Delgado Galan M, Quintanilla Lazaro E, Rabago Torre LR. Postcolonoscopy colorectal cancer: What we need to know in the age of screening and magnifying endoscopy techniques. World J Gastrointest Endosc 2025; 17(7): 107430 [DOI: 10.4253/wjge.v17.i7.107430]
Corresponding Author of This Article
Luis Ramon Rabago Torre, MD, PhD, Department of Gastroenterology, San Rafael Hospital, Street Serrano 199, Madrid 28016, Spain. lrabagot@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jul 16, 2025; 17(7): 107430 Published online Jul 16, 2025. doi: 10.4253/wjge.v17.i7.107430
Postcolonoscopy colorectal cancer: What we need to know in the age of screening and magnifying endoscopy techniques
Maria Delgado Galan, Elvira Quintanilla Lazaro, Luis Ramon Rabago Torre
Maria Delgado Galan, Elvira Quintanilla Lazaro, Department of Gastroenterology, Hospital Severo Ochoa, Leganes 28914, Madrid, Spain
Luis Ramon Rabago Torre, Department of Gastroenterology, San Rafael Hospital, Madrid 28016, Spain
Author contributions: Delgado Galan M was responsible for preparing the initial draft of the manuscript, conducting the literature review, and composing the text in Spanish; Quintanilla Lazaro E revised the draft, contributed additional ideas, and restructured the manuscript using EndNote; Rabago Torre LR performed the final revision, completed the initial translation into English, and responded to the reviewers’ suggestions.
Conflict-of-interest statement: We do not have any conflict-of-interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Luis Ramon Rabago Torre, MD, PhD, Department of Gastroenterology, San Rafael Hospital, Street Serrano 199, Madrid 28016, Spain. lrabagot@gmail.com
Received: March 24, 2025 Revised: April 10, 2025 Accepted: June 7, 2025 Published online: July 16, 2025 Processing time: 108 Days and 8.9 Hours
Abstract
Post-colonoscopic colorectal cancer (PCCRC), also known as interval CRC, is defined as CRC diagnosed more than six months after a colonoscopy in which no cancer was detected. It typically arises from missed lesions or incomplete resections and is now recognized as one of the most reliable quality indicators for assessing colonoscopy performance. With an incidence rate of 3.6% to 9.3%, PCCRC remains a significant concern, highlighting the limitations of colonoscopy in CRC screening—not only in terms of diagnostic accuracy but also in its preventive role and effectiveness in treating lesions. A range of clinical, endoscopic, and biological factors has been associated with an increased risk of PCCRC. Identifying these factors can help stratify high-risk patients, enabling earlier detection and improving preventive strategies for interval CRC. Reducing PCCRC should be a top priority for every endoscopy unit. While technological advancements will enhance polyp detection, minimize missed lesions, prevent incomplete resections, and improve overall procedural quality, the most impactful strategy remains internal self-assessment within each unit. This review should evaluate key performance metrics, including cecal intubation rate, adenoma detection rate, withdrawal time, PCCRC incidence, and incomplete resections—both at the individual endoscopist level and across the entire unit.
Core Tip: Post-colonoscopy colorectal cancer (PCCRC) remains the most reliable parameter for assessing colonoscopy quality, as it reflects its effectiveness in diagnosing and preventing colorectal cancer. More than 80% of cases are attributed to preventable factors, making their reduction a key challenge for endoscopy units. While technological advancements will enhance procedural quality, the most crucial step in reducing PCCRC is the continuous evaluation of endoscopy units to identify limitations and implement targeted improvement strategies.
