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Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas

AIM: To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological type. METHODS: This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer (CRC) screening program; 2979 complete colonosco...

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Autores principales: Bretagne, Jean-François, Hamonic, Stéphanie, Piette, Christine, Viel, Jean-François, Bouguen, Guillaume
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064036/
https://www.ncbi.nlm.nih.gov/pubmed/27784967
http://dx.doi.org/10.3748/wjg.v22.i38.8549
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author Bretagne, Jean-François
Hamonic, Stéphanie
Piette, Christine
Viel, Jean-François
Bouguen, Guillaume
author_facet Bretagne, Jean-François
Hamonic, Stéphanie
Piette, Christine
Viel, Jean-François
Bouguen, Guillaume
author_sort Bretagne, Jean-François
collection PubMed
description AIM: To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological type. METHODS: This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer (CRC) screening program; 2979 complete colonoscopies from 18 endoscopists were included. Variability in performance between endoscopists for detection of at least one adenoma (A), one proximal adenoma (PA), one distal adenoma (DA), and one proximal serrated polyp (PSP) was assessed by using multilevel logistic regression models. RESULTS: The observed detection rates among the 18 endoscopists ranged from 24.6% to 47.6% (mean = 35.7%) for A, from 19.1% to 39.0% (mean = 29.4%) for DA, from 6.0% to 22.9% (mean = 12.4%) for PA, and from 1.3% to 19.3% (mean = 6.9%) for PSP. After adjusting for patient-level variables (sex, age), the interendoscopist detection rates variability achieved a significant level for A, PA, and PSP but not for DA (P = 0.03, P = 0.02, P = 0.02 and P = 0.08, respectively). This heterogeneity, as measured by the variance partition coefficient, was approximately threefold higher for PA (6.6%) compared with A (2.1%), and twofold higher for PSP (12.3%) compared with PA. CONCLUSION: These results demonstrate significant interendoscopist variability for proximal polyp particularly for serrated polyps, but not for distal adenoma detection. These findings contribute to explain the decreased effectiveness of complete colonoscopies at preventing proximal CRCs and the need to carefully assess the proximal colon during scope procedure.
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spelling pubmed-50640362016-10-26 Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas Bretagne, Jean-François Hamonic, Stéphanie Piette, Christine Viel, Jean-François Bouguen, Guillaume World J Gastroenterol Retrospective Cohort Study AIM: To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological type. METHODS: This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer (CRC) screening program; 2979 complete colonoscopies from 18 endoscopists were included. Variability in performance between endoscopists for detection of at least one adenoma (A), one proximal adenoma (PA), one distal adenoma (DA), and one proximal serrated polyp (PSP) was assessed by using multilevel logistic regression models. RESULTS: The observed detection rates among the 18 endoscopists ranged from 24.6% to 47.6% (mean = 35.7%) for A, from 19.1% to 39.0% (mean = 29.4%) for DA, from 6.0% to 22.9% (mean = 12.4%) for PA, and from 1.3% to 19.3% (mean = 6.9%) for PSP. After adjusting for patient-level variables (sex, age), the interendoscopist detection rates variability achieved a significant level for A, PA, and PSP but not for DA (P = 0.03, P = 0.02, P = 0.02 and P = 0.08, respectively). This heterogeneity, as measured by the variance partition coefficient, was approximately threefold higher for PA (6.6%) compared with A (2.1%), and twofold higher for PSP (12.3%) compared with PA. CONCLUSION: These results demonstrate significant interendoscopist variability for proximal polyp particularly for serrated polyps, but not for distal adenoma detection. These findings contribute to explain the decreased effectiveness of complete colonoscopies at preventing proximal CRCs and the need to carefully assess the proximal colon during scope procedure. Baishideng Publishing Group Inc 2016-10-14 2016-10-14 /pmc/articles/PMC5064036/ /pubmed/27784967 http://dx.doi.org/10.3748/wjg.v22.i38.8549 Text en ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Bretagne, Jean-François
Hamonic, Stéphanie
Piette, Christine
Viel, Jean-François
Bouguen, Guillaume
Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas
title Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas
title_full Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas
title_fullStr Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas
title_full_unstemmed Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas
title_short Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas
title_sort interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064036/
https://www.ncbi.nlm.nih.gov/pubmed/27784967
http://dx.doi.org/10.3748/wjg.v22.i38.8549
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