Risk factors for advanced lesions undetected at prior colonoscopy: not always poor preparation

Abstract

Failure to detect advanced neoplasia is common in a community-based endoscopy facility. Previously undetected advanced lesions are more frequently found in the left colon and rectum. Risk factors for non-detection of advanced adenoma are similar to those for advanced neoplasia recurrence. Lowering non-detection rates is crucial for correct follow-up recommendations. Patients should be aware of rates of detection of advanced neoplasia after previous normal colonoscopic findings.

Evidence for accelerated colorectal adenoma–carcinoma progression inMUTYH-associated polyposis?

“…Although colonoscopy is the gold standard for colonic examinations, studies have shown that even advanced lesions may remain undetected 24. However, even if some of the lesions were missed lesions, the risk of developing CRC is still considerable.…”

Miss rate of colorectal neoplastic polyps and risk factors for missed polyps in consecutive colonoscopies

“…Cecal intubation, adequate bowel preparation, and a colonoscopic withdrawal time of 6 minutes or more are suggested to ensure complete removal of polyps and improvement of polyp detection based on previous studies 78. Despite these efforts, it has been reported that a significant number of polyps are missed during surveillance colonoscopy,91011121314151617 thereby leading to the development of interval cancers from the missed neoplastic polyps 18. Based on several tandem or consecutive colonoscopy studies,912131415 the miss rate of polyps is reported to be 16.8% to 28%.…”

Evaluación de dos estrategias de cribado de cáncer colorrectal: test inmunológico versus test bioquímico. Cataluña, 2008-2010

“…La tasa de detección depende de factores como el test utilizado, la preparación efectuada para la limpieza intestinal y a la experiencia de los profesionales en la realización de colonoscopias 26 , por lo que es necesario auditar todos estos criterios y garantizar que el programa cumpla con los estándares de calidad. En nuestro caso, el mismo equipo de gastroenterólogos realizó las colonoscopias, independientemente del tipo de TSOH, por lo que el aumento observado en la tasa de detección es atribuible básicamen-te al tipo de test.…”