Prevalence, Clinicopathologic Characteristics, and Predictors of Interval Colorectal Cancers in Korean Population

Kim, Chang Joon; Jung, Yoon Suk; Park, Jung Ho; Kim, Hong Joo; Cho, Yong Kyun; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik; Lee, Shin Yeong; Kim, Hwa Mok; Bang, Ki Bae; Lee, Dong Hoon; Park, Dong Il

doi:10.5217/ir.2013.11.3.178

Cited by 16 publications

(12 citation statements)

References 30 publications

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“…However, this results show a relatively high proportion of interval cancer than previous our study (6.2%) 4. The higher proximal location rate of interval cancer (52%) was similar to that of previous studies, but only in univariate analysis 2,5,7,8.…”

Section: Discussionsupporting

confidence: 90%

Microsatellite Instability Status of Interval Colorectal Cancers in a Korean Population

Lee¹,

Park²,

Yang³

et al. 2016

Gut and Liver

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Background/AimsA subset of patients may develop colorectal cancer after a colonoscopy that is negative for malignancy. These missed or de novo lesions are referred to as interval cancers. The aim of this study was to determine whether interval colon cancers are more likely to result from the loss of function of mismatch repair genes than sporadic cancers and to demonstrate microsatellite instability (MSI).MethodsInterval cancer was defined as a cancer that was diagnosed within 5 years of a negative colonoscopy. Among the patients who underwent an operation for colorectal cancer from January 2013 to December 2014, archived cancer specimens were evaluated for MSI by sequencing microsatellite loci.ResultsOf the 286 colon cancers diagnosed during the study period, 25 (8.7%) represented interval cancer. MSI was found in eight of the 25 patients (32%) that presented interval cancers compared with 22 of the 261 patients (8.4%) that presented sporadic cancers (p=0.002). In the multivariable logistic regression model, MSI was associated with interval cancer (OR, 3.91; 95% confidence interval, 1.38 to 11.05).ConclusionsInterval cancers were approximately four times more likely to show high MSI than sporadic cancers. Our findings indicate that certain interval cancers may occur because of distinct biological features.

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Section: Discussionsupporting

confidence: 90%

Microsatellite Instability Status of Interval Colorectal Cancers in a Korean Population

Lee¹,

Park²,

Yang³

et al. 2016

Gut and Liver

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“…In the study by Kim et al, 8 the prevalence of interval cancer was 6.2% (30 cases among 482 patients). However, this result may be limited by referral, selection, and recall biases, as it was based on data obtained via telephone calls from a single tertiary referral center.…”

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confidence: 91%

“…Therefore, the prevalence and predictors of interval cancer in the Korean population have been undisclosed. In this regard, I read with great interest the study by Kim et al, 8 who are to be congratulated for their clinical study showing the prevalence, clinicopathological characteristics, and predictors of interval cancers in the Korean population. However, I have concerns about the study methodology and therefore the conclusions drawn.…”

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confidence: 99%

Interval Cancers after a Negative Colonoscopy Finding in a Korean Population: A Small Step for Gastroenterologists but One Giant Leap for Koreans

Myung

2014

Intest Res

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Kim et al. 8 also suggested that young age and right-side location were independent factors associated with interval cancer in a multivariate analysis. In a recent study from Canada, however, female sex, older age, and performance of the colonoscopy by a non-gastroenterologist were identified as predictors of interval cancers after a negative colonoscopy. 3,4Although other authors suggested the accelerated tumor biology in young patients as a cause of interval cancer, the authors of the Canadian studies 3,4 suggested that a deficiency in the quality of colonoscopic data rather than accelerated tumor biology was the cause of most of the interval cancers occurring after a negative colonoscopy. Furthermore, information on family CRC history or hereditary syndromes was not described by Kim et al.; therefore, their study might have been unable to evaluate the age impact on interval cancers, as young age in familial CRC may have a confounding effect on the interval cancer. As pointed out by the authors, it would be better if quality colonoscopic data such as bowel preparation, completeness, and adenoma detection rate, as well as qualifications of endoscopists, were assessed as predictors of the occurrence of interval cancers. Considering the wide variation in the detection rates of adenomas and serrated polyps between endoscopists, the quality of colonoscopic data should be stressed and assessed as a predictor of interval cancers. However, to answer these questions, a population-based cohort design with complete follow-up might be warranted.While we applaud the investigators for obtaining Korean

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“… 11 In a Manitoba Cancer Registry database, approximately 7.9% (approximately 1 in 13) of 4,833 CRCs were classified as missed cancers. 12 In Korea, the prevalence of interval cancer was reported to be 6.2% by Kim et al 24 ; however, this study was limited by referral bias, selection bias, and recall bias, as it was based on data obtained by telephone calls from a single tertiary referral center. Therefore, well-designed population studies are necessary to determine the prevalence of interval cancer in Korea.…”

Section: Prevalence Of Interval Cancersmentioning

confidence: 94%

“… 11 , 12 Table 1 summarizes the major findings of studies conducted since 2006 reflecting the prevalence of interval cancers. 8 , 11 , 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 Based on 57,839 patients from the Surveillance, Epidemiology, and End Results-Medicare database, 7.2% of patients developed interval cancers. 11 In a Manitoba Cancer Registry database, approximately 7.9% (approximately 1 in 13) of 4,833 CRCs were classified as missed cancers.…”

Section: Prevalence Of Interval Cancersmentioning

confidence: 99%

Colonoscopy Quality is the Answer for the Emerging Issue of Interval Cancer

Myung

2014

Intest Res

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Colonoscopy is currently regarded as the gold standard and preferred screening method for colorectal cancer (CRC). Recently, however, a limitation of colonoscopy in the prevention of CRCs has been identified, particularly in the right-sided colon, and the problem of so-called interval cancers has emerged. The prevalence of interval cancer is estimated to be between 4% and 8% of CRCs detected. Although the exact etiology of interval cancer remains unknown, factors implicated in the development of interval cancers include missed lesions at the time of colonoscopy, incomplete resection of previous neoplastic lesions, different tumor biology, and serrated pathway of carcinogenesis. However, recent evidence suggests that interval cancers are related to the training of the endoscopist and quality of the colonoscopy rather than tumor biology. Therefore, the importance of adequate training and continuous monitoring of the colonoscopy quality, which are amenable to improvement, cannot be overstated in order to prevent the risk of interval cancers. In this study, the current literature regarding the prevalence and potential factors related to interval cancers and colonoscopy quality-related issues are reviewed.

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Prevalence, Clinicopathologic Characteristics, and Predictors of Interval Colorectal Cancers in Korean Population

Cited by 16 publications

References 30 publications

Microsatellite Instability Status of Interval Colorectal Cancers in a Korean Population

Microsatellite Instability Status of Interval Colorectal Cancers in a Korean Population

Interval Cancers after a Negative Colonoscopy Finding in a Korean Population: A Small Step for Gastroenterologists but One Giant Leap for Koreans

Colonoscopy Quality is the Answer for the Emerging Issue of Interval Cancer

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