Post‐colonoscopy Colorectal Cancer

Colorectal cancer (CRC) is the third most common malignancy and the fourth leading cause of cancer-related deaths worldwide. Some people develop CRC after a colonoscopy in which cancer was not diagnosed, termed post-colonoscopy colorectal cancer (PCCRC). In this chapter, the authors review the epidemiology of PCCRCs, namely, the prevalence, outcomes, and risk factors. They outline a stepwise approach to identify the most common explanations in routine practice that could inform interventions for improving colonoscopy effectiveness. The authors consider disease burden and risk factors for patients with inflammatory bowel disease, a population in which PCCRC risk is elevated. They also describe how to calculate PCCRC rates to allow bench marking of performance and perform root cause analyses to try and find the reasons the cancers occur. Finally, the authors describe measures that can be introduced to try and reduce their incidence and improve the quality of colonoscopy.