Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

Manuel Zorzi, Carlo Senore, Filippo Da Re, Alessandra Barca, Luigina Bonelli, Renato Cannizzaro, Giovanni De Pretis, Lucia Di Furia, Emilio Di Giulio, Paola Mantellini, Carlo Naldoni, Romano Sassatelli, Douglas K. Rex, Marco Zappa, Cesare Hassan, Giuseppe Feliciangeli, Cinzia Campari, Fabio Falcini, Orietta Giuliani, Omero TriossiVincenzo Matarese, Chiara Fedato, Anna Turrin, S. Baracco, F. Monica, Beatrice Mallardi, Francesco Quadrino, Ivana Valle, Patrizia Landi, E. Buscarini, Richard Nienstedt, P. Occhipinti, Arrigo Arrigoni, Mario Grassini

Research output: Contribution to journalArticle

Abstract

Objectives To assess detection rate and predictive factors of sessile serrated polyps (SSPs) in organised colorectal cancer (CRC) screening programmes based on the faecal immunochemical test (FIT). Design Data from a case series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected, including the age-standardised and sex-standardised adenoma detection rate (ADR) of the individual endoscopists. The SSP detection rate (SSP-DR) was assessed for the study population. To identify SSP-predictive factors, multilevel analyses were performed according to patient/centre/ endoscopist characteristics. Results We analysed 72 021 colonoscopies, of which 1295 presented with at least one SSP (SSP-DR 1.8%; 95% CI 1.7% to 1.9%). At the per-patient level, SSPDR was associated with males (OR 1.35; 95% CI 1.17 to 1.54) and caecal intubation (OR 3.75; 95% CI 2.22 to 6.34), but not with the FIT round. The presence of at least one advanced adenoma was more frequent among subjects with SSPs than those without (OR 2.08; 95% CI 1.86 to 2.33). At the per-endoscopist level, SSP-DR was associated with ADR (third vs first ADR quartile: OR 1.55; 95% CI 1.03 to 2.35; fourth vs first quartile: OR 1.89; 95% CI 1.24 to 2.90). Conclusion The low prevalence of SSPs and the lack of association with the FIT round argue against SSP as a suitable target for FIT-based organised programmes. Strict association of SSP-DR with the key colonoscopy quality indicators, namely caecal intubation rate and high ADR further marginalises the need for SSP-specific quality indicators in FIT-based programmes.

Original languageEnglish
JournalGut
DOIs
Publication statusAccepted/In press - Feb 19 2016

ASJC Scopus subject areas

  • Gastroenterology

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