b'extends beyond the confines of a single healthcarePCCRC-3y or DCRC. This finding is likely driven system.Givenitssizeandthefactthatthe VHAby the fact that nearly 40% of patients in this group serves as a reference standard in the healthcare field,had stage IV cancers at diagnosis, compared with the knowledge derived from a VHA-based study can15% to 17% in the other two groups, the research-help inform patients, practitioners, and policy mak- erswrote.Thisobservationisnotsurprising ers in other healthcare organizations and enrich thebecause patients who recently underwent colonos-CRC research field as a whole. copy are expected to benefit from the detection of As to why PCCRC occurs, the study team noted thatcancer in its early stages and from CRC prevention most cases occur because most of these cancers arevia polypectomy.still small and at an early stage within a 3-year inter- Thestudyalsopointedoutthat93%ofpatients val after colonoscopy. The observation that patientsin the no colonoscopy group had undergone colo-with DCRC and patients with PCCRC-3y had simi- noscopy more than 10 years before CRC diagnosis larcancerstagedistributionsupportsthisnotionor had no colonoscopy that could be identified in and is consistent with a dwell time for PCCRC-3ythe Corporate Data Warehouse or CMS data. The similar to that of sporadic DCRC, they advised. Inauthors emphasized that their finding puts a spotlight turn, this finding supports the notion that acceleratedon the importance of regular and programmatic CRC neoplasia progression may not be a major factor inscreening and of measuring colonoscopy quality. the pathogenesis of most PCCRC 1Kahi CJ, Myers LJ, Monahan PO, Barker BC, Stump TE, Im-Alsoofnoteisthatthestudydeterminedthatperiale TF. Mortality After Postcolonoscopy Colorectal Cancer patients with CRC and no prior colonoscopy hadin the Veterans Affairs Health Care System. JAMA Netw Open. significantlyworseACMandCSMthaneither2023;6(4):e236693. doi:10.1001/jamanetworkopen.2023.6693111'