A large population-based study from a Dutch colorectal cancer screening program found that short-term risk of post-colonoscopy colorectal cancer (PCCRC) is driven more by endoscopist performance than by the presence of high-risk polyps. Following more than 239,000 participants between 2014 and 2020, researchers discovered no association between high-risk polyp features and the likelihood of developing cancer within three years. Instead, endoscopist quality metrics, particularly adenoma detection rate (ADR) and proximal serrated polyp detection rate (PSPDR), were strongly protective. Each one-point increase in ADR reduced the risk of PCCRC by 6%, while each one-point increase in PSPDR lowered it by 8%. Patients examined by high-performing endoscopists had the lowest rates of post-colonoscopy cancer, even if they had high-risk polyps, while those with low-performing endoscopists faced the highest risk—even when their polyps were considered low risk.

Source: Clinical Gastroenterology & Hepatology