Abstract
BACKGROUND: Post-colonoscopy colorectal cancers (PCCRCs) pose challenges in clinical practice. PCCRCs occur due to a combination of procedural and biological causes. In a nested case-control study, we compared clinical and molecular features of PCCRCs and detected CRCs (DCRCs).METHODS: Whole-genome chromosomal copy number changes and mutation status of genes commonly affected in CRC were examined by low-coverage WGS and targeted sequencing, respectively. MSI and CIMP status was also determined.RESULTS: In total, 122 PCCRCs and 98 DCRCs with high-quality DNA were examined. PCCRCs were more often located proximally (P < 0.001), non-polypoid appearing (P = 0.004), early stage (P = 0.009) and poorly differentiated (P = 0.006). PCCRCs showed significantly less 18q loss (FDR <0.2), compared to DCRCs. No significant differences in mutations were observed. PCCRCs were more commonly CIMP high (P = 0.014) and MSI (P = 0.029). After correction for tumour location, only less 18q loss remained significant (P = 0.005).CONCLUSION: Molecular features associated with the sessile serrated lesions (SSLs) and non-polypoid colorectal neoplasms (CRNs) are more commonly seen in PCCRCs than in DCRCs. These together with the clinical features observed support the hypothesis that SSLs and non-polypoid CRNs are contributors to the development of PCCRCs. The future focus should be directed at improving the detection and endoscopic removal of these non-polypoid CRN and SSLs.
Original language | English |
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Pages (from-to) | 865-873 |
Number of pages | 9 |
Journal | British Journal of Cancer |
Volume | 126 |
Issue number | 6 |
Early online date | 15 Dec 2021 |
DOIs | |
Publication status | Published - 1 Apr 2022 |
Keywords
- ISLAND METHYLATOR PHENOTYPE
- MICROSATELLITE INSTABILITY
- CHROMOSOME INSTABILITY
- SERRATED PATHWAY
- ADENOMA
- RISK
- PREVALENCE
- MORTALITY
- NEOPLASMS
- RESECTION