, MD⁷, Abubaker O. Abdalla, MD⁸, Khalid Ahmed, MD⁹, Mohamed Abdallah, MD¹⁰, Mohammad Bilal, MD¹¹, Aasma Shaukat, MD, MPH^12
1University of Missouri - Kansas City School of Medicine, Kansas City, MO; ²Al-Azhar University, Gaza, Palestinian Territories; ³The University of Jordan, Amman, 'Amman, Jordan; ⁴Menoufia University, Menoufia, Ad Daqahliyah, Egypt; ⁵Cairo University School of Medicine, Cairo, Al Jizah, Egypt; ⁶Rutgers New Jersey Medical School, Newark, NJ; ⁷Brown University, Providence, RI; ⁸Emory University, Atlanta, GA; ⁹University of Pennsylvania, Philadelphia, PA; ¹⁰Cleveland Clinic, Cleveland, OH; ¹¹University of Minnesota and Minneapolis VA Health Care System, Minneapolis, MN; ¹²NYU Langone Health, New York, NY

Introduction: While studies have reported adenoma detection rates in fecal immunochemical test (FIT) -positive individuals, there is a lack of data on the performance of FIT in detecting sessile serrated lesions (SSLs). Therefore, we conducted a meta-analysis to evaluate the serrated polyp detection rate (SPDR) and SSL detection rate (SSLDR) in FIT-positive individuals undergoing colonoscopy.

Methods: We conducted a comprehensive search of PubMed, Scopus, and Embase databases up to March 2024 to identify studies reporting SSLs in FIT-positive patients undergoing colonoscopy. The primary outcome was the overall prevalence of SPs and SSLs. Secondary outcomes included SPDR and SSLDR. Prevalence of SPs was calculated as the detection of any SP [SSL, traditional serrated adenoma (TSA), or hyperplastic polyp (HP)] divided by total patients/colonoscopies. Prevalence of SSLs excluded TSAs and HPs from the analysis. SPDR was the number of colonoscopies detecting one or more SP divided by total colonoscopies. SSLDR was calculated similarly but focused on SSLs only. Other outcomes included


advanced SSLs (SSL with dysplasia or ≥ 10 mm) detection rate, polyps prevenance and detection rates based on location (proximal vs. distal), gender, and FIT threshold. A proportion meta-analysis, utilizing the random effects model, was used to generate the pooled rates with their corresponding 95% confidence intervals (CI). I2 adjudicated the heterogeneity.

Results: Twenty-two studies met the inclusion criteria, involving 513,080 FIT-positive individuals undergoing colonoscopy. The pooled prevalence of SPs was 19.4% (95% CI: 16.5%–22.8%, I² = 99.747%), with a pooled SPDR of 12.7% (95% CI: 8.7%–18.3%, I² = 99.913%) (Men: 3.8%, and women: 4.2%). For SSLs, the overall pooled prevalence was 7.7% (95% CI: 6.2%–9.5%, I² = 99.415%), with a pooled SSLDR of 4.3% (95% CI: 3.4%–5.5%, I² = 99.586%) (Men: 4.4% and Women 4.4%) (Proximal SSLDR: 1.6%, and distal SSLDR 1%). The overall pooled prevalence of detected advanced SSLs was 7% (95%CI: 2.1%–3.5%, I² = 94.076%), while pooled advanced SSLDR was 1.4% (95% CI: 1 %– 1.9%, I² = 97.024%). Table 1 summarizes the results for SPDR and SSLDR, stratified by location, gender, FIT threshold, and the country of origin of the studies.

Discussion: Our analysis provides valuable information regarding SSL detection rates in FIT-positive individuals which can be used as a quality benchmark in FIT-based population screening programs.


Disclosures:


Fouad Jaber, MD, MS¹, Mohammad Jaber, MD², Saqr Alsakarneh, MD¹, Tala Alsharaeh, MD³, Abdelrahman Mohamed Mahmoud, MD⁴, Anas Alselek, MD⁵, Yazan Abboud, MD⁶, Mouhand F.H. Mohamed, MD⁷, Abubaker O. Abdalla, MD⁸, Khalid Ahmed, MD⁹, Mohamed Abdallah, MD¹⁰, Mohammad Bilal, MD¹¹, Aasma Shaukat, MD, MPH¹². P3649 - Prevalence and Detection Rates of Serrated Polyps and Sessile Serrated Lesions in Average Risk Persons With Positive Fecal Immunohistochemical Test Undergoing Colonoscopy: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.