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International Journal of Colorectal Disease

Published in:

01-02-2016 | Original Article

Factors associated with reclassification of hyperplastic polyps after pathological reassessment from screening and surveillance colonoscopies

Authors: Christoph Schramm, Moritz Kaiser, Uta Drebber, Inga Gruenewald, Jeremy Franklin, Fabian Kuetting, Andrea Bowe, Vera Hoffmann, Sebastian Gatzke, Ulrich Toex, Hans-Michael Steffen

Published in: International Journal of Colorectal Disease | Issue 2/2016

Abstract

Introduction

A substantial interobserver variation in the differential diagnosis of hyperplastic polyps (HPs) and sessile or traditional serrated adenomas (SSAs/TSAs) has been described.

Methods

The aim of this study is to determine the magnitude of reclassification of HPs and associated factors after pathological reassessment of specimens from screening and surveillance colonoscopies, and to estimate its consequences for follow-up recommendations.

Results

Among 1694 screening and surveillance colonoscopies, a total of 536 polyps were initially diagnosed as HPs and remained unchanged in 88.5 % (n = 474), whereas 7.6 (n = 41) and 1.1 % (n = 6) were reclassified as SSA and TSA, respectively. Compared to definite HPs, SSAs were found more frequently in men than in women (82.9 vs. 61.2 %, p < 0.05), and in individuals ≥65.0 years (51.2 vs. 31.6 %, p = 0.05). Also, more SSAs were >5 mm in size (36.6 vs. 6.3 %, p < 0.05) and were localized in the proximal colon (31.7 vs. 11.8 %, p < 0.05). In a mixed model analysis, age ≥65.0 years (OR 4.13, 95 % CI 1.22–14.2), snare polypectomy (OR 23.6, 95 % CI 4.86–115), and coincident advanced adenomas (OR 7.56, 95 % CI 1.31–43.5) were significantly (p < 0.05) associated with reclassification to SSAs. Only 0.53 % of patients had received false recommendations for follow-up visits based on the incorrect HP diagnosis. A c.1799T>A, p.V600E BRAF mutation was detected in 21.9 % (n = 9) of reclassified SSAs.

Conclusion

Considering these factors may be helpful in serrated lesions that are difficult to allocate. Incorrect recommendations regarding control colonoscopy intervals due to misdiagnosed HPs can explain only a small fraction of interval colorectal cancers.

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Title: Factors associated with reclassification of hyperplastic polyps after pathological reassessment from screening and surveillance colonoscopies
Authors: Christoph Schramm
Moritz Kaiser
Uta Drebber
Inga Gruenewald
Jeremy Franklin
Fabian Kuetting
Andrea Bowe
Vera Hoffmann
Sebastian Gatzke
Ulrich Toex
Hans-Michael Steffen
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 2/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2404-6

At a glance: The STEP trials

Springer Medicine

Factors associated with reclassification of hyperplastic polyps after pathological reassessment from screening and surveillance colonoscopies

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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