| Association between Endoscopist Volume and Interval Cancers after Colonoscopy: Results from the National Colorectal Cancer Screening Program in Korea |
Dong Jun Kim1,2
, Nan-He Yoon3, Jae Kwan Jun4,5, Mina Suh4,5, Sunhwa Lee4, Seongju Kim1,6, Ji Eun Kim7, Hooyeon Lee1,2,6
|
1Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Public Health, Graduate School, The Catholic University of Korea, Seoul, Korea
3Division of Social Welfare and Health Administration, Wonkwang University, Iksan, Korea
4National Cancer Control Institute, National Cancer Center, Goyang, Korea
5Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
6Department of Public Health and Healthcare Management, Graduate School, The Catholic University of Korea, Seoul, Korea
7Department of Medical Science, Soonchunhyang University Graduate School, Asan, Korea
|
|
|
|
Received: January 3, 2024; Accepted: April 15, 2024. Published online: April 16, 2024. |
|
|
|
| ABSTRACT |
Purpose
The rate of interval colorectal cancer (iCRC) is now accepted as a key performance indicator of organized colorectal cancer (CRC) screening programs. We aimed to examine the association between endoscopist volumes and the rate of iCRC among individuals with a positive fecal immunochemical test (FIT) within a nationwide population-based CRC screening program.
Materials and Methods
Individuals aged ≥50 years who underwent colonoscopy after a positive FIT from January 1, 2019 until December 31, 2020 in the Korean National Cancer Screening Program (KNCSP) were enrolled. We converted the data into per-endoscopist screening results, calculated the iCRC rates per endoscopist, and compared them to the previous year's annual volume that was divided into five groups (V1, 1–9; V2, 10–29; V3, 30–59; V4, 60–119; V5, ≥120).
Results
A total of 10,412 endoscopists performed 216,907 colonoscopies. Overall, the average rate of iCRC per endoscopist was 8.46 per 1,000 examinations. Compared with the group with the highest volume (V5 group), the rate of iCRC was 2.21 times higher in the V1 group. Similar trends were observed in the other groups (V2: Relative risks [RR], 2.15; 95% Confidence Interval [CI], 1.57–2.94; V3: RR, 1.56, 95% CI, 1.15–2.13; V4: RR, 1.18; 95% CI, 0.83–1.67).
Conclusion
The findings emphasize that endoscopists with lower procedure volumes have higher risks of interval cancer being missed or undetected. To maximize the preventative impact of colonoscopy for colorectal cancer, this issue should be addressed by monitoring endoscopist volumes and variations in performances. |
| Key words:
Colorectal neoplasms, Cancer screening, Quality management, Colonoscopy, Endoscopist volume, Interval cancers |
|
PDF Links
Full text via DOI
Download Citation 
