TY - JOUR
T1 - Diagnostic variability in the histopathological assessment of advanced colorectal adenomas and early colorectal cancer in a screening population
AU - Smits, Lisanne J. H.
AU - Vink-Börger, Elisa
AU - van Lijnschoten, Gesina
AU - Focke-Snieders, Isabelle
AU - van der Post, Rachel S.
AU - Tuynman, Jurriaan B.
AU - van Grieken, Nicole C. T.
AU - Nagtegaal, Iris D.
N1 - Publisher Copyright: © 2021 The Authors. Histopathology published by John Wiley & Sons Ltd.
PY - 2022/4
Y1 - 2022/4
N2 - Aim: The aim of this study was to evaluate interobserver variability between individual pathologists and a panel of pathologists in the histopathological assessment of advanced colorectal neoplasms in the Dutch bowel cancer screening population. Methods and results: Histological slides of adenomas with high-grade dysplasia and early colorectal carcinomas (CRC) from 20 different laboratories were reviewed by the pathology panel of the Dutch bowel screening programme. Interobserver variability was reported by descriptive statistics. In addition, potential clinical consequences of discrepancies were evaluated. A total of 104 cases of adenomas with high-grade dysplasia and 83 early CRCs were reviewed. Discrepancies were observed in 41 of 104 (39.4%) adenoma cases, which potentially had clinical consequences in 16 (15.4%) cases. For CRC, discrepancies were shown in 44 of 83 cases (53.0%) and would have potentially led to alternative treatment strategies in 25 (30.1%) cases. Most frequently, discrepancies were observed in the assessment of lymphovascular invasion (23 of 73 cases, 31.5%). Conclusion: This study showed that considerable interobserver variability is present in the histopathological assessment of advanced colorectal neoplasia, which may impact upon treatment choices. Additional stains and education, as well as intercollegial consultation, might decrease this variability.
AB - Aim: The aim of this study was to evaluate interobserver variability between individual pathologists and a panel of pathologists in the histopathological assessment of advanced colorectal neoplasms in the Dutch bowel cancer screening population. Methods and results: Histological slides of adenomas with high-grade dysplasia and early colorectal carcinomas (CRC) from 20 different laboratories were reviewed by the pathology panel of the Dutch bowel screening programme. Interobserver variability was reported by descriptive statistics. In addition, potential clinical consequences of discrepancies were evaluated. A total of 104 cases of adenomas with high-grade dysplasia and 83 early CRCs were reviewed. Discrepancies were observed in 41 of 104 (39.4%) adenoma cases, which potentially had clinical consequences in 16 (15.4%) cases. For CRC, discrepancies were shown in 44 of 83 cases (53.0%) and would have potentially led to alternative treatment strategies in 25 (30.1%) cases. Most frequently, discrepancies were observed in the assessment of lymphovascular invasion (23 of 73 cases, 31.5%). Conclusion: This study showed that considerable interobserver variability is present in the histopathological assessment of advanced colorectal neoplasia, which may impact upon treatment choices. Additional stains and education, as well as intercollegial consultation, might decrease this variability.
KW - adenocarcinoma
KW - adenoma
KW - clinical pathology
KW - colorectal neoplasms
KW - observer variation
UR - http://www.scopus.com/inward/record.url?scp=85122472831&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/his.14601
DO - https://doi.org/10.1111/his.14601
M3 - Article
C2 - 34813117
SN - 0309-0167
VL - 80
SP - 790
EP - 798
JO - Histopathology
JF - Histopathology
IS - 5
ER -