Interobserver agreement in the reporting of colorectal polyp pathology among bowel cancer screening pathologists in Wales. Issue 6 (24th April 2013)

• Record Type: Journal Article
• Authors: Turner, Jeff K; Williams, Geraint T; Morgan, Meleri; Wright, Melissa; Dolwani, Sunil
• Is Part Of: Histopathology. Volume 62:Issue 6(2013)
• Page Start: 916
• Page End: 924
• Publication Date: 2013-04-24
• Subjects: agreement -- bowel cancer -- histopathology polyps -- screening; Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12110
• Languages: English
• ISSNs: 0309-0167

Abstract

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.