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These cancers may have been overlooked at the time of colonoscopy or developed rapidly during the window between colonoscopies and are therefore referred to as "missed" colorectal cancers. The three- to five-year timeframe is well inside the ten years recommended between colonoscopies for colorectal cancer screening in the general public, as well as the five years indicated for people at increased risk.
The research results were published online in the journal Gastroenterology.
"Not only did we find that colonoscopy isn't perfect, we discovered a number of factors associated with these 'missed' cancers," said
The missed cancers were also more likely to appear in the right side of the colon, at the far end of the colonoscope's reach. "Our first thought was that perhaps doctors did not view the entire colon, or that preparation for the procedure was not complete, which would obscure their view," said Samadder. "However, the medical records of the patients with missed cancers showed these problems were seldom present."
The study integrated information about colonoscopies performed at
While the term 'missed' may indicate that cancer or precancerous polyps were present but not seen, the category also includes cancers that had no visible evidence at the time of colonoscopy but developed rapidly afterward. According to Samadder, "Cancers in the right side are often biologically different than those in other parts of the colon, arising from different types of polyps. These types of polyps are flatter and faster growing, which may explain why they are not seen during colonoscopy as well as how a cancer could develop even when no polyps were visible."
The study showed that in
Many organizations, such as the
"This is not entirely a quality of care issue," Samadder said. "Our findings implicate genetic and biological issues associated with having previous polyps and having a family history of colorectal cancer."
Samadder's research team currently has funding from the
Keywords for this news article include: Cancer, Surgery, Genetics, Oncology, Gastroenterology, Gastrointestinal Endoscopy,
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