Affiliation:
1. Gastroenterology Department Hospital General Universitario Dr. Balmis Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) Departamento de Medicina Clínica, Universidad Miguel Hernández Alicante Spain
2. Gastroenterology Department Hospital Universitario de Torrevieja Torrevieja Spain
3. Gastroenterology Department Hospital Universitario Vega Baja Orihuela Spain
4. Gastroenterology Department Hospital Universitario de San Juan San Juan de Alicante Spain
5. Gastroenterology Department Hospital Universitario Marina Baixa Villajoyosa Spain
6. Gastroenterology Department Hospital Universitario del Vinalopó Elche Spain
7. Gastroenterology Department Hospital General Universitario de Elche Elche Spain
8. Gastroenterology Department Hospital Virgen de Los Lírios Alcoy Spain
9. Gastroenterology Department Hospital General Universitario de Elda Elda Spain
10. Clinical Pharmacology Unit Hospital General Universitario Dr. Balmis Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) Universidad Miguel Hernández IDIBE CIBERehd Alicante Spain
Abstract
AbstractBackgroundPost‐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.
Funder
Instituto de Salud Carlos III
Subject
Gastroenterology,Oncology