Abstract

BACKGROUND & AIMS:

Colonoscopy examination does not always detect colorectal cancer (CRC)- some patients develop CRC after negative findings from an examination. When this occurs before the next recommended examination, it is called interval cancer. From a colonoscopy quality assurance perspective, that term is too restrictive, so the term post-colonoscopy colorectal cancer (PCCRC) was created in 2010. However, PCCRC definitions and methods for calculating rates vary among studies, making it impossible to compare results. We aimed to standardize the terminology, identification, analysis, and reporting of PCCRCs and CRCs detected after other whole-colon imaging evaluations (post-imaging colorectal cancers [PICRCs]).

背景与目的：结肠镜检查并非完全可以检测结直肠癌（CRC）-一些患者在检查结果为阴性后，发生结直肠癌。当在下一次推荐检查之前出现这种情况，称其为间隔癌。从结肠镜检查质量保证的角度来看，该术语限制性太强，因此于2010年创建了术语—结肠镜检查后结肠直肠癌（PCCRC）。但是，PCCRC定义和计算发生率的方法因研究而异，因此无法比较结果。我们的目标是标准化其他全结肠成像评估后检测到的PCCRCs和CRC的术语，鉴定，分析和报告（成像后结直肠癌[PICRCs]）。

METHODS:

A 20-member international team of gastroenterologists, pathologists, and epidemiologists; a radiologist; and a non-medical professional met to formulate a series of recommendations, standardize definitions and categories (to align with interval cancer terminology), develop an algorithm to determine most-plausible etiologies, and develop standardized methodology to calculate rates of PCCRC and PICRC. The team followed the Appraisal of Guidelines for Research and Evaluation II tool. A literature review provided 401 articles to support proposed statements; evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The statements were voted on anonymously by team members, using a modified Delphi approach.

方法：由20名成员组成的国际胃肠病学家，病理学家和流行病学家团队、；放射科医师以及非医学专业人员会面，来制定一系列建议、标准化定义和类别（与间隔癌症术语一致），开发算法以确定最合理的病因，并制定标准化方法来计算PCCRC和PICRC的比率。该团队遵循了“评估研究和评估指南II”工具。文献综述提供了401篇文章来支持提议的声明；使用GRADE（建议评估，发展和评估等级）系统对证据进行评级。这些声明是由团队成员使用改进的德尔菲方法匿名投票的。

RESULTS:

The team produced 21 statements that provide comprehensive guidance on PCCRCs and PICRCs. The statements present standardized definitions and terms, as well as methods for qualitative review, determination of etiology, calculation of PCCRC rates, and non-colonoscopic imaging of the colon.

结果：该小组编写了21份声明，为PCCRC和PICRC提供全面指导。这些声明提供了标准化的定义和术语，以及定性评价的方法，病因学的确定，PCCRC率的计算以及结肠的非结肠镜检查。

CONCLUSIONS:

A 20-member international team has provided standardized methods for analysis of etiologies of PCCRCs and PICRCs and defines its use as a quality indicator. The team provides recommendations for clinicians, organizations, researchers, policy makers, and patients.