title: High prevalence of sessile serrated adenomas in contemporary outpatient colonoscopy practice.
abstract: BACKGROUND
  Sessile serrated adenomas (SSA) are the polyp precursor of 15-20% of colorectal carcinomas. There is debate about their prevalence and increasing discussion about the need for a serrated polyp detection rate as a quality indicator for colonoscopy.
  
  
  OBJECTIVE
  To assess the prevalence of SSA at an outpatient gastroenterology service.
  
  
  METHODS
  This is a retrospective study of an unselected consecutive series of patients who had an outpatient colonoscopy between April 2013 and May 2014. The colonoscopy reports were reviewed to identify age, gender, indication for procedure, completion, withdrawal time, adequacy of bowel preparation, number, size and location of polyps. The pathology of all polyps was centrally reviewed by a gastrointestinal pathologist.
  
  
  RESULTS
  A total of 707 patients underwent colonoscopy within the study period. The mean age of the cohort was 58 years, and 50.6% were female. Polyp(s) were identified in 66.5% of patients. The SSA detection rate was 20.1%, and the adenoma detection rate was 48.0%. SSA detection was associated with longer withdrawal times. Conventional adenoma detection was associated with older age, male gender, longer withdrawal time and a positive faecal occult blood test result.
  
  
  CONCLUSIONS
  SSA are highly prevalent in an unselected series of patients attending a gastroenterology outpatient department. Identifying and removing these polyps may help prevent interval colorectal carcinoma. This result may serve as a benchmark for a high-quality colonoscopy service.
authors.affiliation: Department of Anatomical Pathology, Envoi Specialist Pathologists, Brisbane, Queensland, Australia.|The Conjoint Gastroenterology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Bettington
authors.affiliation: Department of Anatomical Pathology, Envoi Specialist Pathologists, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Neal
authors.initials: N
authors.lastname: Walker
authors.affiliation: Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Brisbane, Queensland, Australia.|The Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Cairns, Queensland, Australia.
authors.forename: Tony
authors.initials: T
authors.lastname: Rahman
authors.affiliation: Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Ann
authors.initials: A
authors.lastname: Vandeleur
authors.affiliation: The Conjoint Gastroenterology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.|Department of Chemical Pathology, Pathology Queensland, Brisbane, Queensland, Australia.
authors.forename: Vicki
authors.initials: V
authors.lastname: Whitehall
authors.affiliation: The Conjoint Gastroenterology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.|Department of Gastroenterology and Hepatology, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Leggett
authors.affiliation: Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Brisbane, Queensland, Australia.|The Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Cairns, Queensland, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Croese
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D000368:Aged; D001315:Australia / Q000453:epidemiology; D019985:Benchmarking; D003111:Colonic Polyps / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D003113:Colonoscopy / Q000191:economics / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence; D012189:Retrospective Studies
keywords: colonoscopy; colorectal cancer; polyp; prevalence; sessile serrated adenoma