Post-colonoscopy colorectal cancer (PCCRC) rates vary considerably depending on the method used to calculate them: a retrospective observational population-based study of PCCRC in the English National Health Service

ObjectivePost-colonoscopy colorectal cancer (PCCRC) is a key quality indicator of colonoscopy. This study compares methods for defining PCCRC rates, proposes a new method of calculating them and quantifies them across the English National Health Service (NHS).DesignThis retrospective observational p...

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Vydáno v:Gut Ročník 64; číslo 8; s. 1248 - 1256
Hlavní autoři: Morris, Eva J A, Rutter, Matthew D, Finan, Paul J, Thomas, James D, Valori, Roland
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ Publishing Group LTD 01.08.2015
BMJ Publishing Group
Edice:Original article
Témata:
Aged
Aged, 80 and over
Codes
Colonoscopy
Colorectal cancer
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - epidemiology
Datasets
Disease
Endoscopy
England - epidemiology
Female
Health risk assessment
Health services
Hospitals
Humans
Incidence
Investigations
Linked Data
Male
Medical diagnosis
Medical screening
Methods
Middle Aged
National Health Programs - statistics & numerical data
Quality
Retrospective Studies
Time Factors
Tumors
England
United Kingdom > UK
COLONOSCOPY
COLORECTAL CANCER
ISSN:0017-5749, 1468-3288, 1468-3288
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Shrnutí:ObjectivePost-colonoscopy colorectal cancer (PCCRC) is a key quality indicator of colonoscopy. This study compares methods for defining PCCRC rates, proposes a new method of calculating them and quantifies them across the English National Health Service (NHS).DesignThis retrospective observational population-based study involved all individuals with a first primary diagnosis of colorectal cancer made between 2001 and 2010 and treated in the English NHS. Previously published methods for deriving PCCRC rates were applied to the linked routine health data for this population to investigate the effect on the rate. A new method, based on the year of the colonoscopy rather than colorectal cancer diagnosis, was then used to calculate PCCRC rates.ResultsOf 297 956 individuals diagnosed with colorectal cancer, a total of 94 648 underwent a colonoscopy in the 3 years prior to their diagnosis. The application of the published methods and exclusion criteria to the dataset produced significantly different PCCRC rates from 2.5% to 7.7%. The new method demonstrates that PCCRC rates within 3 years of colonoscopy (without exclusions) decreased in the English NHS over 8 years, falling from 10.6% to 7.3% for colonoscopies performed in 2001 and 2007 respectively.ConclusionsThe method used to determine PCCRC rates significantly affects findings with potential to substantially underestimate rates. To enable international benchmarking there needs to be a standardised method for defining PCCRC. This study proposes a new methodology using colonoscopy as a denominator and between 2001 and 2007 this method indicated an 8.6% PCCRC rate across the English NHS. It also demonstrated PCCRC rates have fallen over time.
Bibliografie:ObjectType-Article-1
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ISSN:0017-5749
1468-3288
1468-3288
DOI:10.1136/gutjnl-2014-308362