Post-colonoscopy colorectal cancer: Characteristics and predictive factors

García-Borruel, María Muñoz; Molina, A.; Perálvarez, Manuel Luís Rodriguez; Rincón, Estefanía Moreno; Medrano, I. Pérez; Ruiz, Francisco; Juanena, Luis Leonardo Casáis; Navarro, María Pleguezuelo; Rodriguez, A; Pastor, Carlos Villar

doi:10.1016/j.medcle.2017.11.020

Cited by 6 publications

(7 citation statements)

References 19 publications

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“…The WEO consensus proposes using the 3‐year PCCRC rate to benchmark services. Our 3‐year PCCRC rate was 2.2%, which is similar to the rates reported in Canada (3.4%), 7 Utah, USA (3.5%), 11 and Córdoba, Spain (3.6%), 12 but less than the rates reported in England (4.7%), 13 Sweden (7%), 14 and Belgium (7.6%) 15 . Differences in methodology used to calculate the PCCRC rate, with different time frames and inclusion or exclusion criteria, could explain these variations 16 .…”

Section: Discussionsupporting

confidence: 87%

Incidence, characteristics, and predictive factors of post‐colonoscopy colorectal cancer

Baile‐Maxía,

Mangas‐Sanjuan,

Sala‐Miquel

et al. 2024

UEG Journal

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BackgroundPost‐colonoscopy colorectal cancer (PCCRC) is colorectal cancer (CRC) diagnosed after a colonoscopy in which no cancer is found.ObjectiveAs PCCRC has become an important quality indicator, we determined its rates, characteristics, and index colonoscopy‐related predictive factors.MethodsWe carried out a multicenter, observational, retrospective study between 2015 and 2018. Rates were calculated for PCCRC developing up to 10 years after colonoscopy. PCCRC was categorized according to the most plausible explanation using World Endoscopy Organization methodology. Our PCCRC population was compared to a control cohort without CRC matched 1:4 by sex, age, index colonoscopy date, indication, endoscopist, and hospital.ResultsOne hundred seven PCCRC and 2508 detected CRC were diagnosed among 101,524 colonoscopy (0.1%), leading to rates of 0.4%, 2.2%, 3.1%, and 4.1% at 1, 3, 5, and 10 years, respectively. PCCRC was in right (42.4%), left (41.4%), and transverse (16.4%) colon with 31.5% at stage I, 24.7% stage II, 32.6% stage III, and 11.2% stage IV. Twenty point three percent were classified as incomplete resection, 5.4% as unresected lesions, 48.6% as missed lesions with adequate colonoscopy, and 25.7% as missed lesions with inadequate colonoscopy. The median time from colonoscopy to PCCRC was 42 months. Previous inadequate preparation (OR 3.05, 95%CI 1.73–5.36) and piecemeal polypectomy (OR 19.89, 95%CI 8.67–45.61) were independently associated with PCCRC.ConclusionsIn our population, 4.1% of CRC cases were PCCRC. Most of these lesions were in right colon and attributable to lesions not visualized despite adequate bowel cleansing. Previous inadequate cleansing and piecemeal polypectomy were associated with PCCRC.

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Section: Discussionsupporting

confidence: 87%

Incidence, characteristics, and predictive factors of post‐colonoscopy colorectal cancer

Baile‐Maxía,

Mangas‐Sanjuan,

Sala‐Miquel

et al. 2024

UEG Journal

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“…The aADR in the IG was very high (49.1%) compared with the CG (36%), similar to previous experiences reported in a systematic review [ 37 ]. A recently published study concluded that an appropriate follow-up using high-quality colonoscopy is crucial for the prevention of CRC in patients with risk factors [ 38 ]. The recommendation on CRC screening in medium-risk populations from the Spanish Society of Family and Community Medicine and the Gastroenterology Society is to achieve the implementation of universal screening with the participation of primary care in collaboration with hospital care [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Improvements in the Effectiveness of Early Detection in Colorectal Cancer with Open-Label Randomised Study

