Intended for healthcare professionals

  1. Ethna McFerran, post-doctoral researcher in cancer health economics1,
  2. James F O’Mahony, research assistant professor2,
  3. Edward Goodall, member of the Northern Ireland Cancer Research Consumer Forum3,
  4. Mark Lawler, professor of digital health1
  1. 1Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT9 7AE, UK
  2. 2Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, Dublin, Ireland
  3. 3Northern Ireland Cancer Research Consumer Forum, Belfast City Hospital, Belfast, UK
  1. Correspondence to: E McFerran e.mcferran{at}

Fixing it will require strategic investment in data collection and infrastructure

Heisser and colleagues’ (doi:10.1136/bmj.l6109) linked meta-analysis of colorectal cancer and adenoma prevalence in the years following a negative colonoscopy shows that while neoplasms (including adenomas) were observed in more than 20% of participants within five years, advanced neoplasms were rare even after 10 years (2.1% in men, 1.8% in women).1 The authors concluded that a 10 year screening interval after negative colonoscopy, as currently recommended,2 could be adequate.1

In a second paper, Burr and colleagues (doi:10.1136/bmj.l6090) quantify rates of colorectal cancer up to three years after a negative colonoscopy in England.3 They report a decreasing incidence of post-colonoscopy cancers over the period of investigation (from 9.0% in 2005 to 6.5% in 2013), but highlight statistically significant variation between colonoscopy providers. Specifically, they find higher rates of post colonoscopy cancers following privately provided colonoscopy, after controlling for certain confounding factors (adjusted odds ratio 1.63 (95% confidence interval 1.39 to 1.91), P<0.01). Rates were also higher among women, older …

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