b'Figure. Kaplan-Meier Curves for All-Cause and Colorectal Cancer (CRC)-Specific MortalityDCRC indicates detected colorectal cancer; PCCRC, postcolonoscopy colorectal cancer.Source: Mortality After Postcolonoscopy Colorectal Cancer in the Veterans Affairs Health Care System. JAMA Netw Open.2023;6(4):e236693. doi:10.1001/jamanetworkopen.2023.6693higher ACM (aHR, 1.76; 95% CI, 1.70-1.82; P In line with previous studies indicating that endos-0.001) and CSM (aHR, 2.22; 95% CI, 2.12-2.32; P copist specialty is a factor associated with colonos-0.001). Compared with patients with DCRC, patientscopyquality,thestudydeterminedloweroddsof with PCCRC-3y had significantly lower odds of hav- PCCRC-3ywhenprocedureswereperformedby ing undergone colonoscopy performed by a gastro- gastroenterologists. enterologist (odds ratio, 0.48; 95% CI, 0.43-0.53; PBackground information in the report noted that past 0.001). research has estimated prevalence rates of PCCRC-3y that range from approximately 2% to 10% of all CRC Mortality Rate Not Affected cases and a predilection for the proximal colon. Overall, the study found that rates of PCCRC-3y inIn the VHA, one of the largest integrated healthcare the VA system was similar to other settings and thatsystems in the United States, colorectal cancer screen-having PCCRC-3y didnt have much effect on ACMing is widely practiced and is guided by directives and CSM, compared with other CRC patients. that emphasize the importance of high-quality screen-The researchers also reported that, compared withing and require measurement and reporting of colo-patientswithDCRC,thosewithPCCRC-3yhadnoscopy quality metrics, the authors pointed out.comparable cancer stage distribution, higher predi- Measuring and monitoring the rates of PCCRC and lectionforproximalcolonlocationandincreasedits associated factors and consequences for patient risk of a medically urgent presentation, such as boweloutcomes is critical to meaningful quality improve-obstruction or peritonitis. Performance of colonos- ment and ensuring that veterans receive high-quality copy outside the VA was associated with PCCRC-3ycolonoscopies, the study added. In addition, study-but not with mortality, they noted. ing PCCRC in the VHA has broad relevance, which 110'