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Validation of serrated polyps (SPs) in Swedish pathology registers
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.ORCID-id: 0000-0003-2862-8855
Department of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Boston MA, United States; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston MA, United States; Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston MA, United States.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Boston MA, United States; Institute of Health and Society, University of Oslo, Oslo, Norway; Vårdcentralen Värmlands Nysäter, Centre for Clinical Research, County Council of Värmland, Sweden.
Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Medicine, Columbia University College of Physicians and Surgeons, New York NY, United States.ORCID-id: 0000-0003-1024-5602
2019 (engelsk)Inngår i: BMC Gastroenterology, ISSN 1471-230X, E-ISSN 1471-230X, Vol. 20, nr 1, artikkel-id 3Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Little is known about the natural history of serrated polyps (SPs), partly due to the lack of large-scale epidemiologic data. In this study, we examined the validity of SP identification according to SNOMED (Systematised Nomenclature of Medicine) codes and free text from colorectal histopathology reports.

Methods: Through the ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden) study, we retrieved data on SPs from all pathology departments in Sweden in 2015-2017 by using SNOMED codes and free-text search in colorectal histopathology reports. Randomly selected individuals with a histopathology report of SPs were validated against patient charts using a structured, retrospective review.

Results: SPs were confirmed in 101/106 individuals with a histopathology report of SPs, yielding a positive predictive value (PPV) of 95% (95%CI = 89-98%). By year of diagnosis, the PPV was 89% (95%CI = 69-97%), 96% (95%CI = 81-99%) and 97% (95%CI = 89-99%) for individuals diagnosed before 2001 (n = 19), between 2001 and 2010 (n = 26) and after 2010 (n = 61), respectively. According to search method, the PPV for individuals identified by SNOMED codes was 100% (95%CI = 93-100%), and 93% (95%CI = 86-97%) using free-text search. Recorded location (colon vs. rectum) was correct in 94% of all SP histopathology reports (95%CI = 84-98%) identified by SNOMED codes. Individuals with SPs were classified into hyperplastic polyps (n = 34; 32%), traditional serrated adenomas (n = 3; 3%), sessile serrated adenomas/polyps (SSA/Ps) (n = 70; 66%), unspecified SPs (n = 3, 3%), and false positive SPs (n = 5, 5%). For individuals identified by SNOMED codes, SSA/Ps were confirmed in 49/52 individuals, resulting in a PPV of 94% (95%CI: 84-98%). In total, 57% had >= 2 polyps (1: n = 44, 2-3: n = 33 and >= 4: n = 27). Some 46% of SPs (n = 71) originated from the proximal colon and 24% were >= 10 mm in size (n = 37). Heredity for colorectal cancer, intestinal polyposis syndromes, or both was reported in seven individuals (7%). Common comorbidities included diverticulosis (n = 45, 42%), colorectal cancer (n = 19, 18%), and inflammatory bowel disease (n = 10, 9%).

Conclusion: Colorectal histopathology reports are a reliable data source to identify individuals with SPs.

sted, utgiver, år, opplag, sider
BMC , 2019. Vol. 20, nr 1, artikkel-id 3
Emneord [en]
Hyperplastic polyp, Serrated adenoma, Serrated polyp, Sessile serrated adenoma, polyp, Traditional serrated adenoma, Validation
HSV kategori
Identifikatorer
URN: urn:nbn:se:oru:diva-79085DOI: 10.1186/s12876-019-1134-6ISI: 000505006900003PubMedID: 31892305Scopus ID: 2-s2.0-85077353973OAI: oai:DiVA.org:oru-79085DiVA, id: diva2:1385780
Merknad

Funding Agency:

Karolinska Institutet and Union for International Cancer Control (Yamagiwa-Yoshida Award)  YY2/17/554363

Tilgjengelig fra: 2020-01-15 Laget: 2020-01-15 Sist oppdatert: 2023-07-03bibliografisk kontrollert
Inngår i avhandling
1. Various Aspects of Gastrointestinal Disease: Examining Validity and Health Economic Outcomes
Åpne denne publikasjonen i ny fane eller vindu >>Various Aspects of Gastrointestinal Disease: Examining Validity and Health Economic Outcomes
2022 (engelsk)Licentiatavhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Introduction: Recent years have seen significant research advances within the gastroenterological field. Some of these consist of the recognition of serrated polyps as a precursor to colorectal cancer, and the realization of the health economic burden associated with gastrointestinal diseases.

Aim: In this thesis, we aim to validate the specificity of serrated polyps in the ESPRESSO cohort (Paper I). We also aim to estimate work loss in patients with celiac disease, including the temporal relationship of work loss before and after diagnosis (Paper II).

Method: By using the ESPRESSO cohort, we collected data on patients with serrated polyps and patients with celiac disease. In Paper I, the specificity of serrated polyps in the ESPRESSO cohort were validated by a structured retrospective review of patient chart. In Paper II, we estimated work loss in patients with celiac disease as compared withgeneral-population comparators matched on age, sex, county of residence and year of diagnosis.

Result: The presence of a serrated polyp was confirmed in 101 out of 106 individuals identified through the ESPRESSO cohort, yielding a positive predictive value of 95% (95% confidence interval: 89-98%). Patients with celiac disase had 42.5 lost work days as compared to 28.6 days in comparators (mean difference, 14.7; 95% confidence interval, 13.2-16.2), corresponding to a relative increase of 49%. Excess work loss in patients with celiac disease was observed even 5 years before diagnosis and remained eleveated during the years after diagnosis this loss. Notebly, the excess work loss was concentrated to a small proportion while most celiac patients did not have any work loss before or after diagnosis. 

Conclusion: The ESPRESSO cohort has a high specificity for serrated polyps. Patients with celiac disease miss more work days than the general population even before diagnosis, and this loss persists after diagnosis.

sted, utgiver, år, opplag, sider
Örebro: Örebro universitet, 2022. s. 49
Serie
Örebro Studies in Medicine, ISSN 1652-4063
Emneord
Serrated polyp, sessile serrated lesion, validation, celiac disease, sick leave, cost, economic burden, health economics
HSV kategori
Identifikatorer
urn:nbn:se:oru:diva-104059 (URN)978-91-7529-452-0 (ISBN)
Veileder
Tilgjengelig fra: 2023-02-17 Laget: 2023-02-07 Sist oppdatert: 2023-02-20bibliografisk kontrollert

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