Simple clinical risk score identifies patients with serrated polyps in routine practice.Bouwens MW, Winkens B, Rondagh EJ, Driessen AL, Riedl RG, Masclee AA, Sanduleanu S. Cancer Prev Res (Phila). 2013 Jul 3. [Epub ahead of print] Large, proximal or dysplastic (LPD) serrated polyps (SPs) need accurate endoscopic recognition and removal as these might progress to colorectal cancer. Herewith, we examined the risk factors for having ≥1 LPD SP. We developed and validated a simple SP risk score as a potential tool for improving their detection. We reviewed clinical, endoscopic and histologic features of SPs in a study of patients undergoing elective colonoscopy (derivation cohort). A self-administered questionnaire was obtained. We conducted logistic regression analyses to identify independent risk factors for having ≥1 LPD SP and incorporated significant variables into a clinical score. We subsequently tested the performance of the SP score in a validation cohort. We examined 2244 patients in the derivation and 2402 patients in the validation cohort; 6.3% and 8.2% had ≥1 LPD SP, respectively. Independent risk factors for LPD SPs were age >50 years (OR 2.2, 95% CI 1.3 – 3.8, p=0.004), personal history of SPs (OR 2.6. 95% CI 1.3 – 4.9, p=0.005), current smoking (OR 2.2, 95% CI 1.4 – 3.6, p=0.001) and non-daily/no aspirin use (OR 1.8, 95% CI 1.1 – 3.0, p=0.016). In the validation cohort, a SP score ≥5 points was associated with a 3.0 fold increased odds for LPD SPs, compared to patients with a score <5 points. In the present study, age >50 years, a personal history of SPs, current smoking and non-daily/no aspirin use were independent risk factors for having LPD SPs. The SP score might aid the endoscopist in the detection of such lesions.