The research is the largest and most detailed review of post-colonoscopy colorectal cancers (PCCRCs) to date. It analysed 1,724 cases across 126 NHS hospitals in England and found that nearly 70% of these cancers were avoidable. Almost half (44%) of patients experienced harm as a result of delayed diagnosis, including premature death in 8% of cases.
Over 35,000 colorectal cancers are diagnosed in England each year, with the vast majority of these diagnosed through colonoscopies delivered within the NHS. When cancer is diagnosed at an early stage, treatment is more effective and long-term survival is substantially improved so it is a priority to increase rates of early diagnosis in the NHS.
Colonoscopy is a vital test used both to diagnose bowel cancer and to prevent it by removing pre-cancerous growths. However, some cancers still occur after a previous colonoscopy. These PCCRCs represent a missed opportunity to catch disease earlier or prevent it altogether.
Until now, reviews of such cases in England have been inconsistent and incomplete. This new audit, funded by Bowel Cancer UK, Cancer Research UK, Health Data Research UK and the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, created the first national system for identifying PCCRCs and understanding why they arise.
By linking cancer registry and hospital records, the study was able to capture cases even when diagnosis and original colonoscopy took place at different hospitals. Local clinical teams then reviewed each case using a standardised template based on international guidelines.
Read the full story on the Nuffield Department of Population Health website.