Sessile serrated adenoma detection rate is correlated with adenoma detection rate

doi:10.4251/wjgo.v10.i3.82

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World Journal of Gastrointestinal Oncology

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Oncol. Mar 15, 2018; 10(3): 82-90
Published online Mar 15, 2018. doi: 10.4251/wjgo.v10.i3.82

Sessile serrated adenoma detection rate is correlated with adenoma detection rate

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

Daisuke Ohki, Yosuke Tsuji, Yoshiki Sakaguchi, Chihiro Minatsuki, Hiroto Kinoshita, Keiko Niimi, Satoshi Ono, Yoku Hayakawa, Shuntaro Yoshida, Atsuo Yamada, Shinya Kodashima, Nobutake Yamamichi, Yoshihiro Hirata, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo 113-0033, Japan

Tomohiro Shinozaki, Department of Biostatistics, School of Public Health, the University of Tokyo, Tokyo 113-0033, Japan

Keiko Niimi, Center for Epidemiology and Preventive Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo 113-0033, Japan

Shuntaro Yoshida, Mitsuhiro Fujishiro, Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo 113-0033, Japan

Tetsuo Ushiku, Masashi Fukayama, Department of Pathology, Graduate School of Medicine, the University of Tokyo, Tokyo 113-0033, Japan

Author contributions: Ohki D and Tsuji Y contributed to planning the study protocol and manuscript writing; Shinozaki T provided advice on the statistical analysis of the data; Sakaguchi Y, Kinoshita H, Niimi K, Ono S, Yoshida S, Yamada A, Kodashima S, Yamamichi N and Hirata Y performed endoscopic procedures, checked the manuscript and suggested improvement ; Hayakawa Y and Minatsuki M checked the manuscript and suggested improvement; Ushiku T and Fukayama M provided advice on the histopathological diagnoses, checked the manuscript and suggested improvement; Koike K gave the final approval of the manuscript.

Institutional review board statement: In our institution, the comprehensive retrospective analysis of each patient’s medical record was approved by our ethics committee (No. 2058); this study is included in that category.

Informed consent statement: All study participants provided informed written consent prior to study enrollment.

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

Data sharing statement: No additional data are available.

Correspondence to: Yosuke Tsuji, MD, PhD, Assistant Professor, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, 7-3-1, Hongo, Tokyo 113-8655, Japan. ytsuji-tky@umin.ac.jp

Telephone: +81-3-38155411 Fax: +81-3-34486544

Received: December 20, 2017
Peer-review started: December 21, 2017
First decision: January 15, 2018
Revised: February 5, 2018
Accepted: March 6, 2018
Article in press: March 6, 2018
Published online: March 15, 2018
Processing time: 83 Days and 19 Hours

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

Core tip: Sessile serrated adenomas (SSAs) are difficult to detect and are associated with interval colorectal cancer (CRC). To reduce interval CRC and CRC death, SSA detection is important, and evaluation of the sessile serrated adenoma detection rate (SSADR) is crucial. In Western countries, there have been some reports showing the correlation of adenoma detection rate (ADR) and SSADR. However, in Asian countries, little is known about the correlation between ADR and SSADR. We investigated the association between ADR and SSADR and significant predictors for SSA detection in Japanese population. We found that ADR is correlated with SSADR, and patients with adenomas have a higher prevalence of SSAs than those without adenomas.