Journal
HISTOPATHOLOGY
Volume 80, Issue 5, Pages 790-798Publisher
WILEY
DOI: 10.1111/his.14601
Keywords
adenocarcinoma; adenoma; clinical pathology; colorectal neoplasms; observer variation
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This study evaluated the interobserver variability between individual pathologists and a panel of pathologists in assessing advanced colorectal neoplasms, finding discrepancies in the assessment of adenomas with high-grade dysplasia and early colorectal carcinomas, which may impact treatment choices. Additional stains, education, and intercollegial consultation may help decrease this variability.
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.
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