Sessile serrated polyp prevalence determined by a colonoscopist with a high lesion detection rate and an experienced pathologist

Abdeljawad, Khaled; Vemulapalli, Krishna C.; Kahi, Charles J.; Cummings, Oscar W.; Snover, Dale C.; Rex, Douglas K.

doi:10.1016/j.gie.2014.04.064

Cited by 172 publications

(172 citation statements)

References 41 publications

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“…In general, these prevalences are lower than those in the COCOS trial. The prevalences of serrated lesions, on the other hand, are similar to those reported in an American colonoscopy study (51). For countries with other prevalence rates, recalibration of the model to country-specific prevalence rates is required to acquire more accurate estimations of screening impact for those countries.…”

Section: Discussionsupporting

confidence: 64%

Long-Term Impact of the Dutch Colorectal Cancer Screening Program on Cancer Incidence and Mortality—Model-Based Exploration of the Serrated Pathway

Greuter

Demirel

Lew

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: We aimed to predict the long-term colorectal cancer incidence, mortality, and colonoscopy demand of the recently implemented Dutch colorectal cancer screening program.Methods: The Adenoma and Serrated pathway to Colorectal Cancer model was set up to simulate the Dutch screening program consisting of biennial fecal immunochemical testing combined with the new Dutch surveillance guidelines, between 2014 and 2044. The impact of screening and surveillance was evaluated under three sets of natural history assumptions differing in the contribution of the serrated pathway to colorectal cancer incidence. In sensitivity analyses, other assumptions concerning the serrated pathway were varied. Model-predicted outcomes were yearly colorectal cancer incidence, mortality, and colonoscopy demand per year.Results: Assuming an aging population, colorectal cancer incidence under 30 years of screening is predicted to decrease by 35% and 31% for a contribution of 0% and 30% of the serrated

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Section: Discussionsupporting

confidence: 64%

Long-Term Impact of the Dutch Colorectal Cancer Screening Program on Cancer Incidence and Mortality—Model-Based Exploration of the Serrated Pathway

Greuter

Demirel

Lew

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…The biological behaviour of those two types is considered to be different: SSA are widely recognized as precursor lesions of serrated pathway colorectal carcinoma [2,3], while HP are still considered to have no malignant potential. The prevalence of SSA remains unclear, varying between 2.8 % (standard care) and 9 % (single-expert endoscopy and pathology reports) in patients undergoing screening and/or diagnostic colonoscopy [4][5][6][7]. Similarly, although there are two different variants of the pathway from serrated adenomas to colorectal carcinoma with regards to cancer aggressiveness [8], the relevance in clinical practice especially with regards to screening colonoscopy and associated adenoma findings is not yet clear.…”

