Clinicopathological Correlates of Dysplastic Sessile Serrated Lesion: A Prospective Cohort Study With a High Detection Rate

Lamba, Mehul; Brown, Ian; Bettington, Mark; Ryan, Kimberley; Hanigan, Katherine; Lasenby, Kay; Dixon, Alicia; Grimpen, Florian; Gan, Chun Loo; Tutticci, Nicholas J.; Appleyard, Mark; Leggett, Barbara A.

doi:10.1016/j.gastha.2021.12.010

Cited by 1 publication

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“…For example, PCCRC‐3Y rate for Bowel Cancer Screening Programme colonoscopies performed by specially credentialed endoscopists in the English NHS was 3.1% for period 2006–2010, compared with 7.3% observed in the overall English NHS 5,17 . Our endoscopy unit has previously reported high SSLDR 18 . In addition, the median ADR for proceduralists performing over 50 colonoscopies during year 2018–19 in our unit was 52 (IQR 41–58).…”

Section: Discussionmentioning

confidence: 67%

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Post‐colonoscopy cancer rate at a tertiary referral hospital in Australia: A data linkage analysis

Lamba

Khaing

Ryan

et al. 2022

J of Gastro and Hepatol

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Background and Aim: Colorectal cancer (CRC) diagnosed following a cancer-negative colonoscopy is termed as post-colonoscopy CRC (PCCRC). The World Endoscopy Organization has recently standardized the definition of PCCRC-3Y (CRC developing within 3 years of a cancer-negative colonoscopy). In the present study, we sought to assess PCCRC-3Y rate, perform root-cause analyses, and identify factors associated with development of PCCRC at a tertiary referral hospital in Australia. Methods: All patients undergoing colonoscopy from 2011 to 2018 were matched to a population-based cancer register. PCCRC-3Y rate was assessed for years 2011-2015. All PCCRC cases that developed within 6-48 months after a cancer-negative colonoscopy underwent root-cause analyses. Descriptive statistics were used to summarize data. Results: Among 17 828 patients undergoing colonoscopy, 367 CRC cases were diagnosed during the study period. This included nine PCCRC cases, which developed at a median of 14 months (range 7-34 months) after cancer-negative colonoscopy. The PCCRC-3Y rate for years 2011-2015 was 2.16% (95% CI 0.91-5.15). All nine PCCRC cases were moderately or poorly differentiated adenocarcinomas; seven of nine were early-stage CRC (stages I and II) and six of nine probably represented missed lesions at index colonoscopy despite an apparently adequate examination. History of inflammatory bowel disease (IBD) (odds ratio [OR] 21.9, 95% confidence interval [CI] 4.6-103.7, P < 0.001) and diverticulosis (OR 5.4, 95% CI 1.4-20.5, P = 0.01) were significantly associated with development of missed CRC. Conclusions: In our tertiary referral colonoscopy cohort, PCCRC-3Y rate was 2.16% (95% CI 0.91-5.15). IBD and diverticulosis were significantly associated with risk of PCCRC. The majority of PCCRC lesions were likely missed at index colonoscopy, despite an apparently adequate examination.

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Section: Discussionmentioning

confidence: 67%

“…5,17 Our endoscopy unit has previously reported high SSLDR. 18 In addition, the median ADR for proceduralists performing over 50 colonoscopies during year 2018-19 in our unit was 52 (IQR 41-58). Therefore, the observed low PCCRC-3Y rate in the present study is likely contributed by high polyp detection rate of proceduralists at our center.…”

Section: Discussionmentioning

confidence: 84%