Clin Endosc.  2018 Sep;51(5):485-490. 10.5946/ce.2017.183.

Mis-sizing of Adenomatous Polyps is Common among Endoscopists and Impacts Colorectal Cancer Screening Recommendations

Affiliations
  • 1Department of Medicine, University of Arizona Medical Center, Tucson, AZ, USA. staleban@yahoo.com
  • 2Department of Molecular and Cellular Biology, University of Arizona, Tucson, AZ, USA.
  • 3Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
  • 4Division of Gastroenterology, Department of Medicine, University of Arizona Medical Center, Tucson, AZ, USA.

Abstract

BACKGROUND/AIMS
To determine the accuracy of identifying ≥6-mm adenomatous polyps during colonoscopy and define its impact on subsequent interval screening.
METHODS
We conducted a retrospective study of patients who underwent colonoscopies at Banner University Medical Center, Tucson from 2011 to 2015. All patients with ≥6-mm adenomatous polyps based on their colonoscopy report were included. Adenomatous polyps were excluded if they did not meet the criteria. Discrepancies in the polyp size were determined by calculating the percentage of size variation (SV). Clinical mis-sizing was defined as SV >33%.
RESULTS
The polyps analyzed were predominantly <10 mm in size. Approximately 13% of the examined polyps met the inclusion criteria, and 40.7% of the adenomas were ≥10 mm. A total of 189 ≥6-mm adenomatous polyps were collected from 10 different gastroenterologists and a colorectal surgeon. Adenomatous polyps were clinically mis-sized in 56.6% of cases and overestimated in 71.4%. Among the adenomas reviewed, 22% of mis-sized polyps and 11% of non-mis-sized polyps resulted in an inappropriate surveillance interval.
CONCLUSIONS
We found that more than half of ≥6-mm adenomatous polyps are mis-sized and that there is a tendency to overestimate adenoma size among endoscopists. This frequently leads to inappropriate intervals of surveillance colonoscopy.

Keyword

Polyp size; Endoscopist estimate; Adenomatous polyps
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