Section: Introductionmentioning

confidence: 99%

Impact of reassessment of colonic hyperplastic polyps by expert GI pathologists

Schachschal

Sehner

Choschzick

et al. 2016

Int J Colorectal Dis

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BACKGROUND: Recommended follow-up intervals after endoscopic removal of hyperplastic polyps (HP) and sessile serrated adenomas (SSA) differ because of assumed differences in biological behaviour. However, histopathologic differentiation is difficult, with higher SSA rates reported from specialist GI histopathologists. OBJECTIVE: The objective of this study was to clarify the relevance of histologic reassessment of HP. DESIGN AND SETTING: From a prospective screening colonoscopy study relevant serrated lesions (excluding distal small HP 5 mm) diagnosed by private practice pathologists were reassessed by four specialized GI pathologists PATIENTS: One thousand sixty-nine screening colonoscopies were performed in patients. MAIN OUTCOME MEASUREMENTS: In terms of main outcome measurements, there is a likelihood of changes of the HP diagnosis on reassessment, as well as interrater variability. RESULTS: SSA were initially diagnosed in 7 cases (0.7 %) and relevant HP in 83 (7.8 %; 101 lesions). Of the latter, the chance of a change in diagnosis from HP to SSA by any of the four specialist histopathologists was higher for larger (>5 mm) and right-sided lesions (19.1 vs 1.3 %, OR 18.4, p = 0.04) including a higher likelihood to change recommended follow-up intervals (32.1 vs 3.3 %, p < 0.01). However, follow-up intervals were determined by concomitant adenomas in 41 %. Interrater variability was also higher for these lesions (p = 0.04), with an overall kappa value of 0.48. However, this issue related to only 1.2 % of the 1069 study cases. LIMITATION: The limitations this study are the limited case number as well as limited retrospective assessment. CONCLUSIONS: Right-sided HP >5 mm had a higher chance of change in diagnosis to SSA; therefore, they should probably be treated like adenomas and be removed. However, reliable data for recommendations on follow-up intervals of HP or SSA will require follow-up studies. Abstract Background Recommended follow-up intervals after endoscopic removal of hyperplastic polyps (HP) and sessile serrated adenomas (SSA) differ because of assumed differences in biological behaviour. However, histopathologic differentiation is difficult, with higher SSA rates reported from specialist GI histopathologists.Objective The objective of this study was to clarify the relevance of histologic reassessment of HP.Design and setting From a prospective screening colonoscopy study relevant serrated lesions (excluding distal small HP ≤5 mm) diagnosed by private practice pathologists were reassessed by four specialized GI pathologists Patients One thousand sixty-nine screening colonoscopies were performed in patients.Main outcome measurements In terms of main outcome measurements, there is a likelihood of changes of the HP diagnosis on reassessment, as well as interrater variability.Results SSA were initially diagnosed in 7 cases (0.7 %) and relevant HP in 83 (7.8 %; 101 lesions). Of the latter, the chance of a change in diagnosis from HP to SSA by any of the four specialist histopathologists was hig...

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“…The sessile serrated adenomas / polyps (SSA/Ps) predominate in the right colon 13 . They tend to be flat in the proximal colon (75%), 64% being bigger than 5mm, and 17% bigger than 10mm.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of endoscopic and histopathological features of superficial elevated lesions resected by endoscopic mucosal resection in the distal and proximal colon

Parada

Ribas

Venco³

et al. 2016

Rev. Col. Bras. Cir.

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Objective: to compare endoscopic and histopathologic features of superficial, elevated lesions with one or more centimeters in diameter, diagnosed by videocolonoscopy on the distal and proximal colon, and subjected to mucosal resection. Methods: we conducted a retrospective, cross-sectional, observational study involving 8,075 videocolonoscopies. From this total, we evaluated 166 mucosectomies in 145 patients with superficial, elevated lesions with a diameter equal to or greater than 1cm. Results: the lesion prevalence was lower in G1 than in G2 (34.9% vs. 65%). The mean age, gender distribution and size (1.9cm in G1 versus 2.0cm in G2, p=0.921) were similar. There was no difference of mucosal surfaces in relation to the location (p=0.575). Considering Intraepithelial neoplasias, both the low grade, high grade (including carcinomas) and hyperplasic ones showedd no difference (p=0.527), nor did the neoplastic lesions when divided into serrated and non-serrated (p=0.124). Excluding 13 hyperplastic lesions and two carcinomas, 124 (82.1%) were non-serrated and 27 (17.9%), serrated. Conclusion: were found no significant differences between endoscopic and histopathological aspects of superficial, elevated lesions of 1cm or more in diameter in distal colon compared with the proximal, when resected by mucosectomy. Although not significant, there was a tendency of association between the location of the lesion and the presence of serrated features.

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Sessile serrated polyp prevalence determined by a colonoscopist with a high lesion detection rate and an experienced pathologist

Cited by 172 publications

References 41 publications

Long-Term Impact of the Dutch Colorectal Cancer Screening Program on Cancer Incidence and Mortality—Model-Based Exploration of the Serrated Pathway

Long-Term Impact of the Dutch Colorectal Cancer Screening Program on Cancer Incidence and Mortality—Model-Based Exploration of the Serrated Pathway

Impact of reassessment of colonic hyperplastic polyps by expert GI pathologists

Comparative analysis of endoscopic and histopathological features of superficial elevated lesions resected by endoscopic mucosal resection in the distal and proximal colon

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