Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test

The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

Equipe Working Group

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14 Citations (Scopus)

Abstract

Objectives To assess detection rate and predictive factors of sessile serrated polyps (SSPs) in organised colorectal cancer (CRC) screening programmes based on the faecal immunochemical test (FIT). Design Data from a case series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected, including the age-standardised and sex-standardised adenoma detection rate (ADR) of the individual endoscopists. The SSP detection rate (SSP-DR) was assessed for the study population. To identify SSP-predictive factors, multilevel analyses were performed according to patient/centre/ endoscopist characteristics. Results We analysed 72 021 colonoscopies, of which 1295 presented with at least one SSP (SSP-DR 1.8%; 95% CI 1.7% to 1.9%). At the per-patient level, SSPDR was associated with males (OR 1.35; 95% CI 1.17 to 1.54) and caecal intubation (OR 3.75; 95% CI 2.22 to 6.34), but not with the FIT round. The presence of at least one advanced adenoma was more frequent among subjects with SSPs than those without (OR 2.08; 95% CI 1.86 to 2.33). At the per-endoscopist level, SSP-DR was associated with ADR (third vs first ADR quartile: OR 1.55; 95% CI 1.03 to 2.35; fourth vs first quartile: OR 1.89; 95% CI 1.24 to 2.90). Conclusion The low prevalence of SSPs and the lack of association with the FIT round argue against SSP as a suitable target for FIT-based organised programmes. Strict association of SSP-DR with the key colonoscopy quality indicators, namely caecal intubation rate and high ADR further marginalises the need for SSP-specific quality indicators in FIT-based programmes.

Original languageEnglish (US)
JournalGut
DOIs
StateAccepted/In press - Feb 19 2016

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Occult Blood
Hematologic Tests
Polyps
Early Detection of Cancer
Endoscopy
Colorectal Neoplasms
Adenoma
Colonoscopy
Intubation
Multilevel Analysis
Statistical Factor Analysis
Histology
History

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{adc2d1234f2d41958df8aa29e8e049c5,
title = "Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)",
abstract = "Objectives To assess detection rate and predictive factors of sessile serrated polyps (SSPs) in organised colorectal cancer (CRC) screening programmes based on the faecal immunochemical test (FIT). Design Data from a case series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected, including the age-standardised and sex-standardised adenoma detection rate (ADR) of the individual endoscopists. The SSP detection rate (SSP-DR) was assessed for the study population. To identify SSP-predictive factors, multilevel analyses were performed according to patient/centre/ endoscopist characteristics. Results We analysed 72 021 colonoscopies, of which 1295 presented with at least one SSP (SSP-DR 1.8{\%}; 95{\%} CI 1.7{\%} to 1.9{\%}). At the per-patient level, SSPDR was associated with males (OR 1.35; 95{\%} CI 1.17 to 1.54) and caecal intubation (OR 3.75; 95{\%} CI 2.22 to 6.34), but not with the FIT round. The presence of at least one advanced adenoma was more frequent among subjects with SSPs than those without (OR 2.08; 95{\%} CI 1.86 to 2.33). At the per-endoscopist level, SSP-DR was associated with ADR (third vs first ADR quartile: OR 1.55; 95{\%} CI 1.03 to 2.35; fourth vs first quartile: OR 1.89; 95{\%} CI 1.24 to 2.90). Conclusion The low prevalence of SSPs and the lack of association with the FIT round argue against SSP as a suitable target for FIT-based organised programmes. Strict association of SSP-DR with the key colonoscopy quality indicators, namely caecal intubation rate and high ADR further marginalises the need for SSP-specific quality indicators in FIT-based programmes.",
author = "{Equipe Working Group} and Manuel Zorzi and Carlo Senore and {da Re}, Filippo and Alessandra Barca and Bonelli, {Luigina Ada} and Renato Cannizzaro and {de Pretis}, Giovanni and {di Furia}, Lucia and {di Giulio}, Emilio and Paola Mantellini and Carlo Naldoni and Romano Sassatelli and Douglas Rex and Marco Zappa and Cesare Hassan and Giuseppe Feliciangeli and Cinzia Campari and Fabio Falcini and Orietta Giuliani and Omero Triossi and Vincenzo Matarese and Chiara Fedato and Anna Turrin and Susanna Baracco and Fabio Monica and Beatrice Mallardi and Francesco Quadrino and Ivana Valle and Patrizia Landi and Elisabetta Buscarini and Richard Nienstedt and Pietro Occhipinti and Arrigo Arrigoni and Mario Grassini",
year = "2016",
month = "2",
day = "19",
doi = "10.1136/gutjnl-2015-310587",
language = "English (US)",
journal = "Gut",
issn = "0017-5749",
publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test

