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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(04): E610-E620
DOI: 10.1055/a-1352-4095
Review

Sessile serrated lesion detection rates during average risk screening colonoscopy: A systematic review and meta-analysis of the published literature

Madhav Desai
1   Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, United States
,
Joseph C. Anderson
2   Department of Veterans Affairs Medical Center, White River Junction, Vermont, United States
3   The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States
,
Michael Kaminski
4   Department of Gastroenterological Oncology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
5   Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland
6   Institute of Health and Society, University of Oslo, Oslo, Norway
,
Viveksandeep Thoguluva Chandrasekar
7   Department of Gastroenterology and hepatology, University of Kansas Medical Center, Kansas City, Kansas, United States
,
Jihan Fathallah
7   Department of Gastroenterology and hepatology, University of Kansas Medical Center, Kansas City, Kansas, United States
,
Cesare Hassan
8   Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
,
David Lieberman
9   Department of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, Oregon, United States
,
Prateek Sharma
1   Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, United States
7   Department of Gastroenterology and hepatology, University of Kansas Medical Center, Kansas City, Kansas, United States
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Abstract

Background and study aims Sessile serrated lesion (SSL) detection rate has been variably reported and unlike adenoma detection rate (ADR) is not currently a quality indicator for screening colonoscopy. Composite detection rates of SSL in patients undergoing average risk screening colonoscopy are not available.

Methods Electronic database search (Medline, Embase and Cochrane) was conducted for studies reporting detection rates of serrated polyps (SSL, Hyperplastic polyp, traditional serrated adenoma) among average risk subjects undergoing screening colonoscopy. Primary outcomes were pooled SDR (SSL detection rate) and proximal serrated polyp detection rate (PSPDR). Pooled proportion rates were calculated with 95 %CI with assessment of heterogeneity (I2). Publication bias, regression test and 95 %prediction interval were calculated.

Results A total of 280,370 screening colonoscopies among average risk subjects that were eligible with 48.9 % males and an average age of 58.7 years (± 3.2). The pooled SDR was available from 16 studies: 2.5 % (1.8 %–3.4 %) with significant heterogeneity (I2 = 98.66 %) and the 95 % prediction interval ranging from 0.6 % to 9.89 %. When analysis was restricted to large (n > 1000) and prospective studies (n = 4), SDR was 2 % (1.1 %–3.3 %). Pooled PSPDR was 10 % (8.5 %–11.8 %; 12 studies). There was evidence of publication bias (P < 0.01).

Conclusion Definitions of SSL have been varying over years and there exists significant heterogeneity in prevalence reporting of serrated polyps during screening colonoscopy. Prevalence rate of 2 % for SSL and 10 % for proximal serrated polyps could serve as targets while robust high-quality data is awaited to find a future benchmark showing reduction in colorectal cancer arising from serrated pathway.

Supplementary material



Publication History

Received: 06 November 2020

Accepted: 10 December 2020

Article published online:
13 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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