Research presented at the American College of Gastroenterology, conducted at the American University of Beirut Medical Center (AUBMC) offers insights into postcolonoscopy colorectal cancers (PCCRC-3y) and proposes a novel method for calculating adjusted PCCRC-3y rates (PCCRCa-3y) tailored to average-risk patients. 

Ala I. Sharara, MD, was named an Outstanding Poster Presenter and the poster received a Presidential Poster Award.

Colorectal cancer (CRC) remains a significant global health challenge, accounting for approximately 10% of cancer diagnoses and deaths worldwide. PCCRC-3y refers to CRCs detected between 6 and 36 months after a colonoscopy, often attributed to missed lesions or incomplete resections. This study aimed to establish PCCRC-3y rates at AUBMC while introducing an adjustment methodology for more accurate benchmarking. 

Researchers analyzed 852 CRC cases and 30,161 colonoscopies conducted between January 2010 and June 2021. Using this dataset, the unadjusted PCCRC-3y rate was calculated as 5/30,161. To refine this measure, researchers excluded higher-risk patients—such as those under 45 or over 80 years old and individuals with a history of CRC, inflammatory bowel disease, hereditary nonpolyposis colorectal cancer, or colonic metastases. Applying these criteria reduced the pool to 391 CRC cases and 19,341 colonoscopies, resulting in a PCCRCa-3y rate of 1/19,341. 

The study also highlighted that PCCRC-3y accounted for 0.59% of all CRC cases at AUBMC and just 0.26% of cases among average-risk patients. Notably, AUBMC’s high adenoma detection rate of 40.1% likely contributes to these low PCCRC rates. 

The researchers advocate for adopting PCCRCa-3y in future analyses to provide standardized and clinically meaningful benchmarks. Such adjustments are particularly relevant for screening populations predominantly composed of average-risk individuals, ensuring more reliable comparisons across institutions. 

Reference

Sharara AI, Sadaka C, Saleem Halablab, Ibrahim MA, Tawil A, Zakaria El Kouzi. Very low rate of post-colonoscopy colorectal cancer in individuals at average-risk for colorectal cancer. The American Journal of Gastroenterology. 2024;119(10S):S318-S319. doi:https://doi.org/10.14309/01.ajg.0001031172.24396.95