T2 - The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

AU - Equipe Working Group

AU - Zorzi, Manuel

AU - Senore, Carlo

AU - da Re, Filippo

AU - Barca, Alessandra

AU - Bonelli, Luigina Ada

AU - Cannizzaro, Renato

AU - de Pretis, Giovanni

AU - di Furia, Lucia

AU - di Giulio, Emilio

AU - Mantellini, Paola

AU - Naldoni, Carlo

AU - Sassatelli, Romano

AU - Rex, Douglas

AU - Zappa, Marco

AU - Hassan, Cesare

AU - Feliciangeli, Giuseppe

AU - Campari, Cinzia

AU - Falcini, Fabio

AU - Giuliani, Orietta

AU - Triossi, Omero

AU - Matarese, Vincenzo

AU - Fedato, Chiara

AU - Turrin, Anna

AU - Baracco, Susanna

AU - Monica, Fabio

AU - Mallardi, Beatrice

AU - Quadrino, Francesco

AU - Valle, Ivana

AU - Landi, Patrizia

AU - Buscarini, Elisabetta

AU - Nienstedt, Richard

AU - Occhipinti, Pietro

AU - Arrigoni, Arrigo

AU - Grassini, Mario

PY - 2016/2/19

Y1 - 2016/2/19

N2 - Objectives To assess detection rate and predictive factors of sessile serrated polyps (SSPs) in organised colorectal cancer (CRC) screening programmes based on the faecal immunochemical test (FIT). Design Data from a case series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected, including the age-standardised and sex-standardised adenoma detection rate (ADR) of the individual endoscopists. The SSP detection rate (SSP-DR) was assessed for the study population. To identify SSP-predictive factors, multilevel analyses were performed according to patient/centre/ endoscopist characteristics. Results We analysed 72 021 colonoscopies, of which 1295 presented with at least one SSP (SSP-DR 1.8%; 95% CI 1.7% to 1.9%). At the per-patient level, SSPDR was associated with males (OR 1.35; 95% CI 1.17 to 1.54) and caecal intubation (OR 3.75; 95% CI 2.22 to 6.34), but not with the FIT round. The presence of at least one advanced adenoma was more frequent among subjects with SSPs than those without (OR 2.08; 95% CI 1.86 to 2.33). At the per-endoscopist level, SSP-DR was associated with ADR (third vs first ADR quartile: OR 1.55; 95% CI 1.03 to 2.35; fourth vs first quartile: OR 1.89; 95% CI 1.24 to 2.90). Conclusion The low prevalence of SSPs and the lack of association with the FIT round argue against SSP as a suitable target for FIT-based organised programmes. Strict association of SSP-DR with the key colonoscopy quality indicators, namely caecal intubation rate and high ADR further marginalises the need for SSP-specific quality indicators in FIT-based programmes.

AB - Objectives To assess detection rate and predictive factors of sessile serrated polyps (SSPs) in organised colorectal cancer (CRC) screening programmes based on the faecal immunochemical test (FIT). Design Data from a case series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected, including the age-standardised and sex-standardised adenoma detection rate (ADR) of the individual endoscopists. The SSP detection rate (SSP-DR) was assessed for the study population. To identify SSP-predictive factors, multilevel analyses were performed according to patient/centre/ endoscopist characteristics. Results We analysed 72 021 colonoscopies, of which 1295 presented with at least one SSP (SSP-DR 1.8%; 95% CI 1.7% to 1.9%). At the per-patient level, SSPDR was associated with males (OR 1.35; 95% CI 1.17 to 1.54) and caecal intubation (OR 3.75; 95% CI 2.22 to 6.34), but not with the FIT round. The presence of at least one advanced adenoma was more frequent among subjects with SSPs than those without (OR 2.08; 95% CI 1.86 to 2.33). At the per-endoscopist level, SSP-DR was associated with ADR (third vs first ADR quartile: OR 1.55; 95% CI 1.03 to 2.35; fourth vs first quartile: OR 1.89; 95% CI 1.24 to 2.90). Conclusion The low prevalence of SSPs and the lack of association with the FIT round argue against SSP as a suitable target for FIT-based organised programmes. Strict association of SSP-DR with the key colonoscopy quality indicators, namely caecal intubation rate and high ADR further marginalises the need for SSP-specific quality indicators in FIT-based programmes.

UR - http://www.scopus.com/inward/record.url?scp=84960153086&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84960153086&partnerID=8YFLogxK

U2 - 10.1136/gutjnl-2015-310587

DO - 10.1136/gutjnl-2015-310587

M3 - Article

JO - Gut

JF - Gut

SN - 0017-5749

ER -