ESTIMATING DETECTION RATES FOR ADENOMAS, SERRATED POLYPS AND CLINICALLY RELEVANT SERRATED POLYPS BY USING INDIVIDUAL DETECTION RATE RATIOS IN AVERAGE-RISK SCREENING COLONOSCOPIES

2018 ◽  
Author(s):  
C Schramm ◽  
A Mert Senel ◽  
JH Hofer ◽  
H Toermer ◽  
F Stenschke ◽  
...  
Keyword(s):  
Detection Rate ◽  
Average Risk ◽  
Risk Screening ◽  
Detection Rates ◽  
Serrated Polyps ◽  
Rate Ratios

scholarly journals Sessile serrated lesion detection rates during average risk screening colonoscopy: A systematic review and meta-analysis of the published literature

2021 ◽  
Vol 09 (04) ◽  
pp. E610-E620
Author(s):  
Madhav Desai ◽  
Joseph C. Anderson ◽  
Michael Kaminski ◽  
Viveksandeep Thoguluva Chandrasekar ◽  
Jihan Fathallah ◽  
...  
Keyword(s):  
Publication Bias ◽  
Detection Rate ◽  
Prediction Interval ◽  
Screening Colonoscopy ◽  
Significant Heterogeneity ◽  
Average Risk ◽  
Risk Screening ◽  
Detection Rates ◽  
Serrated Polyps ◽  
Serrated Lesion

Abstract Background and study aims Sessile serrated lesion (SSL) detection rate has been variably reported and unlike adenoma detection rate (ADR) is not currently a quality indicator for screening colonoscopy. Composite detection rates of SSL in patients undergoing average risk screening colonoscopy are not available. Methods Electronic database search (Medline, Embase and Cochrane) was conducted for studies reporting detection rates of serrated polyps (SSL, Hyperplastic polyp, traditional serrated adenoma) among average risk subjects undergoing screening colonoscopy. Primary outcomes were pooled SDR (SSL detection rate) and proximal serrated polyp detection rate (PSPDR). Pooled proportion rates were calculated with 95 %CI with assessment of heterogeneity (I2). Publication bias, regression test and 95 %prediction interval were calculated. Results A total of 280,370 screening colonoscopies among average risk subjects that were eligible with 48.9 % males and an average age of 58.7 years (± 3.2). The pooled SDR was available from 16 studies: 2.5 % (1.8 %–3.4 %) with significant heterogeneity (I2 = 98.66 %) and the 95 % prediction interval ranging from 0.6 % to 9.89 %. When analysis was restricted to large (n > 1000) and prospective studies (n = 4), SDR was 2 % (1.1 %–3.3 %). Pooled PSPDR was 10 % (8.5 %–11.8 %; 12 studies). There was evidence of publication bias (P < 0.01). Conclusion Definitions of SSL have been varying over years and there exists significant heterogeneity in prevalence reporting of serrated polyps during screening colonoscopy. Prevalence rate of 2 % for SSL and 10 % for proximal serrated polyps could serve as targets while robust high-quality data is awaited to find a future benchmark showing reduction in colorectal cancer arising from serrated pathway.

Detection rates for adenomas, serrated polyps and clinically relevant serrated polyps can be easily estimated by individually calculated detection rate ratios

2020 ◽  
Vol 55 (6) ◽  
pp. 745-751
Author(s):  
Martin Buerger ◽  
Philipp Kasper ◽  
Ingo Scheller ◽  
Jan-Hinnerk Hofer ◽  
Hans Toermer ◽  
...  
Keyword(s):  
Detection Rate ◽  
Detection Rates ◽  
Serrated Polyps ◽  
Rate Ratios

scholarly journals Rate of detection of serrated lesions at colonoscopy in an average-risk population: a meta-analysis of 129,001 individuals

2021 ◽  
Vol 09 (03) ◽  
pp. E472-E481
Author(s):  
Junjie Huang ◽  
Paul S.F. Chan ◽  
Tiffany W.Y. Pang ◽  
Peter Choi ◽  
Xiao Chen ◽  
...  
Keyword(s):  
Detection Rate ◽  
Meta Analysis ◽  
Population Based ◽  
Average Risk ◽  
Detection Rates ◽  
Random Effects Models ◽  
Serrated Polyps ◽  
Screening Programs ◽  
Crc Screening ◽  
Serrated Lesions

