Digestion最新文献

{"title":"Akkermansia muciniphila and Its Extracellular Vesicles Affect Endocannabinoid System in in vitro Model.","authors":"Pegah Noori, Fattah Sotoodehnejadnematalahi, Pooneh Rahimi, Seyed Davar Siadat","doi":"10.1159/000543446","DOIUrl":"https://doi.org/10.1159/000543446","url":null,"abstract":"<p><strong>Introduction: </strong>Recent studies indicate that the gut microbiota controls the host's immune system. Probiotics use different signaling pathways to regulate intestinal permeability, barrier integrity, and energy balance.</p><p><strong>Methods: </strong>This research examined how Akkermansia muciniphila and its extracellular vesicles (EVs) impact inflammation and genes related to the endocannabinoid system in the STC-1 cell line through RT-PCR and ELISA assays.</p><p><strong>Results: </strong>The study's results indicated that EVs had a significant impact on GLP-1 expression compared to the multiplicity of infections (MOI) ratio. Notably, there was a substantial increase in the expression of PYY and GLP-1 genes across all treatments (p < 0.05). Conversely, the expression of CB-1, CB-2, and FAAH genes notably decreased in the STC-1 cell line when treated with MOI 50 of A. muciniphila and an EV concentration of 100 μg/mL (p < 0.05). Both MOI 50 of A. muciniphila and an EV concentration of 100 μg/mL significantly enhanced the expression of the TLR-2 gene. In contrast, EVs at a concentration of 100 μg/mL substantially reduced TLR-4 gene expression. A. muciniphila-derived EVs notably decreased the levels of inflammatory cytokines (TNF-α and IL-6), while increasing IL-10 expression at MOI 100 and an EV concentration of 100 μg/mL. These findings suggest that A. muciniphila and its EVs could regulate the expression of specific genes, serving as targets for maintaining host energy balance.</p><p><strong>Conclusions: </strong>In summary, this study illustrates that A. muciniphila-derived EVs exhibit anti-inflammatory properties and have the potential to modulate gene expression in cases of obesity and gastrointestinal tract inflammation.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Annual Trends in the Diagnosis of Autoimmune Gastritis Over 11 Years at a Single Facility in Japan.","authors":"Kaoru Nakano, Toshiaki Hirasawa, Ayaka Takasu, Yuka Higashi, Souya Nunobe, Masayuki Shimoda, Kengo Takeuchi, Hiroshi Kawachi","doi":"10.1159/000544812","DOIUrl":"https://doi.org/10.1159/000544812","url":null,"abstract":"<p><strong>Introduction: </strong>Autoimmune gastritis (AIG), a type of chronic atrophic gastritis, is characterized by positive anti-parietal cell antibodies and mucosal atrophy predominantly in the corpus. In Japan, AIG has garnered increasing attention owing to the recent decline in Helicobacter pylori (HP) infection rates, leading to the proposal of diagnostic criteria. These criteria encompass serological test results, endoscopic findings, and histological results, emphasizing the need for collaboration between endoscopists and pathologists to make an accurate diagnosis. In the present study, we aimed to clarify the annual number of patients with AIG diagnosed over the past 11 years and analyze their endoscopic and histological characteristics.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with AIG newly diagnosed at our institution between 2013 and 2023. Patients were categorized into the \"prior endoscopically diagnosed group\" (ED group) and the \"prior pathologically diagnosed group\" (PD group). The annual trend in AIG diagnosis was analyzed, and clinicopathological characteristics were compared between the groups.</p><p><strong>Results: </strong>In total, 118 patients were diagnosed with AIG during the study period. The number of diagnoses increased after 2018, when a focused effort to identify AIG began, peaking in 2021 with 32 cases. All patients diagnosed before 2018 belonged to the ED group, but subsequent years saw increases in both groups of patients. The PD group had significantly more cases of coexisting gastric carcinoma (86.3% versus 26.9%, p<0.001) or HP-associated gastritis (72.4% versus 32.8%, p=0.002) than the ED group, whereas the ED group frequently exhibited typical endoscopic findings, such as atrophic gastritis predominantly in the corpus and adherent mucus.</p><p><strong>Conclusion: </strong>Accurate diagnosis of AIG requires familiarity with the diagnostic criteria by endoscopists and pathologists. In cases complicated by gastric carcinoma or HP-associated gastritis, endoscopic findings alone may not suffice for diagnosis, underscoring the critical role of pathologists in interpreting histological findings.