title: Prevalence of sessile serrated adenoma/polyp in hyperplastic-appearing diminutive rectosigmoid polyps.
abstract: OBJECTIVE
  The American Society for Gastrointestinal Endoscopy recommends that distal colon hyperplastic lesions can be left in place without resection if adenomatous histology can be excluded with >90% negative predictive value. However, some lesions could be sessile serrated adenomas/polyps (SSA/Ps), which is also precancerous. The aim of this study was to describe the prevalence of SSA/Ps in hyperplastic-appearing diminutive rectosigmoid polyps.
  
  
  METHODS
  We prospectively placed 513 consecutive diminutive rectosigmoid polyps that appeared hyperplastic to an expert endoscopist in individual bottles for pathologic. Each polyp was examined by 3 expert GI pathologists.
  
  
  RESULTS
  The prevalence of SSA/P in the study polyps ranged from .6% to 2.1%. The lowest negative predictive value found by the endoscopist for the combination of adenomas plus SSA/Ps was 96.7%.
  
  
  CONCLUSIONS
  The prevalence of SSA/Ps in diminutive rectosigmoid hyperplastic-appearing polyps is very low. These results support the safety and feasibility of a "do not resect" policy for diminutive hyperplastic-appearing rectosigmoid polyps.
authors: Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors: Prasanna
authors: P
authors: Ponugoti
authors: Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors: Jingmei
authors: J
authors: Lin
authors: Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA.
authors: Robert
authors: R
authors: Odze
authors: Department of Pathology, University of Minnesota, Minneapolis, Minnesota, USA.
authors: Dale
authors: D
authors: Snover
authors: Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors: Charles
authors: C
authors: Kahi
authors: Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors: Douglas K
authors: DK
authors: Rex
mesh_terms: D000236:Adenoma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D012809:Colon, Sigmoid / Q000473:pathology* / Q000601:surgery; D003111:Colonic Polyps / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D006965:Hyperplasia; D007417:Intestinal Polyps / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D058996:Quality Improvement; D012007:Rectum / Q000473:pathology* / Q000601:surgery; D047368:Tumor Burden