Recent findings published in the journal Endoscopy have found that 69% of post-colonoscopy colorectal cancers (PCCRCs) could have been prevented. The paper, entitled “National root-cause analysis of 1724 post-colonoscopy colorectal cancers demonstrates avoidable harm”, summarise the findings from the PCCRC audit carried out by a team including Dr Roland Valori, Dr Nicholas Burr and co-authors from the PCCRC project team including Tameera Rahman and Natasha Wood from HDI.
1,724 cases of PCCRCs (colorectal cancer diagnosed between 6 and 48 months after a colonoscopy that did not detect cancer) were reviewed by 122 NHS colonoscopy providers across England.
The findings revealed that:
- 69% of PCCRCs were avoidable
- 44% of cases caused moderate to severe harm to the patient, or premature death
- PCCRCs were most common in difficult-to-examine areas of the bowel (the flexures and transverse colon)
- Contributing factors were not just related to the colonoscopy – patient, clinical decision-making, and administrative issues played a role in over a quarter of PCCRC cases
This study is the largest of its kind to date. It highlights procedural shortcomings, training needs, and system delays, providing critical insights for reducing PCCRCs and improving early cancer detection. This understanding can help guideline setting bodies and frontline teams to improve practice and processes leading to better outcomes for patients.