444 Post Colonoscopy Colorectal Cancer, Are We Compliant? A Year in Review

Post Colonoscopy Colorectal Cancer (PCCRC) is defined as a Colorectal Cancer (CRC) that is diagnosed after a colonoscopy in which no cancer was found.

Aim

To identify the incidence of PCCRC at a district hospital trust and to check our compliance with national guidance (audit against Joint Advisory Group on GI Endoscopy standards). We review the performance in our second cycle and take lessons forward.

Method

Phase 1 collected data from January 2016 to June 2019 following approval. Patients with colorectal cancer were identified from the MDT pathway. Those newly diagnosed with CRC who had colonoscopy within 6-36 months prior to their diagnosis were included. Patients with appendiceal tumours, anal SCC, small bowel GIST, carcinoid tumours or those who had surveillance endoscopies were excluded. Hospital records were used to collect data retrospectively on patient demographics and comorbid diseases. Phase 2 collected data from 01/09/2021 to 01/09/2022 with similar criteria.

Results

The first phase of the study identified 1334 patients. Those not meeting the inclusion criteria as set out from the World Endoscopy Organisation (WEO), or those with non-primary CRC were excluded. Histologically confirmed CRC from phase one yielded 1323 cases. The rate of PCCRC according to the WEO classification was 3%. Phase 2 identified 330 patients with histologically proven CRC, the rate of PCCRC in phase 2 was a marginal decrease to 2%.

Conclusions

Our rate of PCCRC is compliant with national guidance, however key learning points and recommendations are drawn to help NHS services to reach national targets and improve care.