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-23"},"PeriodicalIF":3.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weakly supervised deep learning can analyze focal liver lesions in contrast-enhanced ultrasound.","authors":"Adil Oezsoy, James Alexander Brooks, Marko van Treeck, Yvonne Doerffel, Ulrike Morgera, Jens Berger, Marco Gustav, Oliver Lester Saldanha, Tom Luedde, Jakob Nikolas Kather, Tobias Paul Seraphin, Michael Kallenbach","doi":"10.1159/000545098","DOIUrl":"https://doi.org/10.1159/000545098","url":null,"abstract":"<p><p>Introduction Assessing the malignancy of focal liver lesions is an important yet challenging aspect of routine patient care. Contrast-enhanced ultrasound (CEUS) has proved to be a highly reliable tool but is very dependent on the examiner's expertise. The emergence of artificial intelligence has opened doors to algorithms that could potentially aid in the diagnostic process. In this study, we evaluate the performance of a weakly supervised deep learning model in classifying focal liver lesions (FLL) as malignant or benign. Methods Our retrospective feasibility study was based on a cohort of patients from a tertiary care hospital in Germany undergoing routine CEUS examination to evaluate malignancy of FLL. We trained a weakly supervised attention-based multiple instance learning algorithm during 5-fold cross-validation to distinguish malignant from benign liver tumors, without using any manual annotations, only case labels. We aggregated the on-average best performing cross-validation cycle and tested this combined model on a held-out test set. We evaluated its performance using standard performance metrics and developed explainability methods to gain insight into the model's decisions. Results We enrolled 370 patients, comprising a total of 955,938 images extracted from CEUS videos or manually captured during the examination. Our combined model was able to identify malignant lesions with a mean area under the receiver operating curve of 0.844 in the cross-validation experiment and 0.94 (95% CI 0.89 - 0.99) in the held-out test set. The accuracy, sensitivity, specificity, and F1-Score of the combined model in finding malignant lesions in the held-out test, yielded 80.0%, 81.8%, 84.6%, and 0.81, respectively. Our exploratory analysis using visual explainability methods revealed that the model appears to prioritize information that is also highly relevant to expert clinicians in this task. Conclusions Weakly supervised deep learning can classify malignancy in CEUS examinations of FLLs and thus might one day be able to assist doctors' decision-making in clinical routine.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-21"},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xiayuxue Decoction plays an anti-development role in hepatocellular carcinoma through intestinal-hepatic axis.","authors":"Ting Zhou, Liyuan Pei, Ya Chen, Xuejing Wang, Hongyu Fang, Xiaoyan Zeng, Xuefei Tian","doi":"10.1159/000543834","DOIUrl":"https://doi.org/10.1159/000543834","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the effect of \"intestinal-hepatic axis\" in tumorigenesis of hepatocellular carcinoma (HCC) has been paid more and more attention, and the imbalance of gut microbiota is closely related to the pathogenesis of HCC. The Xiayuxue decoction has inhibitory effect on hepatic fibrosis, but the effect of Xiayuxue decoction (XYXD) on HCC is not clear.</p><p><strong>Methods: </strong>We induced HCC mouse model by diethylnitrosamine (DEN) and CCL4. HCC mice were treated with XYXD gavage. Hematoxylin-eosin staining was used to detect the pathological changes of liver tissue in mice. Immunohistochemistry was used to detect the level of Ki-67 in liver tumor and ZO-1 in colon tissue. The level of inflammatory factors in plasma, liver and colon tissue of mice was detected by ELISA. The changes of macrophages and neutrophils in colorectal tissues of mice were counted by immunofluorescence. 16s sequencing was used to analyze the effect of XYXD treatment on gut microbiota of HCC mice.</p><p><strong>Results: </strong>Our study found that XYXD could inhibit the progress of HCC. XYXD upregulated the expression levels of ZO-1, Occludin and claudin in colon tissue to repair intestinal mucosal barrier. XYXD could alleviate the infiltration of intestinal immune cells in HCC mice by inhibiting the data of macrophages and neutrophils in colon tissue and down-regulating SIgA level. XYXD also regulated the composition of intestinal microorganisms and improve the diversity of gut microbiota, thus affecting the progress of HCC.