{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:48:15Z","timestamp":1759366095825,"version":"build-2065373602"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Post-endoscopy esophageal adenocarcinomas (PEEC) challenge timely diagnosis of esophageal adenocarcinomas (OAs). This study aimed to determine prevalence of PEECs in Auckland region and elucidate the most plausible causes through a root-cause analysis framework.<\/jats:p><jats:p>OA cases diagnosed in Auckland from 2013 to 2022 were retrieved from the New Zealand Cancer Registry (NZCR). Electronic clinical data were collected via the Regional Clinical Portal software. The primary outcome was PEEC prevalence, defined as OA diagnosed 6 to 36 months following an esophagogastroduodenoscopy (EGD) that failed to detect the cancer. Identified PEECs were classified into six categories.<\/jats:p><jats:p>Among 633 OA cases, 45 (7.1%) were PEECs. A higher prevalence of PEEC was observed in patients with Barrett\u2019s esophagus (BE) (18.1% vs 2.7%), undergoing surveillance EGDs (52.6% vs 3.6%) and with early-stage cancers. Root-cause analysis delineated the PEEC causes, classified as follows: A (17.8%): lesion was identified, endoscopic assessment was adequate, follow-up was appropriately planned and executed, yet PEEC developed; B (17.8%): follow-up was delayed due to administrative factors; C (22.2%): follow-up decisions were inappropriate; D (22.2%): inadequate endoscopic assessment; E (11.1%): lesion was unidentified despite adequate assessment; and F (8.9%): lesion was unidentified and assessment was inadequate. Categories B, C, D, and F comprised 71.1% of cases deemed potentially avoidable.<\/jats:p><jats:p>Auckland\u2019s PEEC prevalence aligns with international post-endoscopy upper gastrointestinal cancer rates. Root-cause analysis underscores that a significant proportion of PEECs may be preventable with improved clinical practice.<\/jats:p>","DOI":"10.1055\/a-2676-3883","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T23:31:53Z","timestamp":1754350313000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Post-endoscopy esophageal adenocarcinoma and root cause analysis in Auckland, New Zealand"],"prefix":"10.1055","volume":"13","author":[{"given":"Seong","family":"Shin","sequence":"additional","affiliation":[{"name":"Gastroenterology, Te Whatu Ora Health New Zealand Waitemata, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongyeon","family":"Kang","sequence":"additional","affiliation":[{"name":"Gastroenterology, Te Whatu Ora Health New Zealand Waitemata, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell S","family":"Walmsley","sequence":"additional","affiliation":[{"name":"Gastroenterology, North Shore Hospital, Auckland, New Zealand"},{"name":"Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2893","DOI":"10.1002\/ijc.25516","article-title":"Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008","volume":"127","author":"J Ferlay","year":"2010","journal-title":"Int J Cancer"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1093\/ejcts\/ezx430","article-title":"T1N0 oesophageal cancer: patterns of care and outcomes over 25 years","volume":"53","author":"M Kamel","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"issue":"01","key":"ref5","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1111\/j.1572-0241.1999.00767.x","article-title":"Esophageal Cancer","volume":"94","author":"CJ Lightdale","year":"1999","journal-title":"Am J Gastroenterol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1055\/a-1675-4136","article-title":"Prevalence and risk factors of upper gastrointestinal cancers missed during endoscopy: a nationwide registry-based study","volume":"54","author":"W Januszewicz","year":"2022","journal-title":"Endoscopy;"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1055\/a-1917-0192","article-title":"A root cause analysis system to establish the most plausible explanation for post-endoscopy upper gastrointestinal cancer","volume":"55","author":"U Kamran","year":"2023","journal-title":"Endoscopy"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"E46","DOI":"10.1055\/s-0034-1365524","article-title":"How commonly is upper gastrointestinal cancer missed at endoscopy? 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