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INTER-OBSERVER VARIATION IN THE HISTOLOGICAL DIAGNOSIS OF POLYPS IN COLORECTAL CANCER SCREENING

Abstract : Aim: To determine the inter-observer variation in the histological diagnosis of colorectal polyps. Methods and results: 440 polyps were randomly selected from a colorectal cancer (CRC) screening program. Polyps were first evaluated by a general (324 polyps) or expert (116 polyps) pathologist, and subsequently re-evaluated by an expert pathologist. Conditional agreement was reported and inter-observer agreement was determined by using Kappa statistics. In 421/440 polyps (96%) agreement for the non-adenomatous or adenomatous nature was obtained, corresponding with a very good kappa of 0.88. Differentiating adenomas as non-advanced and advanced obtained consensus in 266/322 adenomas (83%), with a moderate kappa of 0.58. For the non-adenomatous or adenomatous nature, both general and expert pathologists, and expert pathologists among each other, showed very good agreement (kappa-values (95%CI); 0.89(0.83-0.95) and 0.86(0.73-0.98), respectively). Categorizing adenomas as non-advanced and advanced showed moderate agreement between general and expert pathologists, and between expert pathologists (kappa-values (95%CI); 0.56(0.44-0.67) and 0.64(0.43-0.85), respectively). Conclusions: General and expert pathologists demonstrate very good inter-observer agreement for differentiating non-adenomas from adenomas, but only moderate agreement for non-advanced and advanced adenomas. The considerable variation in the interpretation of advanced histology suggests that more objective criteria are required for risk stratification in screening and surveillance guidelines.
keyword : Medicine
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Submitted on : Friday, November 18, 2011 - 2:41:11 AM
Last modification on : Friday, November 18, 2011 - 2:41:11 AM
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Paul G van Putten, Lieke Hol, Herman van Dekken, Han van Krieken, Marjolein van Ballegooijen, et al.. INTER-OBSERVER VARIATION IN THE HISTOLOGICAL DIAGNOSIS OF POLYPS IN COLORECTAL CANCER SCREENING. Histopathology, Wiley, 2011, 58 (6), pp.974. ⟨10.1111/j.1365-2559.2011.03822.x⟩. ⟨hal-00642394⟩

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