Postcolonoscopy colorectal cancers are preventable: a population-based study

Clercq, Chantal M. C. le; Bouwens, Mariëlle; Rondagh, Eveline J.A.; Bakker, C. M.; Keulen, Eric T.P.; Ridder, Rogier J. De; Winkens, Björn; Masclee, Ad; Sanduleanu, Silvia

doi:10.1136/gutjnl-2013-304880

Cited by 309 publications

(254 citation statements)

References 48 publications

(65 reference statements)

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“…Recent large population-based studies that evaluated the incidence and risk of interval CRCs at colonoscopy reported that the incidence varies from 2.9% to 7.9% (18)(19)(20)(21)(22)(23). In addition, these studies demonstrated the protective effect of colonoscopy against CRC; however, they also reported that the efficacy of this technique in the proximal colon was limited.…”

Section: Discussionmentioning

confidence: 99%

“…Of the five patients with PCCRC, two were ascribed to missed lesions and three to new lesions. Although it is impossible to evaluate the exact frequency of missed lesions during colonoscopy, recent studies suggest that 23%-58% of PCCRCs are attributable to missed lesions (18,20,24,25). The reasons for missed lesions include incomplete bowel preparation, suboptimal withdrawal time and technique, and differences in the knowledge and training of endoscopists regarding the recognition of subtle-appearing precursor lesions, such as flat and depressed adenoma or sessile serrated adenomas/ polyps (SSA/P) (9).…”

Section: Discussionmentioning

confidence: 99%

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Post-colonoscopy colorectal cancers in average-risk Korean subjects with a normal initial colonoscopy

Lee

Kim²,

Choi³

et al. 2016

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Post-colonoscopy colorectal cancers in average-risk Korean subjects with a normal initial colonoscopy

Lee

Kim²,

Choi³

et al. 2016

Turk J Gastroenterol

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“…Several studies evaluating interval CRCs found that these cancers can be attributed to incomplete polypectomy in about 10% to 30% of cases 13,20,22,64,65 . Since ADR is essentially geared at assessing detection and not resection, the inadequate quality in these cases would not be reflected by measuring the ADR.…”

Section: Incomplete Adenoma Resectionmentioning

confidence: 99%

“…In fact, 71% to 86% of interval cancers can be attributed to colonoscopist-related factors, as they represent missed lesions or result from incompletely resected lesions [20][21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

Colonoscopy Quality Assessment

Fayad

Kahi

2015

Gastrointestinal Endoscopy Clinics of North America

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Abstract:Colonoscopy is the cornerstone of colorectal cancer screening programs. There is significant variability in the quality of colonoscopy between endoscopists. Colonoscopy quality assessment tracks various metrics in order to improve the effectiveness of colonoscopy, aiming at reducing the incidence and mortality from colorectal cancer. Adenoma detection rate is the prime metric, as it is associated with the risk of interval cancers. Implementing processes to measure and improve the adenoma detection rate is essential to improve the quality of colonoscopy.

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“…Unfortunately, up to 20% of all neoplastic lesions, especially small and flat lesions, are still missed during a colonoscopy (3)(4)(5). This unsatisfactorily high overall miss rate remains a concern and is one of the key factors in the development of interval cancer (6). Many common reasons for missing lesions are related to a number of elements of procedural quality such as bowel preparation (7,8), but they also partly result from the highly operator-dependent nature of the procedure (9).…”

Section: Introductionmentioning

confidence: 99%

Enhanced flat adenoma detection rate with high definition colonoscopy plus i-scan for average-risk colorectal cancer screening

A¹,

Saperas²

2016

Rev Esp Enferm Dig

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Background and aim:The usefulness of high definition colonoscopy plus i-scan (HD+i-SCAN) for average-risk colorectal cancer screening has not been fully assessed. The detection rate of adenomas and other measurements such as the number of adenomas per colonoscopy and the flat adenoma detection rate have been recognized as markers of colonoscopy quality. The aim of the present study was to compare the diagnostic performance of an HD+i-SCAN with that of standard resolution white-light colonoscope.Methods: This is a retrospective analysis of a prospectively collected screening colonoscopy database. A comparative analysis of the diagnostic yield of an HD+i-SCAN or standard resolution colonoscopy for average-risk colorectal screening was conducted.Results: During the period of study, 155/163 (95.1%) patients met the inclusion criteria. The mean age was 56.9 years. Sixty of 155 (39%) colonoscopies were performed using a HD+i-SCAN. Adenoma-detection-rates during the withdrawal of the standard resolution versus HD+i-SCAN colonoscopies were 29.5% and 30% (p = n.s.). Adenoma/colonoscopy values for standard resolution versus HD+i-SCAN colonoscopies were 0.46 (SD = 0.9) and 0.72 (SD = 1.3) (p = n.s.). A greater number of flat adenomas were detected in the HD+i-SCAN group (6/60 vs. 2/95) (p < .05). Likewise, serrated adenomas/polyps per colonoscopy were also higher in the HD+i-SCAN group.Conclusions: A HD+i-SCAN colonoscopy increases the flat adenoma detection rate and serrated adenomas/polyps per colonoscopy compared to a standard colonoscopy in averagerisk screening population. HD+i-SCAN is a simple, available procedure that can be helpful, even for experienced providers. The performance of HD+i-SCAN and substantial prevalence of flat lesions in our average-risk screening cohort support its usefulness in improving the efficacy of screening colonoscopies.

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Postcolonoscopy colorectal cancers are preventable: a population-based study

Abstract: In our experience, 86.4% of all PCCRCs could be explained by procedural factors, especially missed lesions. Quality improvements in performance of colonoscopy, with special attention to the detection and resection of proximally located flat precursors, have the potential to prevent PCCRCs.

Cited by 309 publications

References 48 publications

Post-colonoscopy colorectal cancers in average-risk Korean subjects with a normal initial colonoscopy

Post-colonoscopy colorectal cancers in average-risk Korean subjects with a normal initial colonoscopy

Colonoscopy Quality Assessment

Enhanced flat adenoma detection rate with high definition colonoscopy plus i-scan for average-risk colorectal cancer screening

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