Risk of post-colonoscopy colorectal cancer in Denmark: time trends and comparison with Sweden and the English National Health Service

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  • Lasse Pedersen, Aalborg Univ Hosp, Aalborg University, Dept Surg Gastroenterol
  • ,
  • Roland Valori, Gloucestershire Hosp, Dept Gastroenterol
  • ,
  • Inge Bernstein, Aalborg Univ Hosp, Aalborg University, Dept Surg Gastroenterol
  • ,
  • Karen Lindorff-Larsen, Aalborg Univ Hosp, Aalborg University, NordSim Ctr Skills Training & Simulat
  • ,
  • Charlotte Green
  • Christian Torp-Pedersen, Aalborg Univ, Aalborg University, Dept Hlth Sci & Technol

Background The post-colonoscopy colorectal cancer (PCCRC) rate is a key quality indicator for colonoscopy. Previously published PCCRC rates have been difficult to compare owing to differences in methodology. The primary aim of this study was to compare Danish PCCRC rates internationally and to calculate Danish PCCRC rates using the World Endoscopy Organization (WEO) consensus method for future comparison. The secondary aim was to identify factors associated with PCCRC.

Methods National registries were used to examine the risk of PCCRC. The Danish 3-year rate of PCCRC (PCCRC-3yr) was calculated using previously published methods from England, Sweden, and the WEO. Poisson regression analysis was performed to identify factors associated with PCCRC.

Results The Danish PCCRC-3yr was significantly higher than the rate in the English NHS (relative risk [RR] 1.12, 95% confidence interval [CI] 1.05-1.19) and Sweden (RR 1.15, 95%CI 1.06-1.24). The Danish PCCRC-3yr based on the WEO consensus method fell from 22.5% in 2001 to 7.9% in 2012.The multivariable Poisson regression model found PCCRC to be significantly associated with diverticulitis (RR 3.25, 95%CI 2.88-3.66), ulcerative colitis (RR 3.44, 95%CI 2.79-4.23), hereditary cancer (age = 60 years: RR 3.81, 95%CI 2.74-5.31), and location in the transverse (RR 1.57, 95%CI 1.28-1.94) and ascending colon (RR 1.85, 95%CI 1.64-2.08).

Conclusions The PCCRC-3yr was higher in Denmark than in comparable countries. Differences in colonoscopist training, background, and certification are possible contributing factors. A review of colonoscopist training and certification in Denmark, and continuous audit and feedback of colonoscopist performance may reduce PCCRC-3yr.

Sider (fra-til)733-741
Antal sider9
StatusUdgivet - aug. 2019

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