{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:07:43Z","timestamp":1789553263877,"version":"build-2803163510"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"DOI":"10.13039\/100013791","name":"Bowel Cancer UK","doi-asserted-by":"crossref","award":["19PG0033"],"award-info":[{"award-number":["19PG0033"]}],"id":[{"id":"10.13039\/100013791","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"crossref","award":["C23434\/A23706"],"award-info":[{"award-number":["C23434\/A23706"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Post-colonoscopy colorectal cancer (PCCRC) represents a potential missed opportunity to diagnose or prevent colorectal cancer (CRC). This study aimed to create a standardized, nationwide audit system to determine why PCCRCs occur and to generate evidence to aid prevention.<\/jats:p>\n                  <jats:p>Methods PCCRCs occurring 6\u201348 months after colonoscopy were identified from English national datasets and uploaded to a secure portal. The portal contained case review forms based on World Endoscopy Organization (WEO) recommendations for PCCRC review. National Health Service colonoscopy providers (n\u200a=\u200a126) were asked to review \u2264\u200a25 PCCRCs. The data were analyzed to determine the characteristics of and reasons for PCCRC.<\/jats:p>\n                  <jats:p>Results Of 2859 PCCRCs, 1724 (60.3\u200a%) were reviewed. Colonoscopies were mostly performed for symptoms (59.2\u200a%) or surveillance (26.5\u200a%). PCCRCs were more common at the hepatic and splenic flexures and transverse colon compared with detected CRCs. PCCRC WEO categorizations were: possible missed lesion, examination adequate 68\u200a%; possible missed lesion, examination inadequate 18\u200a%; detected lesion, not resected 9\u200a%; and likely incompletely resected lesion 5\u200a%. Overall, 69.0\u200a% of PCCRCs were avoidable and 44.2\u200a% led to harm, including premature death in 8.0\u200a%. Non-procedural reasons contributed to 27.1\u200a% of PCCRCs: patient factors 10.2\u200a%; clinical decision making 9.5\u200a%; and administrative factors 7.4\u200a%.<\/jats:p>\n                  <jats:p>Conclusions This is the largest detailed PCCRC review to date. The majority of PCCRCs were avoidable and caused significant harm. This study clarifies the causes of diagnostic delays and highlights high-risk patients and areas of the colon, and suggests what needs to be done to reduce PCCRC in the future.<\/jats:p>","DOI":"10.1055\/a-2681-5642","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T22:52:11Z","timestamp":1754952731000},"page":"251-261","source":"Crossref","is-referenced-by-count":3,"title":["A national audit of 1724 post-colonoscopy colorectal cancers: understanding causes and consequences"],"prefix":"10.1055","volume":"58","author":[{"given":"Nicholas","family":"Burr","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Mid Yorkshire Teaching Hospitals NHS Trust, Wakefield, United Kingdom"},{"name":"Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Beaton","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Trudgill","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sandwell and West Birmingham NHS Trust, West Bromwich, United Kingdom"},{"name":"Institute of Cancer and Genomic Studies, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Toowoomba Hospital, Toowoomba, Queensland, Australia"},{"name":"University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tameera","family":"Rahman","sequence":"additional","affiliation":[{"name":"Health Data Insight, Cambridge, United Kingdom"},{"name":"National Disease Registration Service, NHS England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"McPhail","sequence":"additional","affiliation":[{"name":"National Disease Registration Service, NHS England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Wood","sequence":"additional","affiliation":[{"name":"Health Data Insight, Cambridge, United Kingdom"},{"name":"National Disease Registration Service, NHS England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Rutter","sequence":"additional","affiliation":[{"name":"Gastroenterology, University Hospital of North Tees, Stockton on Tees, United Kingdom"},{"name":"Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Valori","sequence":"additional","affiliation":[{"name":"Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva J. A.","family":"Morris","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"PCCRC Audit Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1136\/gutjnl-2015-310912","article-title":"Global patterns and trends in colorectal cancer incidence and mortality","volume":"66","author":"M Arnold","year":"2017","journal-title":"Gut"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1136\/gut.2010.229575","article-title":"A population-based comparison of the survival of patients with colorectal cancer in England, Norway and Sweden between 1996 and 2004","volume":"60","author":"E JA Morris","year":"2011","journal-title":"Gut"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"l6090","DOI":"10.1136\/bmj.l6090","article-title":"Variation in post-colonoscopy colorectal cancer across colonoscopy providers in English National Health Service: population based cohort study","volume":"367","author":"N E Burr","year":"2019","journal-title":"BMJ"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1053\/j.gastro.2018.05.038","article-title":"World Endoscopy Organization consensus statements on post-colonoscopy and post-imaging colorectal cancer","volume":"155","author":"M D Rutter","year":"2018","journal-title":"Gastroenterology"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1111\/apt.18003","article-title":"Diagnostic yield from symptomatic lower gastrointestinal endoscopy in the UK: a British Society of Gastroenterology analysis using data from the National Endoscopy Database","volume":"59","author":"D Beaton","year":"2024","journal-title":"Aliment Pharmacol Ther"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1053\/j.gastro.2019.12.031","article-title":"Causes of post-colonoscopy colorectal cancers based on World Endoscopy Organization system of analysis","volume":"158","author":"R Anderson","year":"2020","journal-title":"Gastroenterology"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1055\/a-2443-0332","article-title":"Application of duty of candour legislation in post-colonoscopy colorectal cancer: a prospective cohort study","volume":"57","author":"E Saunsbury","year":"2025","journal-title":"Endoscopy"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1136\/bmjqs-2023-016932","article-title":"Quantifying the cost savings and health impacts of improving colonoscopy quality: an economic evaluation","volume":"34","author":"S McCarthy","year":"2025","journal-title":"BMJ Qual Saf"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1136\/flgastro-2022-102145","article-title":"UK endoscopy workload and workforce patterns: is there potential to increase capacity? 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