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Feasibility of Large-Scale Identification of Sessile Serrated Polyp Patients Using Electronic Records: A Utah Study

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Abstract

Background/Aims

The serrated pathway accounts for 15–25% of sporadic colorectal cancer (CRC). In our study, we sought to accurately characterize sessile serrated polyps (SSP) in a population by electronically interrogating colonoscopy patients’ endoscopy and pathology reports using a rules-based text search of pre-defined SSP-related terms. To this aim, we compared a sample of putative SSP and hyperplastic polyps (HP) using our algorithm to a determination of SSP or HP by pathologist and molecular examination to determine the feasibility of large-scale identification of SSP in electronic medical records.

Methods

In 23,990 endoscopy reports from colonoscopies with pathology performed at a University of Utah Healthcare facility in 2000–2012, we identified serrated lesions and categorized each as putative SSP or HP using a text search algorithm. We obtained 93 tissue samples for histologic and molecular analysis.

Results

Serrated polyps were categorized as putative SSP (N = 920) and putative HP (N = 7159) by text search algorithm. Histologic examination of 93 samples identified 37 SSP, 11 probable SSP, and 45 HP. Of 26 putative SSP, 25 were SSP/probable SSP (96%) by histology. Of 67 putative HP, 44 were HP (66%) by histology. Reducing size criterion from ≥1 to ≥5 mm in the search algorithm caused improved sensitivity (77.1%) without decline in specificity (97.8%).

Conclusions

A simple rules-based search to identify SSP provides “proof of principle” that SSP can be identified in a large electronic record set. Pilot data indicate defining large, right-sided polyps as ≥5 mm provides adequate sensitivity to detect SSP from electronic records while maintaining high specificity.

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Acknowledgments

We gratefully acknowledge the following individuals for their assistance and expertise: Jathine Wong, computer professional, Huntsman Cancer Institute Pedigree & Population Resource, for programming support; Micky Daurelle, data warehouse engineer, University of Utah Health Sciences, for extraction of medical records; Alison Fraser, database manager and Yuan Wan, programmer, Pedigree & Population Resource (Utah Population Database), for linking of medical records and demographic information; and Anne Cline, biorepository director, and Blake Anderson, histology director, Huntsman Cancer Institute Biorepository and Molecular Pathology Resource.

Institutional Review Board (IRB)

University of Utah approved protocol (57205) and biobanking protocol (10924).

Funding

This work was funded by a pilot award (to KC) from the Huntsman Cancer Institute, Colon Cancer Program. Partial support for all datasets within the Utah Population Database and the Biorepository and Molecular Pathology Shared Resource is provided by the University of Utah Huntsman Cancer Institute and the Huntsman Cancer Institute Cancer Center Support Grant, P30 CA2014 from the National Cancer Institute, National Institutes of Health. Support for the Utah Cancer Registry is provided by Contract No. HHSN2612013000171 from the National Cancer Institute with additional support from the Utah Department of Health.

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Authors and Affiliations

  1. Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Kajsa Affolter & Wade S. Samowitz

  2. Department of Anatomic Pathology, ARUP Laboratories, 500 S Chipeta Way, Salt Lake City, UT, 84108, USA

    Kajsa Affolter & Wade S. Samowitz

  3. Department of Oncological Sciences, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA

    Keith Gligorich

  4. Department of Pathology, University of Utah Health Sciences Center, Huntsman Cancer Hospital, RM N3100, 1950 Circle of Hope, Salt Lake City, UT, 84112, USA

    Kajsa Affolter & Keith Gligorich

  5. Department of Internal Medicine, Gastroenterology, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA

    Niloy Jewel Samadder & Karen Curtin

  6. Department of Endoscopy, University of Utah Health Sciences Center, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA

    Niloy Jewel Samadder

  7. Utah Population Database, 675 Arapeen Drive, Room 210 (Suite 200), Salt Lake City, UT, 84112, USA

    Karen Curtin

Authors
  1. Kajsa Affolter
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  2. Keith Gligorich
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  3. Niloy Jewel Samadder
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  4. Wade S. Samowitz
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  5. Karen Curtin
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Corresponding author

Correspondence to Kajsa Affolter.

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Affolter, K., Gligorich, K., Samadder, N.J. et al. Feasibility of Large-Scale Identification of Sessile Serrated Polyp Patients Using Electronic Records: A Utah Study. Dig Dis Sci 62, 1455–1463 (2017). https://doi.org/10.1007/s10620-017-4543-9

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  • DOI: https://doi.org/10.1007/s10620-017-4543-9

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