Mis-sizing of Adenomatous Polyps is Common Among Endoscopists and Impacts Interval Colorectal Cancer Screening Recommendations
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: To determine the accuracy of identifying ≥6-mm adenomatous polyps during colonoscopy and define its impacton subsequent interval screening. Methods: We conducted a retrospective study of patients who underwent colonoscopies at Banner University Medical Center, Tucsonfrom 2011 to 2015. All patients with ≥6-mm adenomatous polyps based on their colonoscopy report were included. Adenomatouspolyps were excluded if they did not meet the criteria. Discrepancies in the polyp size were determined by calculating the percentageof size variation (SV). Clinical mis-sizing was defined as SV >33%. Results: The polyps analyzed were predominantly <10 mm in size. Approximately 13% of the examined polyps met the inclusioncriteria, and 40.7% of the adenomas were ≥10 mm. A total of 189 ≥6-mm adenomatous polyps were collected from 10 differentgastroenterologists and a colorectal surgeon. Adenomatous polyps were clinically mis-sized in 56.6% of cases and overestimatedin 71.4%. Among the adenomas reviewed, 22% of mis-sized polyps and 11% of non-mis-sized polyps resulted in an inappropriatesurveillance interval. Conclusions: We found that more than half of ≥6-mm adenomatous polyps are mis-sized and that there is a tendency to overestimateadenoma size among endoscopists. This frequently leads to inappropriate intervals of surveillance colonoscopy.
Abstract
Background/Aims: To determine the accuracy of identifying ≥6-mm adenomatous polyps during colonoscopy and define its impacton subsequent interval screening. Methods: We conducted a retrospective study of patients who underwent colonoscopies at Banner University Medical Center, Tucsonfrom 2011 to 2015. All patients with ≥6-mm adenomatous polyps based on their colonoscopy report were included. Adenomatouspolyps were excluded if they did not meet the criteria. Discrepancies in the polyp size were determined by calculating the percentageof size variation (SV). Clinical mis-sizing was defined as SV >33%. Results: The polyps analyzed were predominantly <10 mm in size. Approximately 13% of the examined polyps met the inclusioncriteria, and 40.7% of the adenomas were ≥10 mm. A total of 189 ≥6-mm adenomatous polyps were collected from 10 differentgastroenterologists and a colorectal surgeon. Adenomatous polyps were clinically mis-sized in 56.6% of cases and overestimatedin 71.4%. Among the adenomas reviewed, 22% of mis-sized polyps and 11% of non-mis-sized polyps resulted in an inappropriatesurveillance interval. Conclusions: We found that more than half of ≥6-mm adenomatous polyps are mis-sized and that there is a tendency to overestimateadenoma size among endoscopists. This frequently leads to inappropriate intervals of surveillance colonoscopy.
참고문헌 (27)
- Lieberman DA, "Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US multi-society task force on colorectal cancer", Gastroenterology, 143, pp.844~857 (2012)[DOI]
- Tanaka S, "Evidence-based clinical practice guidelines for management of colorectal polyps", J Gastroenterol, 50, pp.252~260 (2015)[DOI]
- Matsuda T, "Surveillance colonoscopy after endoscopic treatment for colorectal neoplasia: from the standpoint of the Asia-Pacific region", Dig Endosc, 28, pp.342~347 (2016)[DOI]
- Winawer SJ, "Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US multi-society task force on colorectal cancer and the American cancer society", CA Cancer J Clin, 56, pp.143~159 (2006)[DOI]
- Schachschal G, "Endoscopic versus histological characterisation of polyps during screening colonoscopy", Gut, 63, pp.458~465 (2014)[DOI]
- Eichenseer PJ, "Endoscopic mis-sizing of polyps changes colorectal cancer surveillance recommendations", Dis Colon Rectum, 56, pp.315~321 (2013)[DOI]
- Moug SJ, "Endoscopists' estimation of size should not determine surveillance of colonic polyps", Colorectal Dis, 12, pp.646~650 (2010)
- Fennerty MB, "Are endoscopic measurements of colonic polyps reliable?", Am J Gastroenterol, 88, pp.496~500 (1993)
- Margulies C, "How accurate are endoscopic estimates of size", Gastrointest Endosc, 40(2), pp.174~177 (1994)[DOI]
- Chaptini L, "Variation in polyp size estimation among endoscopists and impact on surveillance intervals", Gastrointest Endosc, 80, pp.652~659 (2014)[DOI]
- Pham T, "Mis-sizing of polyps during colonoscopy does not impact colorectal cancer surveillance recommendations", American College of Gastroenterology (ACG) 2015 Annual Scientific Meeting and Postgraduate Course (2015)
- Anderson BW, "Endoscopic overestimation of colorectal polyp size", Gastrointest Endosc, 83, pp.201~208 (2016)[DOI]
- Goede SL, "Cost-savings to medicare from pre-medicare colorectal cancer screening", Med Care, 53, pp.630~638 (2015)[DOI]
- "Colorectal Cancer Control Program (CRCCP)" (2017)[URL]
- "The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002", Gastrointest Endosc, 58(6 Suppl), pp.S3~S43 (2003)[DOI]
- Gopalswamy N, "Is in vivo measurement of size of polyps during colonoscopy accurate", Gastrointest Endosc, 46, pp.497~502 (1997)[DOI]
- Kim JH, "Is forceps more useful than visualization for measurement of colon polyp size?", World J Gastroenterol, 22, pp.3220~3226 (2016)[DOI]
- Kume K, "Endoscopic measurement of polyp size using a novel calibrated hood", Gastroenterol Res Pract, 2014, pp.714294~ (2014)
- Ashktorab H, "Can optical diagnosis of small colon polyps be accurate? Comparing standard scope without narrow banding to high definition scope with narrow banding", World J Gastroenterol, 22, pp.6539~6546 (2016)[DOI]
- Summers RM, "Polyp size measurement at CT colonography: what do we know and what do we need to know?", Radiology, 255, pp.707~720 (2010)[DOI]
- Pohl H, "Incomplete polyp resection during colonoscopy-results of the complete adenoma resection (CARE) study", Gastroenterology, 144, pp.74~80 (2013)[DOI]
- Obuch JC, "Sessile serrated polyps: detection, eradication, and prevention of the evil twin", Curr Treat Options Gastroenterol, 13, pp.156~170 (2015)[DOI]
- Schoen RE, "The pathologic measurement of polyp size is preferable to the endoscopic estimate", Gastrointest Endosc, 46, pp.492~496 (1997)[DOI]
- Levene Y, "The correlation between endoscopic and histopathological measurements in colorectal polyps", Histopathology, 66, pp.485~490 (2015)[DOI]
- Morales TG, "The difference in colon polyp size before and after removal", Gastrointest Endosc, 43, pp.25~28 (1996)[DOI]
- Hofstad B, "Reliability of in situ measurements of colorectal polyps", Scand J Gastroenterol, 27, pp.59~64 (1992)
- Hofstad B, "In situ measurement of colorectal polyps to compare video and fiberoptic endoscopes", Endoscopy, 26, pp.461~465 (1994)[DOI]