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New research published showing variation in post colonoscopy colorectal cancer (PCCRC) rates
15 November 2019

New research has been published in the British Medical Journal (BMJ) which shows significant variation between English endoscopy services in the ability of colonoscopy to detect bowel cancer. This is a key measure of endoscopy performance and the results will require detailed analysis to learn lessons and support quality improvement. Performance on this measure has improved over the time of the study and reducing this variation, and lowering rates further, will enable cancers to be prevented or diagnosed at an earlier stage. This research enables hospitals to understand their PCCRC rates for the first time and to identify where improvements can be made to reduce the rate in the future.

The data relates to colonoscopies performed from 2005-2013 and several initiatives to improve colonoscopy have been introduced since this time. As part of the accreditation pathway JAG asks services to audit and analyse any cases of PCCRC they have identified so that lessons can be learnt and applied. The national endoscopy database (NED) automatically gathers data from hospitals’ endoscopy reporting systems to support individual endoscopists and endoscopy services in identifying areas for improvement. A major new study, NED APRIQOT, is testing whether automatic feedback and advice to endoscopists will improve performance. Furthermore, Improving Safety and Reducing Errors and Endoscopy (ISREE) is a JAG initiative which aims to promote learning from medical errors and patient safety incidents and to encourage an open learning environment. The research also identifies that PCCRC rates at screening providers for the Bowel Cancer Screening Programme (BCSP) are low, and JAG is proud of our involvement in the programme by providing a robust accreditation pathway for screeners.

JAG accreditation supports services to implement the structures to improve the quality of the care provided. JAG accreditation considers all aspects of a service including quality and safety, patient experience, the workforce and training.

For queries about the research and to request your individual service’s data, please contact the research authors at Bowel Cancer Intelligence UK.

Note for patients:

A colonoscopy is a test where the large bowel or colon is examined using a flexible endoscope known as a colonoscope. The test is often the first choice for the investigation of patients with symptoms suggesting bowel cancer, the second most common cause of cancer death in the UK. A PCCRC is where a patient goes on to develop bowel cancer within 3 years of a colonoscopy and could be due to several reasons such as where a previously non-harmful tumour (known as an adenoma) was not completely removed or because the cancer was not identified during the colonoscopy (which could be due to a number of reasons).

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