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

Abstract:

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. Approaches to addressing this are discussed.

journal_name

Histopathology

journal_title

Histopathology

authors

Turner JK,Williams GT,Morgan M,Wright M,Dolwani S

doi

10.1111/his.12110

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

916-24

issue

6

eissn

0309-0167

issn

1365-2559

journal_volume

62

pub_type

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