</p><p><strong>Conclusion: </strong>XYXD inhibits the progress of HCC by influencing gut microbiota to regulate intestinal and liver inflammation and intestinal immune response.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-17"},"PeriodicalIF":3.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic and Clinicopathological Features of a Colorectal Mucin-Rich Variant of Traditional Serrated Adenoma.","authors":"Eiji Kamba, Takashi Murakami, Naoki Tsugawa, Yudai Otsuki, Kei Nomura, Yuichiro Kadomatsu, Hirofumi Fukushima, Tsuyoshi Saito, Tomoyoshi Shibuya, Takashi Yao, Akihito Nagahara","doi":"10.1159/000543700","DOIUrl":"https://doi.org/10.1159/000543700","url":null,"abstract":"<p><strong>Introduction: </strong>The mucin-rich variant of traditional serrated adenoma (MR-TSA), pathologically defined by the presence of goblet cells comprising over 50% of the lesion compared to the absorptive epithelial eosinophilic cytoplasm, was recently introduced as one morphological variants of traditional serrated adenoma (TSA). This study aimed to characterize the endoscopic and clinicopathological characteristics of MR-TSAs.</p><p><strong>Methods: </strong>Lesions pathologically diagnosed as TSAs at our hospital between 2011 and 2023 were reviewed. We analyzed the endoscopic and clinicopathological features of 49 MR-TSAs and 236 conventional TSAs (C-TSAs). Furthermore, immunohistochemical and genetic analyses were performed to ensure that there were no discrepancies with our previous study.</p><p><strong>Results: </strong>MR-TSAs, like C-TSAs, were often located in the sigmoid colon and rectum, with no significant difference in lesion size. Macroscopically, MR-TSAs frequently appeared as type 0-Is with a weak reddish color and had a mucous cap, less often exhibiting a pinecone-like or coral-shaped appearance compared to C-TSAs (p < 0.001). Magnifying endoscopy showed expanded crypt openings in 80% of MR-TSAs (p < 0.001). Both groups had similar IIIH and IVH pit patterns. Immunohistochemical analysis revealed that MUC5AC was expressed more frequently in MR-TSAs than in C-TSAs. Additionally, genetic analysis showed that MR-TSAs more frequently harbored the BRAF mutation than C-TSAs (p < 0.001), whereas MR-TSAs less frequently harbored the KRAS mutation than C-TSAs (p = 0.047).</p><p><strong>Conclusion: </strong>MR-TSAs, frequently harboring the BRAF but not KRAS mutation, exhibited several distinct endoscopic findings, including a sessile morphology, lack of pinecone-like or coral-like appearance, weak reddish color, and mucous cap.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Helicobacter pylori on Immune Checkpoint Inhibition in Hepatocellular Carcinoma: A Multicenter Study.","authors":"Najib Ben Khaled, Christian Schulz, Marianna Alunni-Fabbroni, Kathrin Bronny, Leonie S Jochheim, Behnam Kalali, Osman Öcal, Max Seidensticker, Ignazio Piseddu, Stefan Enssle, Monika Karin, Julia S Schneider, Theresa Strasoldo-Graffemberg, Nadine Koch, Lukas Macke, Florian P Reiter, Christian M Lange, Yinghong Wang, Enrico N De Toni, Markus Gerhard, Julia Mayerle, Jens Ricke, Peter Malfertheiner","doi":"10.1159/000542847","DOIUrl":"https://doi.org/10.1159/000542847","url":null,"abstract":"<p><strong>Introduction: </strong>Immunomodulating effects of Helicobacter pylori (H. pylori) have been shown to inhibit antitumor immunity. Resistance to immune checkpoint inhibitor (ICI)-based therapies is common among patients with hepatocellular carcinoma (HCC). This study aimed to assess the effect of H. pylori on the outcomes of ICI in patients with HCC.</p><p><strong>Methods: </strong>We conducted a multicenter study in patients with HCC across a broad range of treatments. Patients received either ICI-based combination regimens or sorafenib-based therapy. H. pylori serostatus and virulence factors were determined and correlated with overall survival (OS), progression-free survival (PFS), and safety across the treatment modalities.