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Gastroenterology. 2018 Sep;155(3):909-925.e3. doi: 10.1053/j.gastro.2018.05.038. Epub 2018 Jun 27.

World Endoscopy Organization Consensus Statements on Post-Colonoscopy and Post-Imaging Colorectal Cancer.

Author information

1
University Hospital of North Tees, Stockton-on-Tees, UK; Northern Institute for Cancer Research, Newcastle University, UK. Electronic address: matt.rutter@nth.nhs.uk.
2
University Hospital of North Tees, Stockton-on-Tees, UK.
3
Gloucestershire Hospitals National Health Service Foundation Trust, Gloucestershire, UK.
4
National Taiwan University Hospital, Taiwan.
5
San Francisco Medical Center, Kaiser Permanente Division of Research, San Francisco, California.
6
Hospital Clínic and Tumour Bank-Biobank, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
7
Academic Medical Center, Amsterdam, The Netherlands.
8
Institution of Medicine Solna Karolinska Institutet, Stockholm, Sweden.
9
EuropaColon, Salisbury, UK.
10
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology, Bremen Institute for Prevention Research and Social Medicine, Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany.
11
The Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland.
12
Cancer Screening Center, National Cancer Center Hospital, Tokyo.
13
Netherlands Cancer Institute, Amsterdam, The Netherlands; University Medical Center Utrecht, Utrecht, The Netherlands.
14
Leeds Institute of Cancer and Pathology, University of Leeds, St James's Institute of Oncology, St James's University Hospital, Leeds, UK.
15
University College London, London, UK.
16
Cancer Care Ontario, University of Toronto, Toronto, Ontario, Canada.
17
Veterans Affairs Medical Center, White River Junction, Vermont; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
18
University of Pittsburgh, Pittsburgh, Pennsylvania.
19
University of Manitoba, Winnipeg, Manitoba, Canada.
20
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
21
Flinders University, Adelaide, Australia.
22
Maastricht University Medical Center, Maastricht, The Netherlands.

Abstract

BACKGROUND & AIMS:

Colonoscopy examination does not always detect colorectal cancer (CRC)- some patients develop CRC after negative findings from an examination. When this occurs before the next recommended examination, it is called interval cancer. From a colonoscopy quality assurance perspective, that term is too restrictive, so the term post-colonoscopy colorectal cancer (PCCRC) was created in 2010. However, PCCRC definitions and methods for calculating rates vary among studies, making it impossible to compare results. We aimed to standardize the terminology, identification, analysis, and reporting of PCCRCs and CRCs detected after other whole-colon imaging evaluations (post-imaging colorectal cancers [PICRCs]).

METHODS:

A 20-member international team of gastroenterologists, pathologists, and epidemiologists; a radiologist; and a non-medical professional met to formulate a series of recommendations, standardize definitions and categories (to align with interval cancer terminology), develop an algorithm to determine most-plausible etiologies, and develop standardized methodology to calculate rates of PCCRC and PICRC. The team followed the Appraisal of Guidelines for Research and Evaluation II tool. A literature review provided 401 articles to support proposed statements; evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The statements were voted on anonymously by team members, using a modified Delphi approach.

RESULTS:

The team produced 21 statements that provide comprehensive guidance on PCCRCs and PICRCs. The statements present standardized definitions and terms, as well as methods for qualitative review, determination of etiology, calculation of PCCRC rates, and non-colonoscopic imaging of the colon.

CONCLUSIONS:

A 20-member international team has provided standardized methods for analysis of etiologies of PCCRCs and PICRCs and defines its use as a quality indicator. The team provides recommendations for clinicians, organizations, researchers, policy makers, and patients.

KEYWORDS:

AGREE II; CT Colonography; Colonoscopy; Quality Measures

PMID:
29958856
DOI:
10.1053/j.gastro.2018.05.038
[Indexed for MEDLINE]
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