Assessment of Diagnostic Accuracy and Safe Surgical Pathology Reporting Practices of Colorectal Polyps: A Single Institution based Study of 229 Consecutive Cases Over a Period of One Year
Mod J Med Biol
Introduction: Diagnostic and reporting errors are one of the major challenges encountered in provision of quality health care services. Incorrect diagnosis interferes with clinical decision making and ends up with serious consequences in terms of patient management. Practicing regular departmental audits is a milestone towards professional development and excellence. The aim is to highlight and address errors and discrepancies in routine practices to maintain high quality standards and take corrective actions for future. Shaukat Khanum Memorial Cancer hospital being one of the largest cancer centers in Pakistan, colorectal polyps are not an uncommon biopsy specimen received in surgical pathology lab. We conducted an intra-departmental audit of colorectal polyps. The aim of our study was to investigate diagnostic accuracy and quality of reporting of colorectal polyps according to standardized CAP guidelines.
Material and Methods: We performed a retrospective study of 229 cases of colorectal polyps diagnosed in year 2019 after approval by institutional review board. The data was available in hospital archives. Slide review was done by two consultant pathologists to assess diagnostic and reporting errors. The conflicting cases were referred to a third pathologist for final opinion.
Results: The diagnostic discrepancies were observed in 20 (6.1%) cases and reporting errors were present in 61 (18.6%) out of 229 cases (328 biopsies).
Conclusion: Overall the results were satisfactory in terms of patient management. There was only one case with discrepant grading of dysplasia and there were four cases with overcall of adenocarcinoma which turned out be high grade dysplasia on review.
Keywords: Colorectal Cancer (CRC); College of American Pathologists (CAP); Mucin Rich Traditional Serrated Adenomas (MR-TSAs); Serrated Tubulovillous Adenomas (S-TVAs)