University Hospital of North Tees, Stockton-on-Tees, UK; Northern Institute for Cancer Research, Newcastle University, UK.
University Hospital of North Tees, Stockton-on-Tees, UK.
Gastroenterology. 2018 Sep;155(3):909-925.e3. doi: 10.1053/j.gastro.2018.05.038. Epub 2018 Jun 27.
BACKGROUND & AIMS: Colonoscopy examination does not always detect colorectal cancer (CRC)- some patients develop CRC after negative findings from an examination. When this occurs before the next recommended examination, it is called interval cancer. From a colonoscopy quality assurance perspective, that term is too restrictive, so the term post-colonoscopy colorectal cancer (PCCRC) was created in 2010. However, PCCRC definitions and methods for calculating rates vary among studies, making it impossible to compare results. We aimed to standardize the terminology, identification, analysis, and reporting of PCCRCs and CRCs detected after other whole-colon imaging evaluations (post-imaging colorectal cancers [PICRCs]).
A 20-member international team of gastroenterologists, pathologists, and epidemiologists; a radiologist; and a non-medical professional met to formulate a series of recommendations, standardize definitions and categories (to align with interval cancer terminology), develop an algorithm to determine most-plausible etiologies, and develop standardized methodology to calculate rates of PCCRC and PICRC. The team followed the Appraisal of Guidelines for Research and Evaluation II tool. A literature review provided 401 articles to support proposed statements; evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The statements were voted on anonymously by team members, using a modified Delphi approach.
The team produced 21 statements that provide comprehensive guidance on PCCRCs and PICRCs. The statements present standardized definitions and terms, as well as methods for qualitative review, determination of etiology, calculation of PCCRC rates, and non-colonoscopic imaging of the colon.
A 20-member international team has provided standardized methods for analysis of etiologies of PCCRCs and PICRCs and defines its use as a quality indicator. The team provides recommendations for clinicians, organizations, researchers, policy makers, and patients.
结肠镜检查并非总能检测出结直肠癌（CRC）-一些患者在检查结果为阴性后会发展为 CRC。如果这种情况发生在下一次推荐检查之前，就称为间隔期癌症。从结肠镜质量保证的角度来看，这个术语过于局限，因此 2010 年创造了“结肠镜检查后结直肠癌（PCCRC）”一词。然而，PCCRC 的定义和计算发生率的方法在不同的研究中存在差异，使得结果无法进行比较。我们旨在标准化 PCCRC 和其他全结肠影像学检查后发现的 CRC（影像学后结直肠癌[PICRC]）的术语、识别、分析和报告。
由 20 名国际胃肠病学家、病理学家和流行病学家、一名放射科医生和一名非医学专业人员组成的团队开会制定了一系列建议，标准化了定义和类别（与间隔期癌症的术语保持一致），制定了一个确定最可能病因的算法，并制定了标准化方法来计算 PCCRC 和 PICRC 的发生率。该团队遵循了《评估研究和评估 II 工具指南》。文献综述提供了 401 篇文章，以支持提出的声明；使用 GRADE（推荐评估、制定和评估分级）系统对证据进行了评估。团队成员使用修改后的 Delphi 方法匿名投票表决。
该团队提出了 21 项关于 PCCRC 和 PICRC 的全面指导声明。这些声明提出了标准化的定义和术语，以及定性审查、病因确定、PCCRC 发生率计算和结肠非结肠镜成像的方法。
一个由 20 名成员组成的国际团队提供了标准化的方法来分析 PCCRC 和 PICRC 的病因，并将其定义为质量指标。该团队为临床医生、组织、研究人员、政策制定者和患者提供了建议。