Abstract Background and study aims Serrated lesions are precursors of approximately one-third of colorectal cancers (CRCs). Information on their detection rate was lacking as an important reference for CRC screening. This study was a systematic review and meta-analysis to determine the overall detection rate for serrated lesions and their subtypes in average-risk populations undergoing CRC screening with colonoscopy. Patient and methods MEDLINE and Embase were searched to identify population-based studies that reported the detection rate for serrated lesions. Studies on average-risk populations using colonoscopy as a screening tool were included. Metaprop was applied to model within-study variability by binomial distribution, and Freeman-Tukey Double Arcsine Transformation was adopted to stabilise the variances. The detection rate was presented in proportions using random-effects models. Results In total, 17 studies involving 129,001 average-risk individuals were included. The overall detection rates for serrated lesions (19.0 %, 95 % CI = 15.3 %–23.0 %), sessile serrated polyps (2.5 %, 95 % CI = 1.5 %–3.8 %), and traditional serrated adenomas (0.3 %, 95 % CI = 0.1 %–0.8 %) were estimated. Subgroup analysis indicated a higher detection rate for serrated lesions among males (22.0 %) than females (14.0 %), and Caucasians (25.9 %) than Asians (14.6 %). The detection rate for sessile serrated polyps was also higher among Caucasians (2.9 %) than Asians (0.7 %). Conclusions This study determined the overall detection rate for serrated lesions and their different subtypes. The pooled detection rate estimates can be used as a reference for establishing CRC screening programs. Future studies may evaluate the independent factors associated with the presence of serrated lesions during colonoscopy to enhance their rate of detection.

Detection of clinically relevant serrated polyps during screening colonoscopy: results from seven cooperating centers within the German colorectal screening program

Endoscopy ◽  
2018 ◽  
Vol 50 (10) ◽  
pp. 993-1000 ◽  
Author(s):  
Christoph Schramm ◽  
Katharina Janhsen ◽  
Jan-Hinnerk Hofer ◽  
Hans Toermer ◽  
Annette Stelzer ◽  
...  
Keyword(s):  
Detection Rate ◽  
Screening Program ◽  
Simultaneous Detection ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Detection Rates ◽  
Serrated Polyps ◽  
Adenoma Detection ◽  
Increased Risk ◽  
The Individual

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 polyps ≥ 10 mm and/or > 5 mm 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.

Sessile Serrated Polyp (SSP) Detection Rates in Patients Undergoing Average Risk Screening Colonoscopy: Meta-Analysis of Published Literature

2017 ◽  
Vol 152 (5) ◽  
pp. S337-S338
Author(s):  
Madhav Desai ◽  
Julie Nguyen ◽  
Neil Gupta ◽  
Sravanthi Parasa ◽  
Sreekar Vennelaganti ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Risk Screening ◽  
Detection Rates ◽  
Serrated Polyp

Are adenoma and serrated polyp detection rates correlated with endoscopists’ sensitivity of optical diagnosis?

Endoscopy ◽  
2020 ◽  
Vol 52 (09) ◽  
pp. 763-772 ◽  
Author(s):  
Maxime E. S. Bronzwaer ◽  
Jasper L. A. Vleugels ◽  
Sascha C. van Doorn ◽  
Marcel G. W. Dijkgraaf ◽  
Paul Fockens ◽  
...  
Keyword(s):  
Detection Rate ◽  
Lesion Detection ◽  
Optical Diagnosis ◽  
Polyp Detection ◽  
Detection Rates ◽  
Serrated Polyps ◽  
Serrated Polyp ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Post Hoc

Abstract Introduction Endoscopists with a high adenoma detection rate (ADR) and proximal serrated polyp detection rate (PSPDR) detect these polyps more frequently, which may be attributable to better recognition of their endoscopic features. Little is known about the association between endoscopic lesion detection and differentiation skills. Therefore, we evaluated the correlation between the ADR, PSPDR, and the sensitivity of optical diagnosis for adenomas and serrated polyps. Methods We performed an exploratory post-hoc analysis of the DISCOUNT-2 study, including complete colonoscopies after a positive fecal immunochemical test (FIT) performed by endoscopists who performed ≥ 50 colonoscopies. The correlations between the ADR, PSPDR, and the sensitivity of optical diagnosis were calculated using Pearson’s rho correlation coefficient. Results 24 endoscopists performed ≥ 50 colonoscopies, resulting in a total of 2889 colonoscopies. The overall ADR was 84.5 % (range 71.4 % – 95.3 %) and overall PSPDR was 13.7 % (4.3 % – 29.0 %). The sensitivity of optical diagnosis for adenomas and serrated polyps were 94.5 % (83.3 % – 100 %) and 74.0 % (37.5 % – 94.1 %), respectively. No correlation could be demonstrated between the ADR and the sensitivity of optical diagnosis for adenomas (−0.20; P = 0.35) or between the PSPDR and the sensitivity of optical diagnosis for serrated polyps (−0.12; P = 0.57). Conclusions In a homogeneous FIT-positive population, no correlation between the ADR, PSPDR, and the sensitivity of optical diagnosis for adenomas and serrated polyps could be demonstrated. These exploratory results suggest that lesion detection and differentiation require different endoscopic skills. Further prospective studies are needed; until then, monitoring of both performance indicators is important to secure optimal efficacy of FIT-based colorectal cancer screening.

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