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Interobserver agreement in the reporting of colorectal polyp pathology among bowel cancer screening pathologists in Wales

Turner, Jeffrey, Williams, Geraint ORCID:, Morgan, Meleri, Wright, Melissa ORCID: and Dolwani, Sunil ORCID: 2013. Interobserver agreement in the reporting of colorectal polyp pathology among bowel cancer screening pathologists in Wales. Histopathology 62 (6) , pp. 916-924. 10.1111/his.12110

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Aims: To assess the interobserver agreement in the reporting of colorectal polyps among histopathologists participating in the Welsh Bowel Cancer Screening (BCS) programme. Methods and results: Twelve benign polyps representative of BCS cases were identified from pathology files and reported by 28 BCS histopathologists using proforma sheets. The level of agreement between the participants and a gold standard was determined using kappa (κ) statistics. A moderate level of agreement was achieved in the reporting of polyp type [κ = 0.45; 95% confidence interval (CI) 0.34-0.59] and adenomatous lesions were distinguished from non-adenomatous lesions in 96% of cases. Substantial agreement was obtained in distinguishing low- and high-grade dysplasias (κ = 0.67; 95% CI 0.50-0.86), but there was only fair agreement in reporting excision margin status (κ = 0.24; 95% CI 0.07-0.43) with frequent use of the 'uncertain' category. Significant issues included categorizing serrated lesions, recognizing focal high-grade dysplasia and epithelial misplacement, and apparent overdiagnosis of villous change in adenomas. Conclusions: Interobserver variability in some aspects of reporting colorectal polyps by BCS pathologists is suboptimal, with a potential impact upon patient management and the efficient running of the screening service.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RB Pathology
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Uncontrolled Keywords: Adenocarcinoma; Adenoma; Adenomatous Polyps; Colonic Polyps; Colorectal Neoplasms; Early Detection of Cancer; Humans; Hyperplasia; Intestinal Polyps; Observer Variation; Pathology, Clinical; Wales
Publisher: Wiley-Blackwell
ISSN: 0309-0167
Date of Acceptance: 6 February 2013
Last Modified: 31 Oct 2022 09:11

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