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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(06): E799-E809
DOI: 10.1055/a-2330-8037
Review

Endoscopic scoring indices for assessing disease severity in familial adenomatous polyposis: Systematic review

Anna Lerman Silverman 
1   Gastroenterology and Hepatology, Mayo Clinic Scottsdale, Scottsdale, United States (Ringgold ID: RIN384840)
,
Hicham Bouchiba
2   Department of Gastroenterology and Hepatology, Cancer Center, University of Amsterdam, Amsterdam, Netherlands
,
Arthur Aelvoet
2   Department of Gastroenterology and Hepatology, Cancer Center, University of Amsterdam, Amsterdam, Netherlands
,
John MacDonald
3   Alimentiv, Alimentiv Inc, London, Canada (Ringgold ID: RIN590969)
,
Evelien Dekker 
4   Gastroenterology & Hepatology, Academic Medical Center, Amsterdam, Netherlands
,
Alexa Zayadi
3   Alimentiv, Alimentiv Inc, London, Canada (Ringgold ID: RIN590969)
,
Jessica Le
3   Alimentiv, Alimentiv Inc, London, Canada (Ringgold ID: RIN590969)
,
Brian Feagan
3   Alimentiv, Alimentiv Inc, London, Canada (Ringgold ID: RIN590969)
5   Division of Gastroenterology and Department of Epidemiology and Biostatistics, Western University, London, Canada (Ringgold ID: RIN6221)
,
Vipul Jairath
3   Alimentiv, Alimentiv Inc, London, Canada (Ringgold ID: RIN590969)
5   Division of Gastroenterology and Department of Epidemiology and Biostatistics, Western University, London, Canada (Ringgold ID: RIN6221)
,
Christopher Ma
3   Alimentiv, Alimentiv Inc, London, Canada (Ringgold ID: RIN590969)
6   Division of Gastroenterology & Hepatology, Departments of Medicine and Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Canada (Ringgold ID: RIN70401)
,
Jewel Samadder
1   Gastroenterology and Hepatology, Mayo Clinic Scottsdale, Scottsdale, United States (Ringgold ID: RIN384840)
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Abstract

Background and study aims There is limited consensus on the optimal method for measuring disease severity in familial adenomatous polyposis (FAP). We aimed to systematically review the operating properties of existing endoscopic severity indices for FAP.

Methods We searched MEDLINE, EMBASE, and the Cochrane Library from inception to February 2023 to identify randomized controlled trials (RCTs) that utilized endoscopic outcomes or studies that evaluated the operating properties of endoscopic disease severity indices in FAP.

Results A total of 134 studies were included. We evaluated scoring indices and component items of scoring indices, such as polyp count, polyp size, and histology. Partial validation was observed for polyp count and size. The most commonly reported scoring index was the Spigelman classification system, which was used for assessing the severity of duodenal involvement. A single study reported almost perfect interobserver and intra-observer agreement for this system. The InSIGHT polyposis staging system, which was used for assessing colorectal polyp burden, has been partially validated. It showed substantial interobserver reliability; however, the intra-observer reliability was not assessed. Novel criteria for high-risk gastric polyps have been developed and assessed for interobserver reliability. However, these criteria showed a poor level of agreement. Other scoring indices assessing the anal transition zone, duodenal, and colorectal polyps have not undergone validation.

Conclusions There are no fully validated endoscopic disease severity indices for FAP. Development and validation of a reliable and responsive endoscopic disease severity instrument will be informative for clinical care and RCTs of pharmacological therapies for FAP.

Keywords

Endoscopy Upper GI Tract - Precancerous conditions & cancerous lesions (displasia and cancer) stomach - Endoscopy Lower GI Tract - Polyps / adenomas / ... - Colorectal cancer - Endoscopy Small Bowel - Neoplasia

Supplementary Material



Publication History

Received: 16 January 2024

Accepted after revision: 03 May 2024

Article published online:
18 June 2024

© 2024. 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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Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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