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

Khaled Abdeljawad, Krishna C. Vemulapalli, Charles Kahi, Oscar Cummings, Dale C. Snover, Douglas Rex

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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, defi ned 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.

Original languageEnglish
Pages (from-to)517-524
Number of pages8
JournalGastrointestinal Endoscopy
Volume81
Issue number3
DOIs
StatePublished - Mar 1 2015

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Polyps
Adenoma
Sigmoid Colon
Colonoscopy
Pathologists
Endoscopy
Pathology

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

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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; Cummings, Oscar; Snover, Dale C.; Rex, Douglas.

In: Gastrointestinal Endoscopy, Vol. 81, No. 3, 01.03.2015, p. 517-524.

Research output: Contribution to journalArticle

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title = "Sessile serrated polyp prevalence determined by a colonoscopist with a high lesion detection rate and an experienced pathologist",
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, defi ned 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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N2 - 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, defi ned 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.

AB - 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, defi ned 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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