Post-colonoscopy colorectal cancers in a national fecal immunochemical test-based colorectal cancer screening program.

Autor:	Wisse PHA; Gastroenterology and Hepatology, Erasmus MC, Rotterdam, Netherlands., de Boer SY; Gastroenterology and Hepatology, Bevolkingsonderzoek Nederland, Rotterdam, Netherlands., Oudkerk Pool M; Gastroenterology and Hepatology, Bevolkingsonderzoek Nederland, Rotterdam, Netherlands., Terhaar Sive Droste JS; Gastroenterology and Hepatology, Bevolkingsonderzoek Nederland, Rotterdam, Netherlands., Verveer C; Gastroenterology and Hepatology, Bevolkingsonderzoek Nederland, Rotterdam, Netherlands., Meijer GA; Pathology, Netherlands Cancer Institute, Amsterdam, Netherlands., Dekker E; Gastroenterology and Hepatology, Amsterdam UMC Location AMC, Amsterdam, Netherlands., Spaander MCW; Gastroenterology and Hepatology, Erasmus MC, Rotterdam, Netherlands.
Jazyk:	angličtina
Zdroj:	Endoscopy [Endoscopy] 2024 May; Vol. 56 (5), pp. 364-372. Date of Electronic Publication: 2023 Dec 15.
DOI:	10.1055/a-2230-5563
Abstrakt:	Background: Post-colonoscopy colorectal cancers (PCCRCs) decrease the effect of colorectal cancer (CRC) screening programs. To enable PCCRC incidence reduction in the long-term, we classified PCCRCs diagnosed after colonoscopies performed in a fecal immunochemical test (FIT)-based screening program. Methods: PCCRCs diagnosed after colonoscopies performed between 2014-2016 for a positive FIT in the Dutch CRC screening program were included. PCCRCs were categorized according to the World Endoscopy Organization consensus statement into (a) interval PCCRC (diagnosed before the recommended surveillance); (b) non-interval type A (diagnosed at the recommended surveillance interval); (c) non-interval type B (diagnosed after the recommended surveillance interval); or (d) non-interval type C (diagnosed after the intended recommended surveillance interval, with surveillance not implemented owing to co-morbidity). The most probable etiology was determined by root-cause analysis. Tumor stage distributions were compared between categories. Results: 116362 colonoscopies were performed after a positive FIT with 9978 screen-detected CRCs. During follow-up, 432 PCCRCs were diagnosed. The 3-year PCCRC rate was 2.7%. PCCRCs were categorized as interval (53.5%), non-interval type A (14.6%), non-interval type B (30.6%), and non-interval type C (1.4%). The most common etiology for interval PCCRCs was possible missed lesion with adequate examination (73.6%); they were more often diagnosed at an advanced stage (stage III/IV; 53.2%) compared with non-interval type A (15.9%; P <0.001) and non-interval type B (40.9%; P =0.03) PCCRCs. Conclusions: The 3-year PCCRC rate was low in this FIT-based CRC screening program. Approximately half of PCCRCs were interval PCCRCs. These were mostly caused by missed lesions and were diagnosed at a more advanced stage. This emphasizes the importance of high quality colonoscopy with optimal polyp detection. Competing Interests: P. Wisse has received consulting fees from the National Institute for Public Health and Environment for the evaluation of biobank development for the storage of samples of participants of the Dutch colorectal cancer screening program. G.A. Meijer is co-founder and a board member (CSO) of CRCbioscreen BV; he has a research collaboration with CZ Health Insurances (cash matching to ZonMW grant) and research collaborations with Exact Sciences, Sysmex, Sentinel Ch. SpA, Personal Genome Diagnostics (PGDX), DELFi, and Hartwig Medical Foundation; these companies provide materials, equipment and/or sample/genomic analyses. E. Dekker has endoscopic equipment on loan from Olympus and Fujifilm, and has received a research grant from Fujifilm; she has received honorarium for consultancy from Fujifilm, Tillots, Olympus, GI Supply, Cancer Prevention Pharmaceuticals, PAION, and Ambu, and speakers’ fees from Olympus, Roche, GI Supply, Norgine, IPSEN, PAION, and Fujifilm. M.C.W. Spaander has received research support from Sentinel, Sysmex, Norgine, and Medtronic. S.Y. de Boer, M. Oudkerk Pool, J.S. Terhaar sive Droste, and C. Verveer declare that they have no conflicts of interest. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)
Databáze:	MEDLINE
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