Kajsa Affolter1,2,3, Keith Gligorich4,5, Niloy Jewel Samadder6,7, Wade S Samowitz8,9, Karen Curtin6,10. 1. Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA. kajsa.affolter@hsc.utah.edu. 2. Department of Anatomic Pathology, ARUP Laboratories, 500 S Chipeta Way, Salt Lake City, UT, 84108, USA. kajsa.affolter@hsc.utah.edu. 3. Department of Pathology, University of Utah Health Sciences Center, Huntsman Cancer Hospital, RM N3100, 1950 Circle of Hope, Salt Lake City, UT, 84112, USA. kajsa.affolter@hsc.utah.edu. 4. Department of Oncological Sciences, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA. 5. Department of Pathology, University of Utah Health Sciences Center, Huntsman Cancer Hospital, RM N3100, 1950 Circle of Hope, Salt Lake City, UT, 84112, USA. 6. Department of Internal Medicine, Gastroenterology, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA. 7. Department of Endoscopy, University of Utah Health Sciences Center, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA. 8. Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA. 9. Department of Anatomic Pathology, ARUP Laboratories, 500 S Chipeta Way, Salt Lake City, UT, 84108, USA. 10. Utah Population Database, 675 Arapeen Drive, Room 210 (Suite 200), Salt Lake City, UT, 84112, USA.
Abstract
BACKGROUND/AIMS: The serrated pathway accounts for 15-25% of sporadic colorectal cancer (CRC). In our study, we sought to accurately characterize sessile serrated polyps (SSP) in a population by electronically interrogating colonoscopy patients' endoscopy and pathology reports using a rules-based text search of pre-defined SSP-related terms. To this aim, we compared a sample of putative SSP and hyperplastic polyps (HP) using our algorithm to a determination of SSP or HP by pathologist and molecular examination to determine the feasibility of large-scale identification of SSP in electronic medical records. METHODS: In 23,990 endoscopy reports from colonoscopies with pathology performed at a University of Utah Healthcare facility in 2000-2012, we identified serrated lesions and categorized each as putative SSP or HP using a text search algorithm. We obtained 93 tissue samples for histologic and molecular analysis. RESULTS: Serrated polyps were categorized as putative SSP (N = 920) and putative HP (N = 7159) by text search algorithm. Histologic examination of 93 samples identified 37 SSP, 11 probable SSP, and 45 HP. Of 26 putative SSP, 25 were SSP/probable SSP (96%) by histology. Of 67 putative HP, 44 were HP (66%) by histology. Reducing size criterion from ≥1 to ≥5 mm in the search algorithm caused improved sensitivity (77.1%) without decline in specificity (97.8%). CONCLUSIONS: A simple rules-based search to identify SSP provides "proof of principle" that SSP can be identified in a large electronic record set. Pilot data indicate defining large, right-sided polyps as ≥5 mm provides adequate sensitivity to detect SSP from electronic records while maintaining high specificity.
BACKGROUND/AIMS: The serrated pathway accounts for 15-25% of sporadic colorectal cancer (CRC). In our study, we sought to accurately characterize sessile serrated polyps (SSP) in a population by electronically interrogating colonoscopy patients' endoscopy and pathology reports using a rules-based text search of pre-defined SSP-related terms. To this aim, we compared a sample of putative SSP and hyperplastic polyps (HP) using our algorithm to a determination of SSP or HP by pathologist and molecular examination to determine the feasibility of large-scale identification of SSP in electronic medical records. METHODS: In 23,990 endoscopy reports from colonoscopies with pathology performed at a University of Utah Healthcare facility in 2000-2012, we identified serrated lesions and categorized each as putative SSP or HP using a text search algorithm. We obtained 93 tissue samples for histologic and molecular analysis. RESULTS: Serrated polyps were categorized as putative SSP (N = 920) and putative HP (N = 7159) by text search algorithm. Histologic examination of 93 samples identified 37 SSP, 11 probable SSP, and 45 HP. Of 26 putative SSP, 25 were SSP/probable SSP (96%) by histology. Of 67 putative HP, 44 were HP (66%) by histology. Reducing size criterion from ≥1 to ≥5 mm in the search algorithm caused improved sensitivity (77.1%) without decline in specificity (97.8%). CONCLUSIONS: A simple rules-based search to identify SSP provides "proof of principle" that SSP can be identified in a large electronic record set. Pilot data indicate defining large, right-sided polyps as ≥5 mm provides adequate sensitivity to detect SSP from electronic records while maintaining high specificity.
Authors: Timothy D Imler; Justin Morea; Charles Kahi; Eric A Sherer; Jon Cardwell; Cynthia S Johnson; Huiping Xu; Dennis Ahnen; Fadi Antaki; Christopher Ashley; Gyorgy Baffy; Ilseung Cho; Jason Dominitz; Jason Hou; Mark Korsten; Anil Nagar; Kittichai Promrat; Douglas Robertson; Sameer Saini; Amandeep Shergill; Walter Smalley; Thomas F Imperiale Journal: Am J Gastroenterol Date: 2015-03-10 Impact factor: 10.864
Authors: Wade S Samowitz; Hans Albertsen; Jennifer Herrick; Theodore R Levin; Carol Sweeney; Maureen A Murtaugh; Roger K Wolff; Martha L Slattery Journal: Gastroenterology Date: 2005-09 Impact factor: 22.682
Authors: Wade S Samowitz; Hans Albertsen; Carol Sweeney; Jennifer Herrick; Bette J Caan; Kristin E Anderson; Roger K Wolff; Martha L Slattery Journal: J Natl Cancer Inst Date: 2006-12-06 Impact factor: 13.506
Authors: Douglas K Rex; Dennis J Ahnen; John A Baron; Kenneth P Batts; Carol A Burke; Randall W Burt; John R Goldblum; José G Guillem; Charles J Kahi; Matthew F Kalady; Michael J O'Brien; Robert D Odze; Shuji Ogino; Susan Parry; Dale C Snover; Emina Emilia Torlakovic; Paul E Wise; Joanne Young; James Church Journal: Am J Gastroenterol Date: 2012-06-19 Impact factor: 10.864
Authors: Andrew J Gawron; William K Thompson; Rajesh N Keswani; Luke V Rasmussen; Abel N Kho Journal: Am J Gastroenterol Date: 2014-06-17 Impact factor: 10.864
Authors: Khaled Abdeljawad; Krishna C Vemulapalli; Charles J Kahi; Oscar W Cummings; Dale C Snover; Douglas K Rex Journal: Gastrointest Endosc Date: 2014-07-03 Impact factor: 9.427
Authors: James VanDerslice; Marissa C Taddie; Karen Curtin; Caroline Miller; Zhe Yu; Rachael Hemmert; Lisa A Cannon-Albright; Deborah W Neklason Journal: PLoS One Date: 2020-04-23 Impact factor: 3.240
Authors: Wendy Marie Ingram; Anna M Baker; Christopher R Bauer; Jason P Brown; Fernando S Goes; Sharon Larson; Peter P Zandi Journal: Neurol Psychiatry Brain Res Date: 2020-02-21