Optical diagnosis of diminutive polyps in the Dutch Bowel Cancer Screening Program
| Autor: | Christine M. Bakker, Evelien Dekker, Lonne W.T. Meulen, Alouisa J. P. van de Wetering, Eric T.P. Keulen, Ad A.M. Masclee, Hao Ran Cheng, Silvia Sanduleanu-Dascalescu, Chantal V. Hoge, Bjorn Winkens, Roel M M Bogie, Rogier de Ridder, Ankie Reumkens, Jan-Willem Straathof, Quirine E. W. van der Zander |
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| Přispěvatelé: | Interne Geneeskunde, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), RS: NUTRIM - R2 - Liver and digestive health, FHML Methodologie & Statistiek, RS: CAPHRI - R6 - Promoting Health & Personalised Care, MUMC+: MA Maag Darm Lever (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Original article
medicine.medical_specialty ENDOSCOPY Colorectal cancer medicine.medical_treatment Colonoscopy SMALL COLORECTAL POLYPS CLASSIFICATION COLONOSCOPY SURVEILLANCE Optical diagnosis IMPLEMENTATION Medicine HISTOLOGY Pharmacology (medical) POLYPECTOMY lcsh:RC799-869 medicine.diagnostic_test business.industry General surgery Guideline COLON POLYPS medicine.disease Polypectomy EUROPEAN-SOCIETY Endoscopy Colon polyps Diminutive DEFINITION lcsh:Diseases of the digestive system. Gastroenterology business |
| Zdroj: | Endoscopy International Open Endoscopy international open, 8(3), E257-E265. Georg Thieme Verlag Endoscopy International Open, Vol 08, Iss 03, Pp E257-E265 (2020) |
| ISSN: | 2364-3722 |
| DOI: | 10.1055/a-1072-4853 |
| Popis: | Background and study aims Implementation of optical diagnosis of diminutive polyps may potentially increase the efficacy and cost-effectiveness of colonoscopies. To adopt such strategy in clinical practice, the Preservation and Incorporation of Valuable endoscopic Innovations (PIVI) thresholds provide the basis to be met: ≥ 90 % negative predictive value (NPV) for diagnosis of adenomatous histology and ≥ 90 % agreement on surveillance intervals. We evaluated this within the Dutch Bowel Cancer Screening Program (BCSP). Patients and methods Endoscopic and histological data were collected from participants of the national bowel cancer screening program with an unfavorable fecal immunochemical test referred for colonoscopy between February 2014 and August 2015 at four endoscopy centers. The “resect and discard” scenario was studied, resecting diminutive polyps without histological evaluation. Agreement between optical diagnosis and histological diagnosis was measured for surveillance intervals according to Dutch, European and American post-polypectomy surveillance guideline. Results Fifteen certified endoscopists participated in this study and included 3028 diminutive polyps. In 2,330 patients both optical and histological diagnosis were available. Optical diagnosis of diminutive polyps showed NPV of 84 % (95 % CI 80–87) for adenomatous histology in the rectosigmoid. Applying the ‘resect and discard’ strategy resulted in 90.6 %, 91.2 %, 90.9 % agreement on surveillance intervals for the Dutch, European and American guideline respectively. Conclusion Our data representing current clinical practice in the Dutch BCSP practice on optical diagnosis of diminutive polyps showed that accuracy of predicting histology remains challenging, and risk of incorrect optical diagnosis is still significant. Therefore, it is too early to safely implement these strategies. |
| Databáze: | OpenAIRE |
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