No Decrease in the Rate of Early or Missed Colorectal Cancers After Colonoscopy With Polypectomy Over a 10-Year Period: A Population-Based Analysis

Pullens, Hendrikus J.M.; Leenders, Max; Schipper, Marguérite E.I.; Oijen, Martijn G.H. van; Siersema, Peter D.

doi:10.1016/j.cgh.2014.04.032

Cited by 15 publications

(16 citation statements)

References 31 publications

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“…Although PCCRCs were of earlier stage at diagnosis, we found no difference in survival between PCCRCs and detected CRCs overall or on the basis of molecular phenotype, including comparisons between MSI and MSS tumors and CIMPþ and CIMP low/negative tumors. Prior studies have reported similar findings, including those from the Netherlands 26 and Denmark, 27 which found PCCRCs presented at an earlier stage but had comparable survival rates to detected CRCs when adjusted for TNM stage, and an analysis of 3 adenoma prevention trials, which found an earlier stage of presentation. 28 However, this finding is not universal; in a population-based study of PCCRC from Ontario, Canada they reported that PCCRC had a higher likelihood of stage IV disease, worse overall survival, and emergency presentation compared with cancer detected at colonoscopy.…”

Section: Discussionsupporting

confidence: 54%

Clinical and Molecular Features of Post-Colonoscopy Colorectal Cancers

Samadder

Neklason

Snow

et al. 2019

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS:Post-colonoscopy colorectal cancers (PCCRCs) may arise from missed lesions or due to molecular features of tumors that allow them to grow rapidly. We aimed to compare clinical, pathology, and molecular features of PCCRCs (those detected within 6-60 months of colonoscopy) and detected CRCs (those detected within 6 months of a colonoscopy). METHODS:Within a population-based cross-sectional study of incident CRC cases in Utah (from 1995 through 2009), we identified PCCRCs (those cancers that developed within 5 years of a colonoscopy) and matched the patients by age, sex, and hospital site to patients with detected CRC.Archived specimens were retrieved and tested for microsatellite instability (MSI), CpG island methylation, and mutations in KRAS and BRAF. There were 2659 cases of CRC diagnosed within the study window; 6% of these (n [ 159) were defined as PCCRCs; 84 of these cases had tissue available and were matched to 84 subjects with detected CRC. RESULTS:Higher proportions of PCCRCs than detected CRCs formed in the proximal colon (64% vs 44%; P [ .016) and were of an early stage (86% vs 69%; P [ .040). MSI was observed in 32% of PCCRCs compared with 13% of detected CRCs (P [ .005). The other molecular features were found in similar proportions of PCCRCs and detected CRCs. In a multivariable logistic regression, MSI (odds ratio, 4.20; 95% CI, 1.58-11.14) was associated with PCCRC. There was no difference in 5-year survival between patients with PCCRCs vs detected CRCs. CONCLUSION:In this population-based cross-sectional study of incident CRC cases in Utah, we found PCCRCs to be more likely to arise in the proximal colon and demonstrate MSI, so PCCRCs and detected CRC appear to have different features or processes of tumorigenesis. Additional studies are needed to determine if post-colonoscopy cancers arise through a specific genetic pathway. P ost-colonoscopy colorectal cancers (PCCRCs) are a small but clinically important subset of colorectal cancers (CRCs) that refer to cancers that are diagnosed after a colonoscopy in which no cancer is diagnosed. 1 The reported prevalence of PCCRC in various population-based studies across the world range from 3% to 9%, with an estimated pool prevalence of 3.7%. 2 The pathogenesis of PCCRC is likely multifactorial, including cancers and precursor adenomas that are missed or incompletely excised at colonoscopy or unique molecular pathways. Several patient factors (female gender, diverticulosis) and endoscopist factors (non-gastroenterologist physician, rural facility, low adenoma detection rate) have emerged as risk factors for PCCRC. 2-5 However, certain tumor characteristics Abbreviations used in this paper:

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Section: Discussionsupporting

confidence: 54%

Clinical and Molecular Features of Post-Colonoscopy Colorectal Cancers

Samadder

Neklason

Snow

et al. 2019

Clinical Gastroenterology and Hepatology

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“…It was assumed that CRCs diagnosed within six months of the index procedure had already been detected or suspected during the index colonoscopy. 3,12…”

Section: Methodsmentioning

confidence: 99%

Risk of post‐colonoscopy colorectal cancer due to incomplete adenoma resection: A nationwide, population‐based cohort study

et al. 2017

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“…Although colonoscopy is considered to be the most effective way of cancer screening [ 1 ], it still has a non-negligible miss rate [ 9 ], which has not decreased much, even though the equipment has improved over time [ 10 ]. A colorectal polyp can be missed for the following reasons.…”

Section: Introductionmentioning

confidence: 99%

“…The next reason is that the bowel has continuously moving, shiny, pink walls, which sometimes (despite the inflation) fold over polyps. The last factor is fatigue: after a couple of seconds of watching the screen of the endoscopes, the eyes and brain of the gastroenterologist gets used to the environment, and after a longer time of watching they often get tired; this is true not only in the case of inexperienced medical staff [ 9 , 10 ]. This last factor was the reason for thinking about developing a computer aided diagnosis protocol.…”

Section: Introductionmentioning

confidence: 99%

On Structural Entropy and Spatial Filling Factor Analysis of Colonoscopy Pictures

Nagy

Sziová

Pipek

2019

Entropy

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Colonoscopy is the standard device for diagnosing colorectal cancer, which develops from little lesions on the bowel wall called polyps. The Rényi entropies-based structural entropy and spatial filling factor are two scale- and resolution-independent quantities that characterize the shape of a probability distribution with the help of characteristic curves of the structural entropy–spatial filling factor map. This alternative definition of structural entropy is easy to calculate, independent of the image resolution, and does not require the calculation of neighbor statistics, unlike the other graph-based structural entropies.The distant goal of this study was to help computer aided diagnosis in finding colorectal polyps by making the Rényi entropy based structural entropy more understood. The direct goal was to determine characteristic curves that can differentiate between polyps and other structure on the picture. After analyzing the distribution of colonoscopy picture color channels, the typical structures were modeled with simple geometrical functions and the structural entropy–spatial filling factor characteristic curves were determined for these model structures for various parameter sets. A colonoscopy image analying method, i.e., the line- or column-wise scanning of the picture, was also tested, with satisfactory matching of the characteristic curve and the image.

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No Decrease in the Rate of Early or Missed Colorectal Cancers After Colonoscopy With Polypectomy Over a 10-Year Period: A Population-Based Analysis

Cited by 15 publications

References 31 publications

Clinical and Molecular Features of Post-Colonoscopy Colorectal Cancers

Clinical and Molecular Features of Post-Colonoscopy Colorectal Cancers

Risk of post‐colonoscopy colorectal cancer due to incomplete adenoma resection: A nationwide, population‐based cohort study

On Structural Entropy and Spatial Filling Factor Analysis of Colonoscopy Pictures

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