Álvarez-Delgado

Garcia

García-González

et al. 2021

JCM

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Introduction: The general objective of this research is to improve the quality of colorectal cancer screening (CRC) by assessing, as an indicator of effectiveness, the ability of colonoscopy to detect more advanced adenomas in the exposed group than in the control group. Material and Methods: The present work is designed as an open-label randomized study on cancer screening, using two groups based on their exposure to the protocol: an exposed to intervention group (EIG, 167), and a control group (CG, 167), without the intervention of the protocol and by 1:1 matching. Results: In 167 patients in the GEI, 449 polyps are visualized and 274 are adenomas (80.58%), of which 100 (36.49%) are advanced adenomas. In the CG (n = 174), there are 321 polyps and 152 adenomas (82.60%). The variables significantly associated by logistic regression to the detection of adenomas are the male sex with an OR of 2.52. The variable time to withdrawal, ≥9 min, is significant at 99% confidence (p = 0.002/OR 34.67) and the fractional dose is significant at 99% (p = 0.009, OR 7.81). Conclusion: Based on the observations made, our study suggests that the intervention in collaboration between primary care and hospital care is effective from a preventive point of view and achieves the objective of effectiveness and quality of the PCCR.

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“…According to a retrospective study, 36.3% of PCCRC cases had insufficient bowel preparation, implying that good bowel preparation can help prevent PCCRC incidence 25 . Previous studies revealed that the prevalence of the adenoma miss rate (AMR) among patients with inadequate bowel preparation was 15–43%, and the advanced AMR was 18–36% 26–29 .…”

Section: Bowel Preparation Qualitymentioning

confidence: 99%

“…23 Furthermore, a higher BBPS score (scale of According to a retrospective study, 36.3% of PCCRC cases had insufficient bowel preparation, implying that good bowel preparation can help prevent PCCRC incidence. 25 Previous studies revealed that the prevalence of the adenoma miss rate (AMR) among patients with inadequate bowel preparation was 15-43%, and the advanced AMR was 18-36%. [26][27][28][29] Almost one-fifth of patients (18%) with inadequate bowel preparation had high-risk adenomas (advanced adenoma and three or more adenomas) in the subsequent colonoscopy with a mean colonoscopy interval of 271 days.…”

Section: Bowel Preparation Qualitymentioning

confidence: 99%

What are the priority quality indicators for colonoscopy in real‐world clinical practice?

Tiankanon

Aniwan

2023

Digestive Endoscopy

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Colonoscopy is widely used as a colorectal cancer (CRC) screening tool. The effectiveness of a screening colonoscopy is associated with a decreased risk of CRC. However, colonoscopy is an operator‐dependent procedure, and endoscopists' quality performance varies widely. This article reviewed the priority metrics and practices that contribute to high‐quality screening colonoscopy in real‐world clinical practice. With growing evidence, quality indicators have been subject to intense research and associated with reducing postcolonoscopy CRC incidence and mortality. Some quality metrics can reflect an endoscopy unit‐based practice (i.e. quality of bowel preparation and withdrawal time). Other quality indicators primarily reflect individuals' skill and knowledge (i.e. cecal intubation rate, adenoma detection rate, and appropriately assigned follow‐up colonoscopy interval). Measurement and improvement of priority quality indicators for colonoscopy should be made at both the endoscopist and unit levels. Substantial evidence supports the impact of high‐quality colonoscopy in reducing the incidence of postcolonoscopy CRC.

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Post-colonoscopy colorectal cancer: Characteristics and predictive factors

Cited by 6 publications

References 19 publications

Incidence, characteristics, and predictive factors of post‐colonoscopy colorectal cancer

Incidence, characteristics, and predictive factors of post‐colonoscopy colorectal cancer

Improvements in the Effectiveness of Early Detection in Colorectal Cancer with Open-Label Randomised Study

What are the priority quality indicators for colonoscopy in real‐world clinical practice?

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