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Gastrointest Endosc. 2015 Mar;81(3):517-24. doi: 10.1016/j.gie.2014.04.064. Epub 2014 Jul 3.

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

Author information

1
Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
2
Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA; 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.

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.

PMID:
24998465
DOI:
10.1016/j.gie.2014.04.064
[Indexed for MEDLINE]

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