Abstract:
AIM:To determine the inter-observer variation in the histological diagnosis of colorectal polyps. METHODS AND RESULTS: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]. 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 differentiating non-advanced and advanced adenomas suggests that more objective criteria are required for risk stratification in screening and surveillance guidelines.
journal_name
Histopathologyjournal_title
Histopathologyauthors
van Putten PG,Hol L,van Dekken H,Han van Krieken J,van Ballegooijen M,Kuipers EJ,van Leerdam MEdoi
10.1111/j.1365-2559.2011.03822.xsubject
Has Abstractpub_date
2011-05-01 00:00:00pages
974-81issue
6eissn
0309-0167issn
1365-2559journal_volume
58pub_type
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