P2113 - Very Low Rate of Post-Colonoscopy Colorectal Cancer in Individuals at Average-Risk for Colorectal Cancer

Award: Presidential Poster Award

Ala I. Sharara, MD, FACG, Christian Sadaka, MD, Saleem Halablab, MD, Mohamad Ali Ibrahim, MD, Ayman Tawil, MD, Zakaria El Kouzi, MD
American University of Beirut, Beirut, Beyrouth, Lebanon

Introduction: Colorectal cancer (CRC) accounts for around 10% of cancer diagnoses and cancer-related deaths worldwide. Post-colonoscopy colorectal cancers (PCCRC-3y) is characterized by the detection of CRC between 6 and 36 months after an initial colonoscopy. Our study aims to report PCCRC-3y rates at the American University of Beirut Medical Center (AUBMC) in Lebanon. This study also proposes a novel adjusted PCCRC-3y rate (PCCRC_a-3y) calculation criteria tailored to average risk patients which provides a more accurate and reproducible standardized benchmark while minimizing heterogeneity.

Methods: We calculated PCCRC-3y rate at our institution by matching data on CRC patients (Jan 2010-Jun 2021) and colonoscopies (Jan 2007-Dec 2020). To further calculate an adjusted PCCRC (PCCRC_a-3y), we excluded those at higher-than-average risk of CRC. For CRC, we excluded those that were < 45 or >80 years-of-age and those with history of CRC, inflammatory bowel disease, hereditary non-polyposis colorectal cancer, and colonic metastasis from non-GI malignancy.

Results: We analyzed a total of 852 CRC cases and 30161 colonoscopies over our study period. After cross-referencing, we located 5 cases of PCCRC-3y (Table 1). For further analysis, we included 391 CRC and 19341 colonoscopies after excluding higher-risk cases for PCCRC_a-3y calculation using the mentioned criteria. Of the previously identified 5 PCCRC-3y cases, one PCCRC_a-3y would be included. Subsequently, the calculated rate of PCCRC-3y at our institution would be 5/30161 and rate of PCCRC_a-3y would be 1/19,341. In addition, PCCRC-3y accounted for 5/852 (0.59%) of all CRC diagnosed at our institution and 1/391 (0.26%) for average-risk patients.

Discussion: This study reports one of the lowest rates of PCCRC-3y in published literature. It is worth to mention that the adenoma detection rate is 40.1% at AUBMC. Reporting rate using PCCRC_a-3y would be a more accurate, clinically significant, standardized, and reproducible value, as most patients undergoing screening colonoscopies are at average-risk of CRC.



Disclosures:


Ala I. Sharara, MD, FACG, Christian Sadaka, MD, Saleem Halablab, MD, Mohamad Ali Ibrahim, MD, Ayman Tawil, MD, Zakaria El Kouzi, MD. P2113 - Very Low Rate of Post-Colonoscopy Colorectal Cancer in Individuals at Average-Risk for Colorectal Cancer, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.