Universität zu Köln

Schramm, Christoph, Janhsen, Katharina, Hofer, Jan-Hinnerk, Toermer, Hans, Stelzer, Annette, Stenschke, Frank, Stollenwerk, Michael, Scheller, Ingo, Lang, Sonja, Goeser, Tobias and Steffen, Hans-Michael (2018). Detection of clinically relevant serrated polyps during screening colonoscopy: results from seven cooperating centers within the German colorectal screening program. Endoscopy, 50 (10). S. 993 - 1001. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-8812

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Abstract

Background Serrated polyps have been recognized as precursors of colorectal cancer (CRC) via the serrated pathway. Endoscopic detection and histopathological evaluation of serrated polyps are challenging. The aims of this study were to determine detection rates of the recently proposed entity of clinically relevant serrated polyps (crSPs) and to identify factors that influence their detection in a primary colonoscopy screening cohort. Methods We retrospectively analyzed average-risk screening colonoscopies performed at a tertiary academic hospital and six community-based private practices in Germany between 01/01/2012 and 14/12/2016. Exclusion criteria were age <50 years, conditions with increased risk for CRC (e.g. inflammatory bowel disease, history of CRC, hereditary cancer syndromes), and incomplete procedures. CrSPs were defined as serrated polyps10mm and/or>5mm located proximally to the splenic flexure. Conventional adenomas were defined as adenomas excluding serrated polyps. Results A total of 4161 colonoscopies from average-risk individuals were included (median age 62 years [interquartile range 56-69]; 48.6% male). CrSPs were detected in 6.9%, with a mean detection rate of 4.7% (95% confidence interval 2.3%-7.2%). Detection rates ranged from 0% to 16.2%. In multivariate analysis, simultaneous detection of conventional adenomas and an endoscopist adenoma detection rate of 25% were significantly associated with increased detection of crSPs, with odds ratios of 1.43 (95%CI 1.11-1.85; P =0.01) and 7.35 (95%CI 4.43-12.19; P <0.001). The individual endoscopist's detection rate for conventional adenomas and crSPs were significantly correlated (r=0.54, P =0.02). Conclusion Detection rates for crSPs differed between participating endoscopists. However, individual skills to detect polypoid lesions have a relevant bearing on the detection rate of crSPs.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schramm, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Janhsen, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Hofer, Jan-Hinnerk UNSPECIFIED UNSPECIFIED UNSPECIFIED Toermer, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Stelzer, Annette UNSPECIFIED UNSPECIFIED UNSPECIFIED Stenschke, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Stollenwerk, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheller, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeser, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffen, Hans-Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-171580
DOI:	10.1055/a-0598-4477
Journal or Publication Title:	Endoscopy
Volume:	50
Number:	10
Page Range:	S. 993 - 1001
Date:	2018
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1438-8812
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SURVEILLANCE; CANCER; PREVALENCE; LESIONS; RISK; INDIVIDUALS; ASSOCIATION; POLYPECTOMY; GUIDELINES; NEOPLASIA Multiple languages Gastroenterology & Hepatology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17158