SP1.1.6Incidence of post colonoscopy colorectal cancer, are we compliant with national guidelines?

Abstract

Abstract Aims To investigate the incidence of post colonoscopy colorectal cancer (PCCRC) at a district NHS trust and assess compliance with UK key performance indicators and quality assurance standards for colonoscopy guidelines endorsed by JAG and the ACPGBI Methods We conducted a retrospective review of our trust colorectal MDT database to identify patients diagnosed with colorectal cancer in the period between January 2016 till June 2019 who underwent a colonoscopy within 6-36 month prior to their diagnosis with colorectal cancer. Patient demographics, indication of colonoscopy, date of cancer diagnosis, procedure related factors such as quality of bowel preparation, presence of diverticular disease, prior history of inflammatory bowel disease, previously diagnosed polyps and also grade of endoscopist were extrapolated. Results 1323 patients were diagnosed with colorectal cancer during the study period, out of these there were 111 patients who underwent a colonoscopy within 6-36 month prior to their diagnostic colonoscopy. After exclusion of cases with anastomotic recurrence (n = 2) and cases with no PCCRC (n = 82), there were 27 patients with confirmed PCCRC in accordance with WEO classification (PCCRC 2.8%, acceptable target 5%) Upon review of the 27 cases with PCCRC, there was equal gender distribution while the majority were 71-80 years old. There was evidence of diverticular disease in 44% and previous colonic polyps in 48%. The quality of bowel preparation was recorded as good in 25 cases while grade of endoscopist was consultant (n = 24), associate specialist (n = 1), nurse endoscopist (n = 2) Conclusions The incidence of PCCRC in our trust falls within national guidelines.