SSL Detection Rate – How Good Is Good Enough?
É. Ring, F. Nally, J. Campion, A. Joyce, C. Smyth, O. Kelly, R. Farrell, B. Hall.
Gastroenterology Department, Connolly Hospital, Blanchardstown, Dublin.
Sessile serrated polyps (SSLs) are increasingly recognised as important precursors to colorectal cancer. SSL detection rates are a potential key performance indicator (KPI) at colonoscopy. An SSL detection rate of 10% has been suggested as a minimum KPI standard.
To examine the SSL detection rate in a high-volume endoscopy department and to compare gastroenterology and surgical endoscopists.
A retrospective analysis of colonoscopy reports and respective histology results were reviewed over a six-month period between January and June 2022. Data from four consenting endoscopists was included (2 gastroenterologists & 2 surgical endoscopists). The detection of SSL’s and hyperplastic polyps, above the rectum, were included in final analysis.
There were 458 colonoscopies performed over this period. The median age was 64 (IQR 17-88). 86 patients had at least one SSL. This is a 19% SSL detection rate. The median age of patients with an SSL was 66 (IQR 40-88). The endoscopists from the gastroenterology department had SSL detection rates of 26% (n=63 of 244 colonoscopies) and 14% (n=19 of 138 colonoscopies) respectively. The endoscopists from the surgical department had SSL detection rates of 4% (n=1 of 24 colonoscopies) and 6% (n=3 of 52 colonoscopies) respectively.
Our SSL detection rate is good based on a proposed 10% KPI detection rate. The cause of variation in rates between endoscopists is not readily apparent. To further examine optimal SSL detection rates, it would be of benefit to review individual post colonoscopy colorectal cancer rates.