</p><p><strong>Results: </strong>180 patients with HCC were included; among these, 64 were treated with ICI-based regimen and 116 with sorafenib-based regimen. In patients treated with ICI, median OS was shorter in H. pylori-positive patients (10.9 months in H. pylori-positive vs. 18.3 months; p = 0.0384). H. pylori positivity was associated with a shorter PFS in ICI recipients (3.9 months vs. 6.8 months, p = 0.0499). In patients treated with sorafenib, median OS was not shorter among H. pylori-positive patients (13.4 months in H. pylori-positive vs. 10.6 months; p = 0.3353). Immune-related adverse events and rates of gastrointestinal bleeding were comparable between H. pylori-positive and -negative patients.</p><p><strong>Conclusion: </strong>H. pylori seropositivity was linked to poorer outcomes in patients with HCC treated with ICI. This association was not observed among patients receiving sorafenib-based therapies.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibitory effects of probiotic & gastro-intestinal bacteria on H. pylori in vitro.","authors":"Johannes Raphael Westphal, Nadine Koch, Lukas Macke, Riccardo Vasapolli, Didem Saka, Ramiro Vilchez-Vargas, Tianjun Song, Peter Malfertheiner, Christian Schulz","doi":"10.1159/000543447","DOIUrl":"https://doi.org/10.1159/000543447","url":null,"abstract":"<p><strong>Introduction: </strong>Helicobacter pylori is a highly prevalent pathogen affecting approximately 50% of the world population, causing chronic gastritis and subsequently adenocarcinoma. Antibiotic resistance rates in H. pylori are increasing, thus demanding alternative treatment options. Some beneficial bacteria, including probiotics and gastrointestinal commensals, were shown to inhibit H. pylori growth, viability, and initial attachment to the gastric epithelium.</p><p><strong>Methods: </strong>In this review we systematically summarized the currently available literature for in vitro inhibition of H. pylori through beneficial bacteria from the Lactobacillales order. We performed research on PubMed and Google scholar in accordance with the PRISMA guidelines.</p><p><strong>Results: </strong>A multitude of species was shown to possess anti-H. pylori activity although the majority of investigated bacteria belonged to only one bacterial genus: Lactobacillus. Anti-H. pylori activity was mediated through transcriptional modulation of virulence factors, a competition for binding sites, an induction of a dormancy state of H. pylori and the secretion of anti-H. pylori compounds.</p><p><strong>Conclusion: </strong>Many bacterial compounds that show probiotic properties are capable of inhibiting H. pylori in in vitro experiments. However, a huge variety of test methods to detect anti-H. pylori effects demands for a standardization.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-30"},"PeriodicalIF":3.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questionnaire Survey on the Diagnosis and Treatments of Eosinophilic Gastrointestinal Diseases in Asia.","authors":"Yoshikazu Tsuzuki, Akiko Shiotani, Kazuya Miyaguchi, Shouko Ono, Yutaka Saito, Mitsushige Sugimoto, Yuji Naito, Sachiyo Nomura, Osamu Handa, Tadakazu Hisamatsu, Mitsuhiro Fujishiro, Takahisa Matsuda, Yoshinori Morita, Naohisa Yahagi, Francis K L Chan, Tiing Leong Ang, Murdani Abdullah, Maria Carla Tablante, Varayu Prachayakul, Baiwen Li, Hwoon-Yong Jung, Hisashi Matsumoto, Rie Shiomi, Hiroyuki Imaeda","doi":"10.1159/000544725","DOIUrl":"10.1159/000544725","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic gastrointestinal disease (EGID) is divided into eosinophilic esophagitis (EoE) and non-eosinophilic esophagitis eosinophilic gastrointestinal disease (non-EoE-EGID), based on the involved gastrointestinal organs. The present survey was performed to provide an overview of the current status of the epidemiology, diagnosis, and treatment of EGID in Asia.</p><p><strong>Methods: </strong>Responses to the questionnaire were obtained from 228 doctors at various institutions in eight Asian countries. The questionnaire consisted of 52 questions on EoE and non-EoE EGID.</p><p><strong>Results: </strong>Responses to questionnaire were obtained from 228 doctors from eight countries. The most common participation facilities were university hospitals, followed by public hospitals, private hospitals, and private clinics. 1-10 were the most frequent patients per year in each institution for both EoE and non-EoE-EGID. The 30s and 40s are common age groups for both EoE and non-EoE-EGID. Although endoscopic findings vary among countries, 15 or more eosinophil infiltrations in high-power fields as a diagnostic criterion are used in all countries for EoE. As treatments, the prescription rates of Proton pump inhibitor, diet, topical and systemic steroids, and biologics were similar among the eight countries in EoE. Non-EoE-EGID showed a similar trend to EoE in epidemiology, symptoms, diagnosis, and treatment.