Delgado Galan Maria, Quintanilla Lazaro Elvira, Rabago Torre Luis Ramon
Department of Gastroenterology, Hospital Severo Ochoa, Leganes 28914, Madrid, Spain.
Department of Gastroenterology, San Rafael Hospital, Madrid 28016, Spain.
World J Gastrointest Endosc. 2025 Jul 16;17(7):107430. doi: 10.4253/wjge.v17.i7.107430.
Post-colonoscopic colorectal cancer (PCCRC), also known as interval CRC, is defined as CRC diagnosed more than six months after a colonoscopy in which no cancer was detected. It typically arises from missed lesions or incomplete resections and is now recognized as one of the most reliable quality indicators for assessing colonoscopy performance. With an incidence rate of 3.6% to 9.3%, PCCRC remains a significant concern, highlighting the limitations of colonoscopy in CRC screening-not only in terms of diagnostic accuracy but also in its preventive role and effectiveness in treating lesions. A range of clinical, endoscopic, and biological factors has been associated with an increased risk of PCCRC. Identifying these factors can help stratify high-risk patients, enabling earlier detection and improving preventive strategies for interval CRC. Reducing PCCRC should be a top priority for every endoscopy unit. While technological advancements will enhance polyp detection, minimize missed lesions, prevent incomplete resections, and improve overall procedural quality, the most impactful strategy remains internal self-assessment within each unit. This review should evaluate key performance metrics, including cecal intubation rate, adenoma detection rate, withdrawal time, PCCRC incidence, and incomplete resections-both at the individual endoscopist level and across the entire unit.
结肠镜检查后结直肠癌（PCCRC），也称为间期结直肠癌，定义为在结肠镜检查未发现癌症的情况下，六个月后诊断出的结直肠癌。它通常源于漏诊病变或切除不完全，现在被认为是评估结肠镜检查性能最可靠的质量指标之一。PCCRC的发病率为3.6%至9.3%，仍然是一个重大问题，凸显了结肠镜检查在结直肠癌筛查中的局限性——不仅在诊断准确性方面，而且在其预防作用和治疗病变的有效性方面。一系列临床、内镜和生物学因素与PCCRC风险增加有关。识别这些因素有助于对高危患者进行分层，从而实现早期检测并改进间期结直肠癌的预防策略。减少PCCRC应该是每个内镜检查单位的首要任务。虽然技术进步将提高息肉检测率、减少漏诊病变、防止切除不完全并提高整体操作质量，但最具影响力的策略仍然是各单位内部的自我评估。本综述应评估关键性能指标，包括盲肠插管率、腺瘤检出率、退镜时间、PCCRC发病率和切除不完全情况——包括个体内镜医师层面和整个单位层面。
