结肠镜检查后结直肠癌 (PCCRC) 是结肠镜检查的一个关键质量指标，PCCRC 在 IBD 人群中的发生率很高。直肠癌是克罗恩病 (CD) 患者中 PCCRC 的一个重要危险因素，此前从未接受过检查。通过国家癌症研究所确定了 2001 年至 2015 年诊断直肠癌前 36 个月内接受过结肠镜检查的瑞典成年 CD 患者。患者和癌症登记。我们对他们的医疗记录进行了审查，并根据世界内窥镜组织 (WEO) 进行了根本原因分析和子分​​类。 在 24 名直肠患有 CD 和 PCCRC 的患者中，79% 是男性，中位年龄为 50 岁（ IQR 45-59) 年。中位病程为 21.5 (IQR 19-30) 年。 63% 的病例癌症位于直肠远端 5 cm 处。仅在 1 例病例中报告了直肠后倾。对 PCCRC 最常见的合理解释是“可能漏诊病变，事先检查充分”（63%）；当增加直肠后倾时，77%的检查被认为是阴性的，但被认为是不充分的。最常见的 PCCRC 子类别是非间期 C 型 (54%) 和 B 型 (37%)。根据目前的指南，在 C 型患者中，38% 应该被纳入监测范围。有必要更好地遵守监测指南并进行更细致的随访。强调了在直肠中进行直肠触诊和后倾的重要性，我们建议将其包含在 WEO 算法中。版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

Post-colonoscopy colorectal cancer (PCCRC) is a key quality indicator of colonoscopy, and PCCRC rates are high in the IBD population. Rectal cancer, an important risk factor for PCCRC among patients with Crohn's disease (CD), has not previously been examined.Swedish adult patients with CD who underwent a colonoscopy within 36 months before a rectal cancer diagnosis between 2001 and 2015 were identified through the National Patient and Cancer registers. Their medical records were reviewed and a root-cause analysis and a sub-categorization according to the World Endoscopic Organization (WEO) were performed.Of 24 patients with CD and PCCRC in the rectum, 79% were men and the median age was 50 (IQR 45-59) years. The median disease duration was 21.5 (IQR 19-30) years. The cancer was located in the distal 5 cm of the rectum in 63% of the cases. Retroversion in the rectum was reported in only one case. The most common plausible explanation for PCCRC was 'possible missed lesion, prior examination adequate' (63%); when adding retroversion in the rectum, instead 77% of examinations were considered negative but deemed as inadequate. The most common PCCRC sub-category was non-interval type C (54%) and B (37%). Among those with type C, 38% should have been included in surveillance according to present guidelines.Better adherence to surveillance guidelines and more meticulous follow-up is warranted. The importance of performing rectal palpation and retroversion in the rectum is underscored and we suggest that this is included in the WEO algorithm.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.