</p><p><strong>Conclusion: </strong>The questionnaire survey partially revealed the current status of the epidemiology, symptoms, diagnosis, and treatment of EGID in Asian countries.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"153-164"},"PeriodicalIF":3.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in colonoscopy - where are we now in 2024?","authors":"Wan Ying Lai, Kenneth Weicong Lin, Loi Pooi Ling, James W Li, Louis H S Lau, Philip W Y Chiu","doi":"10.1159/000544030","DOIUrl":"https://doi.org/10.1159/000544030","url":null,"abstract":"<p><strong>Introduction: </strong>Colonoscopy has a crucial role in reducing colorectal cancer incidence and mortality. Different artificial intelligence (AI) systems were developed to further improve its quality assurance (computer-aided quality improvement, CAQ), lesion detection (computer-aided detection, CADe) and lesion characterization (computer-aided characterization, CADx). There were studies investigating the roles of these AI systems in different domains of standard colonoscopies.</p><p><strong>Methods: </strong>In this state-of-the-art narrative review, we summarize the current evidence, discuss existing limitations, as well as explore the future directions of AI in colonoscopy.</p><p><strong>Results: </strong>CAQ enhances colonoscopy quality through real-time feedback and quality monitoring systems, but the studies have inconsistent results due to small training datasets and varied methodologies. CADe increases adenoma detection rate and reduces adenoma missed rates but there are concerns about false positives, unnecessary polypectomies, potential de-skilling of endoscopists, and cost-effectiveness. CADx systems have mixed results and accuracies in differentiating polyp types, its use is further hindered by inadequate representation of sessile serrated lesions and a lack of rigorous trials comparing it with standard colonoscopy.</p><p><strong>Conclusion: </strong>Despite the emerging evidence of AI-assisted colonoscopy, its potential drawbacks and limitations may hinder the further implementation in real-world clinical practice. Long-term data on clinical efficacy, cost effectiveness, liability and data sharing are the key areas to be addressed.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-28"},"PeriodicalIF":3.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal Cancer: Epidemiology, Risk Factors, and Public Health Strategies.","authors":"Takahisa Matsuda, Ai Fujimoto, Yoshinori Igarashi","doi":"10.1159/000543921","DOIUrl":"10.1159/000543921","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is a significant global health issue, ranking as the third most commonly diagnosed cancer and the second leading cause of cancer-related deaths. Countries with a high Human Development Index (HDI) report the highest incidence rates, driven by dietary and lifestyle factors. In contrast, low-to-middle HDI countries are experiencing rising CRC rates due to urbanization and westernization. Japan exemplifies this shift, with increasing CRC incidence linked to the adoption of westernized diets. Despite advances in screening and treatment, CRC-related mortality remains substantial, with 53,088 deaths reported in Japan.</p><p><strong>Summary: </strong>This review examines global and regional CRC trends, focusing on incidence, mortality, and risk factors such as genetic predispositions, diet, and lifestyle influences. The review highlights the growing burden of CRC in Japan and other regions where dietary changes and urbanization are prevalent. Key findings include the significant impact of processed foods, sugary beverages, obesity, alcohol, and smoking on CRC risk, as well as the protective effects of vitamin D, calcium, and fermented foods. The role of inflammatory bowel disease and diabetes in CRC risk is also discussed. Furthermore, the review emphasizes the importance of public health initiatives, including organized screening programs, in mitigating the CRC burden.</p><p><strong>Key messages: </strong>Understanding the interplay between genetic, lifestyle, and environmental factors is crucial for developing effective prevention strategies. Enhancing CRC screening, early detection, and public health interventions can significantly reduce CRC-related mortality. Continued research and collaboration are essential for advancing CRC prevention and improving global health outcomes.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}