Retrospective analysis of missed advanced adenomas on surveillance colonoscopy

Shehadeh, Ihab; Rebala, Srilakshmi; Kumar, Rajinder; Markert, Ronald J.; Barde, C.; Gopalswamy, N.

doi:10.1111/j.1572-0241.2002.05680.x

Cited by 23 publications

(9 citation statements)

References 17 publications

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“…Several previous studies reported that the miss rates for total polyps, adenomas, and advanced adenomas were 16.8% to 28%, 16% to 26%, and 1.7% to 11%, respectively 910111213141517. The variation in adenoma miss rates between studies may be caused by heterogeneity in study design.…”

Section: Discussionmentioning

confidence: 97%

“…Cecal intubation, adequate bowel preparation, and a colonoscopic withdrawal time of 6 minutes or more are suggested to ensure complete removal of polyps and improvement of polyp detection based on previous studies 78. Despite these efforts, it has been reported that a significant number of polyps are missed during surveillance colonoscopy,91011121314151617 thereby leading to the development of interval cancers from the missed neoplastic polyps 18. Based on several tandem or consecutive colonoscopy studies,912131415 the miss rate of polyps is reported to be 16.8% to 28%.…”

Section: Introductionmentioning

confidence: 99%

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Miss rate of colorectal neoplastic polyps and risk factors for missed polyps in consecutive colonoscopies

et al. 2017

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Background/AimsColonoscopic polypectomy is the best diagnostic and therapeutic tool to detect and prevent colorectal neoplasms. However, previous studies have reported that 17% to 28% of colorectal polyps are missed during colonoscopy. We investigated the miss rate of neoplastic polyps and the factors associated with missed polyps from quality-adjusted consecutive colonoscopies.MethodsWe reviewed the medical records of patients who were found to have colorectal polyps at a medical examination center of the Kangbuk Samsung Hospital between March 2012 and February 2013. Patients who were referred to a single tertiary academic medical center and underwent colonoscopic polypectomy on the same day were enrolled in our study. The odds ratios (ORs) associated with polyp-related and patient-related factors were evaluated using logistic regression analyses.ResultsA total of 463 patients and 1,294 neoplastic polyps were analyzed. The miss rates for adenomas, advanced adenomas, and carcinomas were 24.1% (312/1,294), 1.2% (15/1,294), and 0% (0/1,294), respectively. Flat/sessile-shaped adenomas (adjusted OR, 3.62; 95% confidence interval [CI], 2.40–5.46) and smaller adenomas (adjusted OR, 5.63; 95% CI, 2.84– 11.15 for ≤5 mm; adjusted OR, 3.18; 95% CI, 1.60–6.30 for 6–9 mm, respectively) were more frequently missed than pedunculated/sub-pedunculated adenomas and larger adenomas. In patients with 2 or more polyps compared with only one detected (adjusted OR, 2.37; 95% CI, 1.55–3.61 for 2–4 polyps; adjusted OR, 11.52; 95% CI, 4.61–28.79 for ≥5 polyps, respectively) during the first endoscopy, the risk of missing an additional polyp was significantly higher.ConclusionsOne-quarter of neoplastic polyps was missed during colonoscopy. We encourage endoscopists to detect smaller and flat or sessile polyps by using the optimal withdrawal technique.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Miss rate of colorectal neoplastic polyps and risk factors for missed polyps in consecutive colonoscopies

et al. 2017

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“…Since 1997, when the US agency for Health Care Policy and Research first advocated widespread colon cancer screening, refinements in techniques of optical colonoscopy (OC), barium enema (BE), and flexible sigmoidoscopy (FS) have evolved [2,3]. Each examination has a failure rate, ranging from a low of 4% for colonoscopy in right-sided cancers to 46% for FS [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Failed diagnoses are well known to clinicians, but the relative failure rates for the three most widely used screening examinations in community hospitals are not.…”

Section: Introductionmentioning

confidence: 99%

Relative Rates of Missed Diagnosis for Colonoscopy, Barium Enema, and Flexible Sigmoidoscopy in 379 Patients with Colorectal Cancer

Frenette

Strum

2007

J Gastrointest Canc

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“…Thus, the overestimation and limitation in terms of determining the incidence and characteristics of interval CRC have been resulted. 12 – 17 In fact, a number of endoscopists have concerned about the incidence of unpredicted CRC soon after their index colonoscopy during the period of surveillance for each patient.…”

Section: Introductionmentioning

confidence: 99%

Frequency and Characteristics of Interval Colorectal Cancer in Actual Clinical Practice: A KASID Multicenter Study

et al. 2018

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Background/AimsThe aims of the present study were to determine the frequency of interval colorectal cancers (CRCs) after surveillance colonoscopy and to compare the clinicopathologic features and survival outcomes with those of non-interval CRCs.MethodsFrom January 2003 to December 2013, 66,016 follow-up colonoscopies for 38,412 patients performed within recommended time were reviewed retrospectively based on data from 11 tertiary hospitals in South Korea. To compare clinicopathologic features and survival rates for interval CRC, 106 patients with non-interval CRC matched in age and gender were included.ResultsAmong the 66,016 colonoscopies performed within the surveillance period, 63 cases (63/66,016) of interval CRC were detected, and 53 were finally included in the analysis. The mean age was 69.9±8.8 years, and the male to female ratio was 1.94:1. Although the occurrence rate of cancer in the right side colon was higher than that of non-interval CRC, interval CRCs were predominantly left sided. Other clinicopathologic features and overall survival were not significantly different between the two groups. Missed lesion was suspected to be the most common cause (29 cases, 54.7%).ConclusionsThe frequency of interval CRC among patients who had undergone a surveillance colonoscopy was 0.095%. While sharing some similar clinical features and survival outcomes, interval CRCs in Korea developed more often in males and on the left side in contrast to results from Western studies.

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Retrospective analysis of missed advanced adenomas on surveillance colonoscopy

Abstract: The present study shows an advanced polyp miss rate that is comparable with other studies even in a fellowship training setting. Prospective studies with tandem surveillance colonoscopy are needed to confirm our findings.

Cited by 23 publications

References 17 publications

Miss rate of colorectal neoplastic polyps and risk factors for missed polyps in consecutive colonoscopies

Miss rate of colorectal neoplastic polyps and risk factors for missed polyps in consecutive colonoscopies

Relative Rates of Missed Diagnosis for Colonoscopy, Barium Enema, and Flexible Sigmoidoscopy in 379 Patients with Colorectal Cancer

Frequency and Characteristics of Interval Colorectal Cancer in Actual Clinical Practice: A KASID Multicenter Study

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