Sessile serrated lesion detection rates continue to increase: 2008–2020

Nicholas Edwardson; Prajakta Adsul; Zorisadday Gonzalez; V. Shane Pankratz; Gulshan Parasher; Kevin English; Shiraz Mishra

doi:10.1055/a-1990-0509

Endoscopy International Open, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(01): E107-E116
DOI: 10.1055/a-1990-0509

Original article

Sessile serrated lesion detection rates continue to increase: 2008–2020

Nicholas Edwardson

¹University of New Mexico, School of Public Administration, Albuquerque, New Mexico, United States

,

Prajakta Adsul

²University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, United States

³University of New Mexico, Comprehensive Cancer Center, Cancer Control and Population Sciences, Albuquerque, New Mexico, United States

,

Zorisadday Gonzalez

²University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, United States

,

V. Shane Pankratz

²University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, United States

³University of New Mexico, Comprehensive Cancer Center, Cancer Control and Population Sciences, Albuquerque, New Mexico, United States

,

Gulshan Parasher

²University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, United States

⁴University of New Mexico, Department of Gastroenterology, Albuquerque, New Mexico, United States

,

Kevin English

⁵Albuquerque Area Indian Health Board Inc., Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, New Mexico, United States

,

Shiraz Mishra

³University of New Mexico, Comprehensive Cancer Center, Cancer Control and Population Sciences, Albuquerque, New Mexico, United States

⁶University of New Mexico, Department of Pediatrics, Albuquerque, New Mexico, United States

› Institutsangaben

Abstract

Background and study aims We assessed sessile serrated lesion detection rate (SSLDR) at a large academic medical center from 2008 to 2020 and modeled a local, aspirational target SSLDR. We also assessed SSLDRs among all gastroenterology fellows to better understand the relationship between SSLDRs and total colonoscopies performed.

Patients and methods SSL-positive pathology results were flagged from a dataset composed of all screening colonoscopies for average-risk patients from 2008 to 2020. Unadjusted SSLDRs were calculated for individual endoscopists by year. A mixed effects logistic regression was used to estimate the log odds of SSL detection, with one model estimating division-wide predictors of SSL detection and a second model focused exclusively on colonoscopies performed by fellows. Model-adjusted SSLDRs were estimated for all 13 years and across both categories of all endoscopists and fellows only.

Results Adjusted SSLDRs showed a consistent improvement in SSLDR from a low of 0.37 % (95 % confidence interval [CI]: 0.10–0.63) in 2008 to a high of 7.94 % (95 % CI: 6.34–9.54) in 2020. Among fellows only, the odds of SSL detection were significantly lower during their first year compared to their second year (OR: 0.80, 95 % CI: 0.66–0.98) but not significantly higher in their third year compared to their second year (OR: 1.09, 95 % CI: 0.85–1.4).

Conclusions SSLDR increased steadily and significantly throughout our study period but variance among endoscopists persists. The peak SSLDR from 2020 of 7.94 % should serve as the local aspirational target for this division’s attendings and fellows but should be continuously reevaluated.

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