Mark Bettington1,2,3, Neal Walker1,3, Tony Rahman4,5, Ann Vandeleur4, Vicki Whitehall2,3,6, Barbara Leggett2,3,7, John Croese4,5. 1. Department of Anatomical Pathology, Envoi Specialist Pathologists, Brisbane, Queensland, Australia. 2. The Conjoint Gastroenterology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. 3. School of Medicine, University of Queensland, Brisbane, Queensland, Australia. 4. Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Brisbane, Queensland, Australia. 5. The Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Cairns, Queensland, Australia. 6. Department of Chemical Pathology, Pathology Queensland, Brisbane, Queensland, Australia. 7. Department of Gastroenterology and Hepatology, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: Sessile serrated adenomas (SSA) are the polyp precursor of 15-20% of colorectal carcinomas. There is debate about their prevalence and increasing discussion about the need for a serrated polyp detection rate as a quality indicator for colonoscopy. AIMS: To assess the prevalence of SSA at an outpatient gastroenterology service. METHODS: This is a retrospective study of an unselected consecutive series of patients who had an outpatient colonoscopy between April 2013 and May 2014. The colonoscopy reports were reviewed to identify age, gender, indication for procedure, completion, withdrawal time, adequacy of bowel preparation, number, size and location of polyps. The pathology of all polyps was centrally reviewed by a gastrointestinal pathologist. RESULTS: A total of 707 patients underwent colonoscopy within the study period. The mean age of the cohort was 58 years, and 50.6% were female. Polyp(s) were identified in 66.5% of patients. The SSA detection rate was 20.1%, and the adenoma detection rate was 48.0%. SSA detection was associated with longer withdrawal times. Conventional adenoma detection was associated with older age, male gender, longer withdrawal time and a positive faecal occult blood test result. CONCLUSION: SSA are highly prevalent in an unselected series of patients attending a gastroenterology outpatient department. Identifying and removing these polyps may help prevent interval colorectal carcinoma. This result may serve as a benchmark for a high-quality colonoscopy service.
BACKGROUND: Sessile serrated adenomas (SSA) are the polyp precursor of 15-20% of colorectal carcinomas. There is debate about their prevalence and increasing discussion about the need for a serrated polyp detection rate as a quality indicator for colonoscopy. AIMS: To assess the prevalence of SSA at an outpatient gastroenterology service. METHODS: This is a retrospective study of an unselected consecutive series of patients who had an outpatient colonoscopy between April 2013 and May 2014. The colonoscopy reports were reviewed to identify age, gender, indication for procedure, completion, withdrawal time, adequacy of bowel preparation, number, size and location of polyps. The pathology of all polyps was centrally reviewed by a gastrointestinal pathologist. RESULTS: A total of 707 patients underwent colonoscopy within the study period. The mean age of the cohort was 58 years, and 50.6% were female. Polyp(s) were identified in 66.5% of patients. The SSA detection rate was 20.1%, and the adenoma detection rate was 48.0%. SSA detection was associated with longer withdrawal times. Conventional adenoma detection was associated with older age, male gender, longer withdrawal time and a positive faecal occult blood test result. CONCLUSION: SSA are highly prevalent in an unselected series of patients attending a gastroenterology outpatient department. Identifying and removing these polyps may help prevent interval colorectal carcinoma. This result may serve as a benchmark for a high-quality colonoscopy service.
Authors: Cheng Liu; Lochlan J Fennell; Mark L Bettington; Neal I Walker; Joel Dwine; Barbara A Leggett; Vicki L J Whitehall Journal: Clin Epigenetics Date: 2019-06-14 Impact factor: 6.551
Authors: Joseph G H Lee; Jennifer J Telford; Cherry Galorport; Jordan Yonge; Christopher A Macdonnell; Robert A Enns Journal: J Can Assoc Gastroenterol Date: 2020-09-16