Published online Mar 15, 2018. doi: 10.4251/wjgo.v10.i3.82
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
To investigated the association between adenoma detection rate (ADR) and sessile serrated ADR (SSADR) and significant predictors for sessile serrated adenomas (SSA) detection.
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.
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).
Our results demonstrated that ADR is correlated to SSADR. In addition, patients with adenomas had a higher prevalence of SSAs than those without adenomas.
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.