Clinical–alimentary tractRates of New or Missed Colorectal Cancers After Colonoscopy and Their Risk Factors: A Population-Based Analysis
Section snippets
Materials and Methods
The Research Ethics Board of Sunnybrook and Women’s College Health Sciences Centre in Toronto, Ontario, Canada, approved this study.
Patient Characteristics
Between April 1, 1997, and March 31, 2002, we identified 31,074 patients with a diagnosis of CRC in the province of Ontario. The mean age was 69.3 ± 12.2 years; 14,356 (46.9%) were women. We excluded 4 patients <20 years old and 272 with inflammatory bowel disease. We excluded 4710 patients with CRC site classified as synchronous or “other.” The mean age of the “other” group was slightly greater at 70.7 years (standard deviation [SD] 12.3) compared with 69.0 years (SD 12.1) for the remaining
Discussion
In our study, the rate of new or missed CRC after colonoscopy in usual clinical practice was 2%–6%, depending on the site of the cancer. Given the widespread use of colonoscopy, an estimate of the accuracy of this procedure is essential. Approximately 150,000 people in the United States will be diagnosed with CRC in 2006.1 Based on our findings, approximately 5100 of these cancers would not be detected at the initial colonoscopy if all of these persons were to have the procedure. We found that
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L.R. is a senior investigator with the Cancer Quality Council of Ontario.