Incidence, characteristics, and predictive factors of post-colonoscopy colorectal cancer.

Autor: Baile-Maxía S; 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., Mangas-Sanjuan C; 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., Sala-Miquel N; 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., Barquero C; Gastroenterology Department, Hospital Universitario de Torrevieja, Torrevieja, Spain., Belda G; Gastroenterology Department, Hospital Universitario Vega Baja, Orihuela, Spain., García-Del-Castillo G; Gastroenterology Department, Hospital Universitario de San Juan, San Juan de Alicante, Spain., García-Herola A; Gastroenterology Department, Hospital Universitario Marina Baixa, Villajoyosa, Spain., Penalva JC; Gastroenterology Department, Hospital Universitario del Vinalopó, Elche, Spain., Picó MD; Gastroenterology Department, Hospital General Universitario de Elche, Elche, Spain., Poveda MJ; Gastroenterology Department, Hospital Virgen de Los Lírios, Alcoy, Spain., de-Vera F; Gastroenterology Department, Hospital General Universitario de Elda, Elda, Spain., Zapater P; Clinical Pharmacology Unit, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, IDIBE, CIBERehd, Alicante, Spain., Jover R; 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.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2024 Apr; Vol. 12 (3), pp. 309-318. Date of Electronic Publication: 2024 Jan 17.
DOI: 10.1002/ueg2.12512
Abstrakt: Background: Post-colonoscopy colorectal cancer (PCCRC) is colorectal cancer (CRC) diagnosed after a colonoscopy in which no cancer is found.
Objective: As PCCRC has become an important quality indicator, we determined its rates, characteristics, and index colonoscopy-related predictive factors.
Methods: We 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.
Results: One 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.
Conclusions: In 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.
(© 2023 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
Databáze: MEDLINE
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