{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T13:10:04Z","timestamp":1773839404575,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2022,1,5]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Our aim was to determine aetiology of post-colonoscopy colorectal cancers (PCCRCs) identified from population-based data through local root cause analysis at a high-volume mixed secondary and tertiary referral centre.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design\/method<\/jats:title>\n                  <jats:p>A subset of national cancer registration data, collected by the National Cancer Registration and Analysis Service, was used to determine PCCRCs diagnosed between 2005 and 2013 at our centre.<\/jats:p>\n                  <jats:p>Root cause analysis was performed for each identified PCCRC, using World Endoscopy Organisation recommendations, to validate it and assess most plausible explanation. We also assessed whether patient, clinician and\/or service factors were primarily responsible.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 107 \u2018PCCRC\u2019 cases provided from the national dataset, 20 were excluded (16 missing data, 4 duplicates). 87 \u2018PCCRC\u2019 cases were included of which 58 were true PCCRCs and 29 false PCCRCs.<\/jats:p>\n                  <jats:p>False PCCRCs comprised 17 detected cancers (cancer diagnosed within 6 months of negative colonoscopy) and 12 cases did not meet PCCRC criteria. Inflammatory bowel disease was the most common risk factor (18\/58) and the most common site was rectum (19\/58). The most common explanation was \u2018possible missed lesion, prior examination negative but inadequate\u2019 (23\/58) and clinician factors were primarily responsible for PCCRC occurrence in most cases (37\/58).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our single-centre study shows, after local analysis, there was misclassification of PCCRCs identified from a population-based registry. The degree of such error will vary between registries. Most PCCRCs occurred in cases of sub-optimal examination as indicated by poor photodocumentation. Effective mechanisms to feedback root cause analyses are critical for quality improvement.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2021-102016","type":"journal-article","created":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T13:25:59Z","timestamp":1643030759000},"page":"374-380","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Validation of post-colonoscopy colorectal cancer (PCCRC) cases reported at national level following local root cause analysis: REFLECT study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-3545","authenticated-orcid":false,"given":"Ahmir","family":"Ahmad","sequence":"first","affiliation":[{"name":"St Mark's Hospital, Wolfson Unit for Endoscopy, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8074-0962","authenticated-orcid":false,"given":"Angad","family":"Dhillon","sequence":"additional","affiliation":[{"name":"St Mark's Hospital, Wolfson Unit for Endoscopy, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4190-7448","authenticated-orcid":false,"given":"Brian P","family":"Saunders","sequence":"additional","affiliation":[{"name":"St Mark's Hospital, Wolfson Unit for Endoscopy, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3991-1015","authenticated-orcid":false,"given":"Misha","family":"Kabir","sequence":"additional","affiliation":[{"name":"St Mark's Hospital, Wolfson Unit for Endoscopy, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8922-6249","authenticated-orcid":false,"given":"Siwan","family":"Thomas-Gibson","sequence":"additional","affiliation":[{"name":"St Mark's Hospital, Wolfson Unit for Endoscopy, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,1,24]]},"reference":[{"key":"2025090708202065000_13.5.374.1","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 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