Mo1731 High Incidence of Ulcerative Colitis Related Colorectal Cancer in a Low Incidence Area of Sporadic Colon Cancer

difficult to identify especially with suboptimal bowel preparation.The goal of the study was to identify endoscopic features of mucous-capped polyps that help predict SSA/Ps.Methods: We analyzed 147 mucous-capped polyps identified from 2069 colonic polyps from 2011-2014.The 8 features looked at included: presence of borders, elevation, rim of debris, location in colon, size, varicose vessels, nodular surface, and alteration of mucosal folds.Predefined criteria for each endoscopic feature were used to analyze mucous-capped polyps from previously taken pictures through retrospective chart review.One experienced endoscopist (Devers TJ) confirmed the morphology from documentation for a representative group of adenomas.Polyps were identified as an SSA/P when histology showed abnormal proliferation and/or abnormal architecture without the presence of cytological dysplasia seen in adenomatous polyps.We used conditional logistic regression with backward selection to compute odds ratios (ORs), confidence intervals (CI), and p-values looking for endoscopic features that predict SSA/Ps.Results: Ninety-seven percent (n=142) of mucous-capped polyps were from the serrated pathway (hyperplastic (n=98) and SSA/P (n=44)), while 3% (n=5) were from the adenoma-carcinoma sequence.Rim of debris (OR 4.086, p=0.207), varicose vessels (OR 9.921, p <0.005), and nodular surface (OR 3.076, 95% CI 1.250-7.570,p=0.014) were selected out after backward selection.Presence of a nodular surface and varicose vessels were found to have statistical significance in predicting SSA/Ps.Polyp size greater than 10 mm, elevation, distinct borders, location in colon, alteration of mucosal folds, and rim of debris were not found to be statistically significant endoscopic predictors for SSA/Ps.Conclusion: The current study demonstrates that mucous-capped polyps are usually associated with the serrated pathway and that SSA/ Ps possess predictive endoscopic features.Recognition of these characteristics might assist endoscopists in differentiating and detecting these often subtle lesions which may help improve the effectiveness of colonoscopy.