Improving the Accuracy of Serrated Colon Polyp Designation

Abstract

ABSTRACT

Background: Serrated polyps are the most common polyps of the large bowel. In the past decade, the focus on sessile serrated polyp (SSP) has been increased as it has proved that untreated SSP is associated with substantial increased risk of developing colon cancer. The microscopic diagnosis can be challenging due to overlapping features with hyperplastic polyps, which can cause misdiagnosis and inappropriate follow up of the patients.

Methods: The purpose of this study is to assess the effect of educational sessions on appropriate designation of sessile serrated polyps. We re-evaluated hyperplastic polyps for two years and repeated the re-evaluation after few educational sessions.

Results: During the first phase, we evaluated 365 hyperplastic polyps and reclassified 60 (16%) of them as SSP. We also found 11 tubular adenomas, 2 traditional sessile serrated adenomas and 8 mucosal tags. After the education, phase 2, we reviewed another 191 hyperplastic polyps and reclassified 16 (8%) of them as SSP. We found 3 tubular adenomas, but no other polyps. Most of the polyps (67%) were 0.5 cm in diameter or larger.

Conclusion: Our study shows that the educational intervention was successful in increasing the accurate designation of SSP and improved that significantly.