Sessile Serrated Lesion Detection Rates Continue to Increase: 2008-2020

Authors

Nicholas Edwardson, University of New Mexico, School of Public Administration, Albuquerque, New Mexico, United States
Prajakta Adsul, University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, United States; University of New Mexico, Comprehensive Cancer Center, Cancer Control and Population Sciences, Albuquerque, New Mexico, United States
Zorisadday Gonzalez, University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, United States
V Shane Pankratz, University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, United States; University of New Mexico, Comprehensive Cancer Center, Cancer Control and Population Sciences, Albuquerque, New Mexico, United States
Gulshan Parasher, University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, United States; University of New Mexico, Department of Gastroenterology, Albuquerque, New Mexico, United States
Kevin English, Albuquerque Area Indian Health Board Inc., Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, New Mexico, United States
Shiraz Mishra, University of New Mexico, Comprehensive Cancer Center, Cancer Control and Population Sciences, Albuquerque, New Mexico, United States; University of New Mexico, Department of Pediatrics, Albuquerque, New Mexico, United States

Document Type

Article

Publication Date

1-1-2023

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.

Publication Title

Endosc Int Open

ISSN

2364-3722

Volume

11

Issue

1

First Page

107

Last Page

107

DOI

10.1055/a-1990-0509

Recommended Citation

Edwardson N, Adsul P, Gonzalez Z, Pankratz VS, Parasher G, English K, Mishra S. Sessile serrated lesion detection rates continue to increase: 2008-2020. Endosc Int Open. 2023 Jan 26;11(1):E107-E116. doi: 10.1055/a-1990-0509. PMID: 36712908; PMCID: PMC9879655.

Comments

This work was supported by the National Cancer Institute of the National Institutes of Health, grants R01CA192967 (Mishra, PI) and 3P30CA118100-16S4 (Tomkinson PI, Mishra, PD), and the Biostatistics Shared Resource of the University of New Mexico Comprehensive cancer Center, USA