Post-colonoscopy colorectal cancer: the key role of molecular pathological epidemiology

Post-colonoscopy colorectal cancer or so-called “interval cancer” has emerged as one of new research topics, attracting much attention of endoscopists, gastroenterologists, and oncologists alike (1-4). In addition to lesions missed during the index colonoscopy due to technical issues (e.g., skills of endoscopists, quality of bowel preparation) or tumor morphology (e.g., sessile serrated adenoma/polyps) (5), some tumors arising after colonoscopy may have rapidly-growing biological behavior with distinct molecular and pathological features (1-4). Colonoscopy has remained the cornerstone of colorectal cancer screening which can provide primary prevention, early detection, and pathological diagnosis of neoplastic lesions, potentially leading to the reduction in colorectal cancer incidence and mortality (4,6).