Variation in polyp size estimation among endoscopists and impact on surveillance intervals

Chaptini, Louis; Chaaya, Adib; DePalma, Fedele; Hunter, Krystal; Peikin, Steven; Laine, Loren

doi:10.1016/j.gie.2014.01.053

Cited by 58 publications

(72 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…14,15,17,23,[34][35][36] Furthermore, the categories we used for size determination (5 mm/6-10 mm/>10 mm and more) are slightly different from those used in other large studies (5 mm, 6-9 mm, and 10 mm). However, given the lack of reliable size determination and substantial interobserver variability in endoscopic size measurements, [37][38][39][40][41][42] these differences may be of limited relevance. A further limitation of this study may be that SSPs 43 were not included as a separate entity in the database.…”

Section: Discussionmentioning

confidence: 99%

Risk of Malignancy in Adenomas Detected During Screening Colonoscopy

Rösch

Altenhofen²,

Kretschmann³

et al. 2018

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

In this large screening database, it was found that the rates of adenomas with HGD are similar in the proximal and distal colon. The presence of HGD as a risk marker alone does not explain higher rates of proximal interval colorectal cancer. We suggest that certain lesions (flat, serrated lesions) may be missed in the proximal colon and may acquire a more aggressive biology over time. A combination of endoscopy-related factors and biology may therefore account for higher rates of proximal versus distal interval colorectal cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk of Malignancy in Adenomas Detected During Screening Colonoscopy

Rösch

Altenhofen²,

Kretschmann³

et al. 2018

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

show abstract

“…One of the most widespread techniques is the comparison of the polyp with an open biopsy forceps with a known diameter which is held against it. But, besides being time-consuming, some authors showed that there is still a great interobserver variability [6,10,19]. Several other devices to minimize endoscopists' error have been described, such as a graduated ruler [22], a calibrated hood for use in cap-assisted colonoscopy [23,24], a linear probe [25], and a virtual tape measure containing a laserline emitter [26].…”

Section: Discussionmentioning

confidence: 99%

“…Inaccurate size estimation may lead to the performance of unnecessary procedures [6] or misdirect patients to less aggressive followup [5]. There are several studies showing significant inaccuracy of endoscopically estimated polyp size when compared with pathological size [6][7][8]. An overestimation or underestimation is more likely to be important when the misjudgment crosses the 10-mm threshold [9].…”

Section: Introductionmentioning

confidence: 99%

“…Inappropriate surveillance recommendations due to poor estimates range from 10% [6] to 47.8% [7]. Even after considering histological features and synchronous polyps [7], inappropriate surveillance rates remain high.…”

Section: Introductionmentioning

confidence: 99%

“…Even after considering histological features and synchronous polyps [7], inappropriate surveillance rates remain high. Endoscopic size results from a subjective 2-dimensional visual estimation [10] and has considerable variability among colonoscopists [6,8,9]. It is influenced by several factors, including colonoscopist's terminal digit preference [11] and distortion effect of fish eye lenses: objects located at the center of the displayed view appear magnified compared to objects located at the periphery [12].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Variation between Pathological Measurement and Endoscopically Estimated Size of Colonic Polyps

Atalaia-Martins¹,

Marcos²,

Leal³

et al. 2018

GE Port J Gastroenterol

View full text Add to dashboard Cite

Background and Aims: Accurate determination of colonic polyp size is vital to an appropriate surveillance. The main aim of this study was to evaluate variation between the polyp size reported by the endoscopist and its pathological measurement. Methods: A retrospective analysis of all colonic adenomatous polyps resected in a 12-month period was performed at our center. Endoscopic and pathological size for each polyp were compared, and overestimation rates, underestimation rates, and endoscopic-pathological variation (EPV) were calculated. Results: Among the 573 polyps that were included, the mean endoscopic and pathological sizes were 8.00 and 6.66 mm, respectively. The most frequent error, in 62.1%, was overestimation by the colonoscopist. Overestimation and EPV were associated with resection technique (higher in endoscopic mucosal resection and smaller with biopsy forceps) and colonoscopist. They were not associated with years of experience in colonoscopy. Overestimation was more frequent in larger polyps. Conclusions: Our study shows significant discordance between endoscopic and pathological size of colonic polyps with a clear tendency for endoscopic overestimation. Larger polyps are more difficult to accurately assess than smaller ones. This propensity for error was not related to colonoscopist’s years of experience and seems to be an individual tendency.

show abstract