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Sessile serrated polyp prevalence determined by a colonoscopist with a high lesion detection rate and an experienced pathologist - 23/02/15

Doi : 10.1016/j.gie.2014.04.064 
Khaled Abdeljawad, MD 1, Krishna C. Vemulapalli, MBBS, MPH 1, Charles J. Kahi, MD, MSCR 1, 2, Oscar W. Cummings, MD 3, Dale C. Snover, MD 4, Douglas K. Rex, MD 1,
1 Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA 
2 Richard L. Roudebush Veterans Affairs Medical Center, Indiana University School of Medicine, Indianapolis, Indiana, USA 
3 Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA 
4 Department of Pathology, Fairview Southdale Hospital, Edina, Minnesota and Department of Laboratory Medicine and Pathology, the University of Minnesota Medical Center, Minneapolis, Minnesota, USA 

Reprint requests: Douglas K. Rex, MD, 550 N. University Boulevard, Indiana University Hospital #4100, Indianapolis, IN 46202.

Abstract

Background

The prevalence of sessile serrated adenomas and/or polyps (SSA/Ps) is uncertain.

Objective

To determine the prevalence of SSA/Ps and SSA/Ps with cytologic dysplasia (SSA/P-CD) by using a colonoscopist with a high lesion detection rate and an expert in serrated lesion pathology.

Design

Retrospective screening colonoscopy study.

Setting

Academic endoscopy unit.

Patients

A total of 1910 average risk, asymptomatic patients aged ≥50 years underwent screening colonoscopy between August 2005 and April 2012 by a single colonoscopist with a high lesion detection rate.

Interventions

Slides of all lesions in the serrated class proximal to the sigmoid colon and all rectal and sigmoid colon serrated lesions >5 mm in size were reviewed by an experienced GI pathologist.

Main Outcome Measurements

Prevalence of SSA/Ps, defined as the proportion of patients with ≥1 SSA/P.

Results

There were 1910 patients, of whom 389 had 656 lesions in the serrated class. Review by the experienced GI pathologist determined a prevalence of SSA/Ps without cytologic dysplasia of 7.4% and SSA/Ps-CD of 0.6% (total SSA/P prevalence 8.1%). SSA/Ps and SSA/Ps-CD comprised 5.6% and 0.3%, respectively, of all resected polyps. The mean size of SSA/Ps was 7.13 mm (standard deviation [SD] 4.66), and 51 of 77 (66.2%) polyps ≥10 mm in the serrated class were SSA/Ps.

Limitations

Retrospective design.

Conclusion

A colonoscopist with a high lesion detection rate and an experienced pathologist identified a high prevalence (8.1%) of SSA/Ps in a screening population. SSA/Ps are more common than previously believed.

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Abbreviations : CRC, HP, SSA, SSA/P, SSA/P-CD, SSP, TSA, WHO


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 Disclosure: This work was funded by a gift from Scott and Kay Schurz of Bloomington, Indiana. No other financial relationships relevant to this article were disclosed.


© 2015  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 81 - N° 3

P. 517-524 - marzo 2015 Ritorno al numero
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  • Margaret E. MacPhail, Kyle A. Hardacker, Ashish Tiwari, Krishna C. Vemulapalli, Douglas K. Rex

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