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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
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.
Open-Access: 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. See: http://creativecommons.org/licenses/by-nc/4.0/
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
ARTICLE HIGHLIGHTS
Research background
Sessile serrated adenomas (SSAa) are difficult to detect and strongly associated with interval colorectal cancer (CRC). It is necessary to investigate the factors which influence SSA detection and to evaluate the SSA detection rate (SSADR).
Research motivation
In Western countries, some reports have described the correlation of ADR and SSADR. However, to the best of our knowledge, there has been no report in Asian countries showing a correlation between ADR and SSADR. In this context, we investigated the association between ADR and SSADR with significant predictors for SSA detection in total colonoscopy screening or surveillance in the Japanese population.
Research objectives
The main objectives were as follows; the prevalence of each polyp (low-grade or high-grade adenoma, cancer, SSA, or SSA with cytological dysplasia), each gastoroenterologist’s ADR and SSADR, the association between ADR and SSADR for each gastroenterologist and predictors of adenoma and SSA detection.
Research methods
Total colonoscopies performed by the gastroenterologists at the University of Tokyo Hospital between January and December 2014 were retrospectively identified. 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.
Research results
A total of 3691 colonoscopies by 35 gastroenterologists were assessed. 978 low grade adenomas (26.5%), 84 high grade adenomas (2.2%), 81 cancers (2.2%), 66 SSAs (1.8%) and 2 SSAs with cytological dysplasia (0.1%) were detected. 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).
Research conclusions
Our study suggests that ADR is correlated with SSADR. Some reports have described the correlation of ADR and SSADR in Western countries patients; however, to our knowledge, the prevalence of SSAs or SSADR in Asian populations has not yet been fully investigated and appropriate SSADR has not been determined. Therefore, our study holds importance, as it is the first report to demonstrate the correlation between SSADR and ADR in Asian populations. In addition, patients with adenomas may have a higher prevalence of SSAs than those without adenomas.
Research perspectives
This study was a retrospective single center study, and the number of SSA cases was small. Therefore, a large-scale prospective study will be needed to validate these findings.
