ArticleBMJ (Clinical research ed.)2019
Variation in post-colonoscopy colorectal cancer across colonoscopy providers in English National Health Service: population based cohort study.
Article in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 7 of them syntheses that pooled it.
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Who cites it
59 citing papers in PubMed, 7 syntheses or guidelines pooled it, 139 citations in OpenAlex.
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- Linked color imaging versus conventional white-light colonoscopy for the detection of colorectal polyps.The Cochrane database of systematic reviews · 2025Pooled it
- Quality indicators for colonoscopy.Gastrointestinal endoscopy · 2024Guideline
- Prevalence and Progression of Incidental Terminal Ileitis on Non-diagnostic Colonoscopy: A Systematic Review and Meta-analysis.Journal of Crohn's & colitis · 2021Pooled it
- Outcomes at follow-up of negative colonoscopy in average risk population: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- Occurrence of Colorectal Cancer After a Negative Colonoscopy in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis.In vivo (Athens, Greece)Pooled it
- Trial
- Defining post-colon capsule endoscopy colorectal cancer (pCCECRC)-an International Capsule Endoscopy Research (iCARE) group consensus statement.Surgical endoscopy · 2026Article
- Faecal haemoglobin-based referral and investigation prioritisation is associated with colorectal cancer-specific survival in symptomatic patients: a retrospective observational study.British journal of cancer · 2026Observational
- Indicators to identify cancer screening providers with suboptimal case detection: A scoping review.International journal of cancer · 2026Article
- Optimizing colonoscopy-based colorectal cancer screening by low-barrier, low-threshold pretesting.International journal of cancer · 2026Article
- Clinical features of post-colonoscopy colorectal cancer and real-world multi-scale correlation analysis.World journal of gastrointestinal surgery · 2026Article
- Development of a national root cause analysis system for post-endoscopy upper gastrointestinal cancer.Endoscopy international open · 2026Article
- Multicenter study of colon capsule endoscopy in post-polypectomy surveillance.Endoscopy international open · 2026Article
- Patient priorities and decision-making process when choosing between colonic investigation alternatives: a qualitative interview study.BMJ open gastroenterology · 2025Observational
- Observational
- Quantifying the cost savings and health impacts of improving colonoscopy quality: an economic evaluation.BMJ quality & safety · 2025Article
- Case-mix-adjusted mean number of polyps per 100 procedures: a new candidate gold standard colonoscopy key performance indicator.BMJ open gastroenterology · 2025Article
- Multicentre Study of 10,369 Symptomatic Patients Comparing the Diagnostic Accuracy of Colon Capsule Endoscopy, Colonoscopy and CT Colonography.Alimentary pharmacology & therapeutics · 2025Article
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesTo quantify post-colonoscopy colorectal cancer (PCCRC) rates in England by using recent World Endoscopy Organisation guidelines, compare incidence among colonoscopy providers, and explore associated factors that could benefit from quality improvement initiatives.
designPopulation based cohort study.
settingNational Health Service in England between 2005 and 2013. POPULATION: All people undergoing colonoscopy and subsequently diagnosed as having colorectal cancer up to three years after their investigation (PCCRC-3yr).
main outcome measuresNational trends in incidence of PCCRC (within 6-36 months of colonoscopy), univariable and multivariable analyses to explore factors associated with occurrence, and funnel plots to measure variation among providers.
resultsThe overall unadjusted PCCRC-3yr rate was 7.4% (9317/126 152), which decreased from 9.0% in 2005 to 6.5% in 2013 (P<0.01). Rates were lower for colonoscopies performed under the NHS bowel cancer screening programme (593/16 640, 3.6%), while they were higher for those conducted by non-NHS providers (187/2009, 9.3%). Rates were higher in women, in older age groups, and in people with inflammatory bowel disease or diverticular disease, in those with higher comorbidity scores, and in people with previous cancers. Substantial variation in rates among colonoscopy providers remained after adjustment for case mix.
conclusionsWide variation exists in PCCRC-3yr rates across NHS colonoscopy providers in England. The lowest incidence was seen in colonoscopies performed under the NHS bowel cancer screening programme. Quality improvement initiatives are needed to address this variation in rates and prevent colorectal cancer by enabling earlier diagnosis, removing premalignant polyps, and therefore improving outcomes.
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