title: Sessile serrated polyp prevalence determined by a colonoscopist with a high lesion detection rate and an experienced pathologist.
abstract: BACKGROUND
  The prevalence of sessile serrated adenomas and/or polyps (SSA/Ps) is uncertain.
  
  
  OBJECTIVE
  To determine the prevalence of SSA/Ps and SSA/Ps with cytologic dysplasia (SSA/P-CD) by using a colonoscopist with a high lesion detection rate and an expert in serrated lesion pathology.
  
  
  METHODS
  Retrospective screening colonoscopy study.
  
  
  METHODS
  Academic endoscopy unit.
  
  
  METHODS
  A total of 1910 average risk, asymptomatic patients aged ≥50 years underwent screening colonoscopy between August 2005 and April 2012 by a single colonoscopist with a high lesion detection rate.
  
  
  METHODS
  Slides of all lesions in the serrated class proximal to the sigmoid colon and all rectal and sigmoid colon serrated lesions >5 mm in size were reviewed by an experienced GI pathologist.
  
  
  METHODS
  Prevalence of SSA/Ps, defined as the proportion of patients with ≥1 SSA/P.
  
  
  RESULTS
  There were 1910 patients, of whom 389 had 656 lesions in the serrated class. Review by the experienced GI pathologist determined a prevalence of SSA/Ps without cytologic dysplasia of 7.4% and SSA/Ps-CD of 0.6% (total SSA/P prevalence 8.1%). SSA/Ps and SSA/Ps-CD comprised 5.6% and 0.3%, respectively, of all resected polyps. The mean size of SSA/Ps was 7.13 mm (standard deviation [SD] 4.66), and 51 of 77 (66.2%) polyps ≥10 mm in the serrated class were SSA/Ps.
  
  
  CONCLUSIONS
  Retrospective design.
  
  
  CONCLUSIONS
  A colonoscopist with a high lesion detection rate and an experienced pathologist identified a high prevalence (8.1%) of SSA/Ps in a screening population. SSA/Ps are more common than previously believed.
authors.affiliation: Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Khaled
authors.initials: K
authors.lastname: Abdeljawad
authors.affiliation: Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Vemulapalli
authors.affiliation: Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Kahi
authors.affiliation: Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Oscar W
authors.initials: OW
authors.lastname: Cummings
authors.affiliation: Department of Pathology, Fairview Southdale Hospital, Edina, Minnesota and Department of Laboratory Medicine and Pathology, the University of Minnesota Medical Center, Minneapolis, Minnesota, USA.
authors.forename: Dale C
authors.initials: DC
authors.lastname: Snover
authors.affiliation: Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Rex
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D003111:Colonic Polyps / Q000175:diagnosis / Q000453:epidemiology*; D003113:Colonoscopy; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies