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Clin Colorectal Cancer. 2015 Mar;14(1):46-51. doi: 10.1016/j.clcc.2014.11.001. Epub 2014 Nov 15.

Interval colorectal cancer after colonoscopy.

Author information

1
Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: jrichter@mgh.harvard.edu.
2
Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Abstract

BACKGROUND:

As more patients are screened for colorectal cancer a small but significant number of interval cancers develop after colonoscopy for colorectal cancer screening.

MATERIALS AND METHODS:

We reviewed records of 75,314 adult patients who underwent colonoscopy for screening or diagnostic purposes between 1998 and 2006 inclusively, and identified 77 who developed interval cancers within the next 5 years. We reviewed their original endoscopic findings to determine the clinical and endoscopic factors that might predict a greater risk for future cancers.

RESULTS:

Patients aged ≥ 60 years had a higher risk of an interval neoplasm (P < .0001). Interval cancers were more common on the right side of the colon and in the hepatic flexure (both P < .0001). We did not observe an increased rate of interval cancers in patients with poor preparation (P = .799); however, examination completion rates did affect the rate of interval cancers (P = .016).

CONCLUSION:

Better identification of higher risk patients and assurance of follow-up examinations might increase the percentage of colon cancers discovered at an early stage. Special attention to careful examination of the right colon is key.

KEYWORDS:

Cancer screening; Colonoscopy; Colorectal cancer; Interval cancer; Quality

PMID:
25510180
DOI:
10.1016/j.clcc.2014.11.001
[Indexed for MEDLINE]

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