Postcolonoscopy colorectal cancers


Postcolonoscopy colorectal cancers were more likely to arise in the proximal colon and to show microsatellite instability.



In all, 64% of postcolonoscopy colorectal cancers were located in the proximal colon, compared with 44% of detected colorectal cancers.



Microsatellite instability (MSI) was detected in 32% of postcolonoscopy colorectal cancers, versus 13% of detected colorectal cancers.



Postcolonoscopy cancers have an estimated global prevalence ranging from 3% to 9% and an estimated pooled prevalence of 3.7%.



Risk factors for postcolonoscopy colorectal cancers include low adenoma detection rates, rural facilities, and care by physicians who are not gastroenterologists. 



Tumor-specific and patient-specific factors, including location within the colon and superior survival, compared with detected cancers, raises the possibility of underlying molecular differences related to tumorigenesis.



In a study comparing  84 postcolonoscopy colorectal cancers (defined as those detected within 6-60 months of colonoscopy) with with 84 detected colorectal cancers (detected within 6 months of a colonoscopy).



MSI was the only molecular feature that was significantly more frequent in postcolonoscopy versus detected colorectal cancers.



However, postcolonoscopy colorectal cancers were significantly more likely to be early stage (86% versus 69% for detected colorectal cancers.



Five-year survival did not significantly differ between the groups.







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