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Interval cancers after colonoscopy—insights and recommendations

Nature Reviews Gastroenterology & Hepatology volume 9, pages 550554 (2012) | Download Citation

Abstract

Several studies have raised warnings about the limited effectiveness of colonoscopy for the prevention of colorectal cancer (CRC), especially of the proximal colon. Two major categories of factors might be responsible for the development of interval cancers, namely technical, endoscopist-dependent factors and biological characteristics of the cancer that lead to more rapid tumour progression. Recognition of endoscopist-dependent factors is critical, as these factors are probably amenable to correction through improved awareness and education of endoscopists, using quality metrics (such as adenoma detection rates and cecal intubation rates) for objective evaluation and feedback. In this article, the current literature regarding the incidence of, and potential explanations for, interval CRCs is outlined. Although there is probably an interaction between technical and biology-related factors—and an attempt to dissect the biology from the technology might be fraught with difficulties—a structured analysis of individual cases of interval cancer might help in the continuous monitoring of the quality of colonoscopy, and ultimately might reduce the number of interval CRCs.

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Acknowledgements

G. A. Meijer receives research support from the Center for Translational Molecular Medicine (www.ctmm.nl).

Author information

Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands

    • Silvia Sanduleanu
    •  & Ad M. Masclee
  2.  Department of Pathology, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB Amsterdam, The Netherlands

    • Gerrit A. Meijer

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Contributions

S. Sanduleanu contributed to all aspects of this manuscript. A. Masclee and G. A. Meijer contributed equally to the discussion of content and reviewing/editing of the manuscript.

Competing interests

S. Sanduleanu declares that she is a consultant for, on the speakers bureau and receives grant/research support from Pentax Nederland B.V. A. Masclee receives grant/research support from Pentax Ned-erland B.V. G. Meijer receive grant/research support and is a con-sultant for the Center for Translational Molecular Medicine.

Corresponding author

Correspondence to Silvia Sanduleanu.

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DOI

https://doi.org/10.1038/nrgastro.2012.136

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