OC-061 Rates Of Post Colonoscopy Colorectal Cancer (pccrc) Are Significantly Affected By Methodology, But Are Nevertheless Declining In The Nhs: Abstract OC-061 Table 1

Abstract

0.50, 0.80; 10 studies) (figure below), while 0.38 preferred TOE over SE (95% CI: -0.04, 0.80; 3 studies). Conclusion There is no difference between TOE and SE in terms of technical success rate and preference. Success rate of TNE <6 mm in diameter is equivalent to SE, but majority of patients prefer the former over the latter. Hence, TNE (<6 mm in diameter) should be the procedure of choice for screening. Introduction It is recognised that post-colonoscopy colorectal cancer (PCCRC) can be due to missed cancer, or cancer arising from missed or incompletely removed polyps. Thus the rate of post-colonoscopy colorectal cancer (PCCRC) should become a key quality indicator of colonoscopy. A quality indicator should be relevant to patients, clearly defined, standardised, and measurable over time and have a target to aim for. This study compares methods for defining PCCRC rates, proposes a method that best meets these criteria and explores rates over time.Methods Information on all individuals with a primary colorectal cancer and prior colonoscopic investigations in England between 2001 and 2010 was extracted from the National Cancer Data Repository. Previously published methods (Bressler, Cooper, Singh and leClerc) for deriving PCCRC rates were applied to these data to investigate the effect on the rate. A new method, based on the year of the colonoscopy, not CRC diagnosis, is proposed. Results Of 297,956 individuals diagnosed with colorectal cancer in the study period a total of 94,648 underwent a colonoscopy in the 3 years prior to their diagnosis. The table illustrates how application of the published methods and exclusion criteria to the dataset produces significantly different PCCRC rates from 2.4 to 7.8%:

Implementing quality improvement programs for colonoscopy: the emerging need for an international, standardized, multidisciplinary approach

“…A significant variation exists in the performance of endoscopists and of endoscopy units 3 . In colonoscopy, rates of cecal intubation, adenoma detection, and post-colonoscopy colorectal cancer (an indicator of overlooked or incompletely excised premalignant or malignant lesions) vary considerably between units 4 , raising concerns about the quality of some services. These differences only come to light when performance is measured, without which there is no opportunity to support individuals or for endoscopy services to improve.…”