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. 2018 Mar 15;10(3):82-90.
doi: 10.4251/wjgo.v10.i3.82.

Sessile serrated adenoma detection rate is correlated with adenoma detection rate

Daisuke Ohki  1 , Yosuke Tsuji  1 , Tomohiro Shinozaki  2 , Yoshiki Sakaguchi  1 , Chihiro Minatsuki  1 , Hiroto Kinoshita  1 , Keiko Niimi  1 , Satoshi Ono  1 , Yoku Hayakawa  1 , Shuntaro Yoshida  1 , Atsuo Yamada  1 , Shinya Kodashima  1 , Nobutake Yamamichi  1 , Yoshihiro Hirata  1 , Tetsuo Ushiku  3 , Mitsuhiro Fujishiro  1 , Masashi Fukayama  3 , Kazuhiko Koike  1
Affiliations

Sessile serrated adenoma detection rate is correlated with adenoma detection rate

Daisuke Ohki et al. World J Gastrointest Oncol. .

Abstract

Aim: To investigated the association between adenoma detection rate (ADR) and sessile serrated ADR (SSADR) and significant predictors for sessile serrated adenomas (SSA) detection.

Methods: This study is a retrospective, single-center analysis. Total colonoscopies performed by the gastroenterologists at the University of Tokyo Hospital between January and December 2014 were retrospectively identified. Polyps were classified as low-grade or high-grade adenoma, cancer, SSA, or SSA with cytological dysplasia, and the prevalence of each type of polyp was investigated. Predictors of adenoma and SSA detection were examined using logistic generalized estimating equation models. The association between ADR and SSADR for each gastroenterologist was investigated by calculating a correlation coefficient weighted by the number of each gastroenterologist's examination.

Results: A total of 3691 colonoscopies performed by 35 gastroenterologists were assessed. Overall, 978 (26.5%) low- and 84 (2.2%) high-grade adenomas, 81 (2.2%) cancers, 66 (1.8%) SSAs, and 2 (0.1%) SSAs with cytological dysplasia were detected. Overall ADR was 29.5% (men 33.2%, women 23.8%) and overall SSADR was 1.8% (men 1.7%, women 2.1%). In addition, 672 low-grade adenomas (68.8% of all the detected low-grade adenomas), 58 (69.9%) high-grade adenomas, 29 (34.5%) cancers, 52 (78.8%) SSAs, and 2 (100%) SSAs with cytological dysplasia were found in the proximal colon. Adenoma detection was the only significant predictor of SSA detection (adjusted OR: 2.53, 95%CI: 1.53-4.20; P < 0.001). The correlation coefficient between ADR and SSADR weighted by the number of each gastroenterologist's examinations was 0.606 (P < 0.001).

Conclusion: Our results demonstrated that ADR is correlated to SSADR. In addition, patients with adenomas had a higher prevalence of SSAs than those without adenomas.

Keywords: Adenoma detection rate; Colonoscopy; Interval colorectal cancer; Sessile serrated adenoma; Sessile serrated adenoma detection rate.

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Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.

Figures

Figure 1
Figure 1
Study flow chart. EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection.
Figure 2
Figure 2
Typical endoscopic pictures of each polyp. A: Low grade adenoma; B: High grade adenoma; C: Cancer; D: Sessile serrated adenoma; E: Sessile serrated adenoma with cytological dysplasia.
Figure 3
Figure 3
Histopathological pictures of each polyp. A: Low grade adenoma; B: High grade adenoma; C: Cancer; D: Sessile serrated adenoma; E: Sessile serrated adenoma with cytological dysplasia.
Figure 4
Figure 4
Weighted scatter plot and correlation coefficient for detection rates of sessile serrated adenomas and adenomas of each gastroenterologist. The area of the circle is proportional to the number of colonoscopies performed. SSADR: Sessile serrated adenomas; ADR: Adenomas.
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