Original articleClinical endoscopyPathological reassessment of hyperplastic colon polyps in a city-wide pathology practice: implications for polyp surveillance recommendations
Section snippets
Methods
Manitoba is a central Canadian province with a population of approximately 1.2 million. The pathology laboratories in the province are located in the cities of Winnipeg and Brandon, with most of the specimen processing and reporting done in Winnipeg (the largest city in Manitoba, with 56% of the provincial population). Diagnostic Services of Manitoba (DSM) administers all the pathology laboratories in the city of Winnipeg. DSM maintains an archive of all pathology reports from the city in the
Results
A total of 4096 pathology reports of colon polyps reported by 25 different pathologists were reviewed. Overall, approximately 20% of the colon polyps were reported to be some form of SCP (Table 2). The most common SCPs were left-sided HPs (516/876; 59%), followed by right-sided HPs (14%) (Table 2). However, right-sided HPs, with no concomitant other types of SCPs or traditional adenomatous polyps constituted a small minority (3%) of all colon polyp reports.
Slides could be retrieved for 114 of
Discussion
In this study, approximately one-fifth of the previously reported HPs in the right side of the colon and those >5 mm in size were reclassified as SSAs on reassessment by two pathologists with special interest in GI pathology. Polyp size and site of the polyp in the colon were independent predictors of reclassification.
Over the last decade, the serrated polyp pathway has been recognized as an important pathway for colorectal carcinogenesis, particularly for CRCs occurring in the right side of
References (19)
- et al.
Surveillance guidelines should be updated to recognize the importance of serrated polyps
Gastroenterology
(2010) - et al.
Prevalence and variable detection of proximal colon serrated polyps during screening colonoscopy
Clin Gastroenterol Hepatol
(2011) Update on the serrated pathway to colorectal carcinoma
Hum Pathol
(2011)- et al.
Role of the serrated pathway in colorectal cancer pathogenesis
Gastroenterology
(2010) - et al.
Proximal and large hyperplastic and nondysplastic serrated polyps detected by colonoscopy are associated with neoplasia
Gastroenterology
(2010) Canadian Cancer Statistics 2011
(2011)- et al.
Serrated polyps of the colorectum: Is sessile serrated adenoma distinguishable from hyperplastic polyp in a daily practice?
Virchows Archiv
(2007) - et al.
The clinical significance of serrated polyps
Am J Gastroenterol
(2011) European guidelines for quality assurance in colorectal cancer screening and diagnosis
(2010)
Cited by (52)
Colorectal Cancer Screening for the Serrated Pathway
2020, Gastrointestinal Endoscopy Clinics of North AmericaCitation Excerpt :This rate combines important histology such as SSPs and TSAs with other factors such as HPs that are 5 mm or greater and located proximal to sigmoid or splenic flexure. Proximal location and larger size have been shown to be important factors in predicting an SSP histology in lesions that were previously diagnosed as HPs.68,69 Thus, this rate can account for potential misdiagnosed SSPs that have been incorrectly labeled as HPs.
Terminology, Molecular Features, Epidemiology, and Management of Serrated Colorectal Neoplasia
2019, GastroenterologyCitation Excerpt :One study during this time period reviewed more than 1400 HPs, and reclassified 6% of HPs as SSLs.16 After SSLs (then called SSA/Ps) were included in the WHO classification of 2010, 8%–19% of HPs were reclassified as SSLs.17–19 When only larger HPs were taken into account, the proportion of reclassified HPs was as high as 28%.20,21
Colorectal Cancer Screening and Surveillance
2019, Clinical Gastrointestinal Endoscopy
DISCLOSURE: H. Singh's work is supported in part by an American College of Gastroenterology junior faculty development grant. No other financial relationships relevant to this publication were disclosed.
If you would like to chat with an author of this article, you may contact Dr Singh at [email protected].
See CME section; p. 1020.