Interval Colorectal Cancer After Colonoscopy: Exploring Explanations and Solutions

Area of Science:

• Gastroenterology
• Oncology
• Preventive Medicine

Background:

• Colorectal cancer (CRC) screening, particularly colonoscopy, has significantly reduced CRC incidence and mortality.
• Despite its effectiveness, colonoscopy is not perfectly sensitive, leading to interval post-colonoscopy CRC (PCCRC).

Purpose of the Study:

• To review the epidemiology of interval PCCRC.
• To identify common explanations for PCCRC, including missed, new, or incompletely resected lesions.
• To explore prevention strategies for interval PCCRC.

Main Methods:

• Literature review focusing on studies investigating the frequency and causes of interval PCCRC.
• Analysis of factors contributing to PCCRC, such as lesion detection and resection.
• Exploration of current and future prevention opportunities.

Main Results:

• Interval PCCRC remains a concern, with missed lesions, new lesions, and incomplete resections being primary contributors.
• Adherence to quality colonoscopy standards is crucial for prevention.
• Technological advancements and improved training are key future strategies.

Conclusions:

• Improving colonoscopy quality is essential to minimize interval PCCRC.
• Future prevention efforts should focus on enhanced visualization, complete resection techniques, and continuous quality improvement in training and practice.