CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(05): E717-E727
DOI: 10.1055/a-0751-2660
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Post-colonoscopy colorectal cancer in Belgium: characteristics and influencing factors

Elisabeth Macken
1   Gastroenterology & Hepatology, Antwerp University Hospital, Edegem, Antwerp, Belgium
Stefan Van Dongen
2   Evolutionary Ecology Group, Department of Biology, University of Antwerp, Antwerp, Belgium
Isabel De Brabander
3   Belgian Cancer Registry, Brussels, Belgium
Sven Francque
1   Gastroenterology & Hepatology, Antwerp University Hospital, Edegem, Antwerp, Belgium
Ann Driessen
4   Pathology, Antwerp University Hospital, Edegem, Antwerp, Belgium
Guido Van Hal
5   Medical Sociology and Health Policy, University of Antwerp, Antwerp, Belgium
› Author Affiliations
Further Information

Publication History

submitted 30 May 2018

accepted after revision 04 September 2018

Publication Date:
08 May 2019 (online)


Background and study aims Post-colonoscopy colorectal cancer (PCCRC) is an important quality parameter of colonoscopy. Most studies have shown that the risk for colorectal cancer is reduced after an index colonoscopy for screening or diagnostic purposes with or without polypectomy. In this study, we aimed to quantify and describe PCCRC in Belgium, including the possible relationships with patient, physician, and colonoscopy characteristics.

Patients and methods Reimbursement data on colorectal related medical procedures from the Intermutualistic Agency (IMA-AIM) were linked with data on clinical and pathological staging of colorectal cancer (CRC) available at the Belgian Cancer Registry (BCR) over a period covering 9 years (2002 – 2010).

Results In total, 63 518 colorectal cancers were identified in 61 616 patients between 2002 and 2010. We calculated a mean PCCRC rate of 7.6 %. PCCRC was significantly higher in older people and correlated significantly with polyp detection rate and the number of resections and procedures performed per year per physician. Conditional observed survival, given still alive 3 years since first colonoscopy, for PCCRC was worse than for CRC. Older patients and patients with invasive carcinomas had a worse outcome.

Conclusions Although no quality register exists in Belgium, we were able to demonstrate that PCCRC in Belgium is directly related to the experience of the physician performing the procedure. In the absence of a quality register, utilization of population-based data sources proved to be a valuable tool to identify quality parameters.

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