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- Title
Inter-observer variation in the histological diagnosis of polyps in colorectal cancer screening.
- Authors
van Putten, Paul G.; Hol, Lieke; van Dekken, Herman; Han van Krieken, J.; van Ballegooijen, Marjolein; Kuipers, Ernst J.; van Leerdam, Monique E.
- Abstract
van Putten P G, Hol L, van Dekken H, Han van Krieken J, van Ballegooijen M, Kuipers E J & van Leerdam M E (2011) Histopathology , 974-981 To determine the inter-observer variation in the histological diagnosis of colorectal polyps. Four hundred and forty polyps were randomly selected from a colorectal cancer screening programme. 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 using kappa statistics. In 421/440 polyps (96%), agreement for their non-adenomatous or adenomatous nature was obtained, corresponding to a very good kappa value of 0.88. For differentiation of adenomas as non-advanced and advanced, consensus was obtained in 266/322 adenomas (83%), with a moderate kappa value of 0.58. For the non-adenomatous or adenomatous nature, both general and expert pathologists, and expert pathologists between each other, showed very good agreement {kappa values of 0.89 [95% confidence interval (CI) 0.83-0.95] and 0.86 (95% CI 0.73-0.98), respectively}. For categorization of adenomas as non-advanced and advanced, moderate agreement was found between general and expert pathologists, and between expert pathologists [kappa values of 0.56 (95% CI 0.44-0.67) and 0.64 (95% CI 0.43-0.85), respectively]. 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 differentiating non-advanced and advanced adenomas suggests that more objective criteria are required for risk stratification in screening and surveillance guidelines.
- Subjects
POLYPS; COLON cancer diagnosis; ADENOMA; MEDICAL screening; HISTOPATHOLOGY; PATHOLOGISTS; DIAGNOSIS
- Publication
Histopathology, 2011, Vol 58, Issue 6, p974
- ISSN
0309-0167
- Publication type
Article
- DOI
10.1111/j.1365-2559.2011.03822.x