SYSTEMATIC REVIEW AND META-ANALYSIS: THE GLOBAL THREE-YEAR POST-COLONOSCOPY COLORECTAL CANCER RATE AS PER THE WORLD ENDOSCOPY ORGANIZATION METHODOLOGY

Aims Colorectal cancer (CRC) that occur after a negative colonoscopy is called post-colonoscopy colorectal cancer (PCCRC). Until recently, it has been difficult to compare global performance due to different methods used to define PCCRC rates. In 2018, the World Endoscopy Organization (WEO) standardised the methodology to calculate unadjusted PCCRC-3yr rates (PCCRC-3yr).

The PCCRC-3yr is a “false-negative” rate of CRC diagnosed by colonoscopy. A recent systematic review investigated PCCRC-3yr rates but included studies outside the WEO’s methodology. Therefore, the true global prevalence of PCCRC as per the WEO methodology remains unknown.

Methods We searched six databases for studies calculating the PCCRC-3yr rate using the WEO methodology. We performed a systematic review and meta-analysis to calculate the global PCCRC prevalence, change in prevalence over time and associated characteristics.

Results We identified four studies reporting 13,791 PCCRCs. The pooled PCCRC prevalence is 7.5% (95% CI=6.6-8.4%) with high heterogeneity (I²=98%).

Compared to the combined baseline year category of 2011-12, the odds of PCCRC occurrence were significantly higher in 2008–2010 (OR 1.12 (95% CI=1.01–1.24),p=0.03) and 2004–2007 (OR 1.19, 95% CI=1.06-1.33,p=0.03) with high heterogeneity.

Fig. 1

Patients with inflammatory bowel diseases (IBD) had a pooled PCCRC-3yr rate of 29.3% (95% CI=21.3–38.1%) and OR of 6.17 (95% CI=1.06-1.33) with high heterogeneity. The pooled PCCRC-3yr rate in the right colon was 8.6% (95% CI=8.3–8.8%), OR 1.51 (95% CI=1.41-1.61) compared to left-sided disease.

Conclusions The global pooled PCCRC prevalence was 7.5%, with rates reducing overtime. IBD patients have over six times higher odds than those without for developing PCCRC.

Publication History

Article published online:
14 April 2022