Risk of a post-colonoscopy colorectal cancer diagnosis in patients with inflammatory bowel disease: a population-based cohort study

Troelsen, Frederikke Schønfeldt; Sørensen, Henrik Toft; Pedersen, Lars; Erichsen, Rune

doi:10.1055/a-1322-6574

Cited by 17 publications

(17 citation statements)

References 39 publications

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“…A history of IBD was the most common risk factor for PCCRC occurring as a primary indication in 18/58 (31.0%) of true PCCRC cases. Previous national studies have also shown a higher PCCRC-3yr rate in IBD patients 2 7. In England, Burr et al found the PCCRC-3yr in people with IBD was more than three times greater than the entire study cohort 8.…”

Section: Discussionmentioning

confidence: 93%

Validation of post-colonoscopy colorectal cancer (PCCRC) cases reported at national level following local root cause analysis: REFLECT study

Ahmad

Dhillon

Saunders

et al. 2022

Frontline Gastroenterol

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ObjectiveOur aim was to determine aetiology of post-colonoscopy colorectal cancers (PCCRCs) identified from population-based data through local root cause analysis at a high-volume mixed secondary and tertiary referral centre.Design/methodA subset of national cancer registration data, collected by the National Cancer Registration and Analysis Service, was used to determine PCCRCs diagnosed between 2005 and 2013 at our centre.Root cause analysis was performed for each identified PCCRC, using World Endoscopy Organisation recommendations, to validate it and assess most plausible explanation. We also assessed whether patient, clinician and/or service factors were primarily responsible.ResultsOf 107 ‘PCCRC’ cases provided from the national dataset, 20 were excluded (16 missing data, 4 duplicates). 87 ‘PCCRC’ cases were included of which 58 were true PCCRCs and 29 false PCCRCs.False PCCRCs comprised 17 detected cancers (cancer diagnosed within 6 months of negative colonoscopy) and 12 cases did not meet PCCRC criteria. Inflammatory bowel disease was the most common risk factor (18/58) and the most common site was rectum (19/58). The most common explanation was ‘possible missed lesion, prior examination negative but inadequate’ (23/58) and clinician factors were primarily responsible for PCCRC occurrence in most cases (37/58).ConclusionOur single-centre study shows, after local analysis, there was misclassification of PCCRCs identified from a population-based registry. The degree of such error will vary between registries. Most PCCRCs occurred in cases of sub-optimal examination as indicated by poor photodocumentation. Effective mechanisms to feedback root cause analyses are critical for quality improvement.

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Section: Discussionmentioning

confidence: 93%

Validation of post-colonoscopy colorectal cancer (PCCRC) cases reported at national level following local root cause analysis: REFLECT study

Ahmad

Dhillon

Saunders

et al. 2022

Frontline Gastroenterol

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“…In line with our previous study on risk of PCCRC among patients with inflammatory bowel disease, we defined the initial colonoscopy recorded in the DNPR as colonoscopy #1. 43 The first subsequent colonoscopy recorded more than 6 months after colonoscopy #1 was considered colonoscopy #2. In the same manner, we required colonoscopies #3, #4, and #5 to be recorded more than 6 months after colonoscopies number #2, #3, and #4, respectively.…”

Section: Methodsmentioning

confidence: 99%

Risk of a post-colonoscopy colorectal cancer in patients with type 2 diabetes: a Danish population-based cohort study

Troelsen

Sørensen

Pedersen

et al. 2021

BMJ Open Gastroenterol

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ObjectivePrevalent type 2 diabetes (T2D) is associated with an increased risk of colorectal cancer and could impair the quality of bowel preparation for colonoscopy. This may in turn increase the risk of overlooked precancerous polyps and subsequent risk of post-colonoscopy colorectal cancer (PCCRC). We investigated whether patients with T2D are at increased risk of PCCRC compared with patients without T2D.DesignWe conducted a population-based cohort study of patients with T2D and without T2D undergoing colonoscopy in Denmark (1995–2015). We investigated the risk of PCCRC by calculating >6 to 36 months cumulative incidence proportions (CIPs) treating death and colectomy as competing risks. Using Cox proportional-hazards regression analyses, we also computed HRs of PCCRC, comparing patients with T2D and non-T2D. According to the World Endoscopy Organization guidelines, we calculated PCCRC 3-year rates to estimate the proportions of T2D and non-T2D CRC patients experiencing PCCRC.ResultsWe identified 29 031 patients with T2D and 333 232 patients without T2D undergoing colonoscopy. We observed 250 PCCRCs among patients with T2D and 1658 PCCRCs among patients without T2D. The >6 to 36 months CIP after a first-time colonoscopy was 0.64% (95% CI 0.55% to 0.74%) for T2D and 0.36% (95% CI 0.34% to 0.38%) for patients without T2D. The HRs of PCCRC were 1.43 (95% CI 1.21 to 1.72) after a first-time colonoscopy and 1.18 (95% CI 0.75 to 1.85) after a second-time colonoscopy. The PCCRC 3-year rate was 7.9% for patients with T2D and 7.4% for patients without T2D.ConclusionT2D may be associated with an increased HR of PCCRC.

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“…Therefore, the recommended interval between colonoscopy screening is 1-3 years, depending on the condition of the lesions. 313 IBD intraepithelial neoplasia is classified as polypoid, nonpolypoid flat, and endoscopically invisible. 314…”

Section: Grade Of Recommendation: Amentioning

confidence: 99%

Chinese consensus on prevention of colorectal neoplasia (2021, Shanghai)

Fang¹

2022

J of Digest Diseases

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Most patients with colorectal cancer (CRC) were diagnosed in advanced stage and the prognosis is poor. Therefore, early detection and prevention of CRC are very important. As with other cancers, there is also the tertiary prevention for CRC. The primary prevention is etiological prevention, which is mainly the treatment of adenoma or inflammation for preventing the development into cancer. The secondary prevention is the early diagnosis and early treatment for avoiding progressing to advanced cancer. The tertiary prevention belongs to the broad category of prevention, mainly for advanced CRC, through surgical treatment and postoperative adjuvant chemotherapy, radiotherapy, targeted therapy, immunotherapy for preventing tumor recurrence or metastasis. This consensus is based on the recent domestic and international consensus guidelines and the latest progress of international researches

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Risk of a post-colonoscopy colorectal cancer diagnosis in patients with inflammatory bowel disease: a population-based cohort study

Cited by 17 publications

References 39 publications

Validation of post-colonoscopy colorectal cancer (PCCRC) cases reported at national level following local root cause analysis: REFLECT study

Validation of post-colonoscopy colorectal cancer (PCCRC) cases reported at national level following local root cause analysis: REFLECT study

Risk of a post-colonoscopy colorectal cancer in patients with type 2 diabetes: a Danish population-based cohort study

Chinese consensus on prevention of colorectal neoplasia (2021, Shanghai)

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