Journal of clinical gastroenterology最新文献

{"title":"Predictive Value of MRI Functional Liver Imaging Score and Spontaneous Portal Shunt for First Decompensation in Patients With Chronic Hepatitis B.","authors":"Jie Zou, Fei Jia, Yanli Jiang, Pin Yang, Fengxian Fan, Pengfei Wang, Haoyuan Li, Yuan Ding, Kai Ai, Jing Zhang","doi":"10.1097/MCG.0000000000002221","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002221","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of Gd-EOB-DTPA enhanced MRI functional liver imaging score and spontaneous portal shunt on the occurrence of first hepatitis decompensation in patients with chronic hepatitis B (CHB).</p><p><strong>Methods: </strong>Clinical and MRI data of 443 patients with CHB who received Gd-EOB-DTPA enhanced MRI scanning from October 2019 to October 2022 were retrospectively collected. All patients had a complete clinical laboratory examination 1 week before and after MR examination. According to the FIB-4 score and Child-Pugh(CP) grading criteria, the patients were divided into 4 groups: CLD group, CPA group, CPB group, and CPC group. The correlation between clinical laboratory indicators such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and imaging parameters such as functional liver imaging score (FLIS), spontaneous portosystemic shunt (SPSS), splenic craniocaudal diameter (SCCD), portal vein width and splenic vein width of patients in different groups was compared. Intragroup correlation coefficient (ICC) was used to evaluate the consistency of FLIS, SPSS and SCCD results among different observers. The ROC curve was used to compare the diagnostic efficiency of each imaging parameter for different groups of patients. The laboratory and imaging parameters that differed across groups were analyzed using Cox regression to evaluate the predictive efficacy of each parameter for the occurrence of first liver decompensation in patients with high-risk CHB in the CLD group and the CPA and CPB groups.</p><p><strong>Results: </strong>FLIS and its 3 parameters (EnQS, ExQS, and PVQS) were moderately strongly correlated with clinical groups (r=-0.370 to -0.543, P<0.001). The consistency of FLIS and its 3 quantitative parameters among different observers was high (r=0.965, P<0.001). SCCD and AUC of 0.844 (95% CI: 0.792-0.896) were the optimal parameters for distinguishing LC between the CLD group and the CPA group. The best FLIS criteria for predicting LC in CLD/CPA groups and for predicting LC in CPA/B groups were ≥4. The AUC for the differentiation of LC from CPB/C in the CLD/CPA groups was 0.801 (95% CI: 0.759-0.843), while the AUC for CPB and CPC was 0.858 (95% CI: 0.813-0.903). FLIS is not an independent predictor of first hepatitis decompensation in patients with CHB. Univariate analysis showed that SPSS, SCCD≥14.36 cm, age, and AST were independent risk factors for first hepatitis decompensation. The dichotomy of SPSS combined with SCCD can provide a better predictor of the first hepatitis decompensation event.</p><p><strong>Conclusion: </strong>FLIS has the best diagnostic efficacy in classifying liver function in patients with CHB. SPSS and SCCD have high predictive value in predicting the first hepatitis decompensation event in the CLD group and the CPA and CPB groups.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Prevalence of Eating Disorders Among Adults With Irritable Bowel Syndrome\".","authors":"Yu Yan, Lin-Jing Wang, Xing-Jie Shen","doi":"10.1097/MCG.0000000000002223","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002223","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Population-Based Assessment of Physical Activity and Exercise in Persons With IBD.","authors":"Sydney Chochinov, Casandra Dolovich, Gia Ly, Adebanke Oketola, Samuel Narvey, Maitreyi Raman, Sandra Webber, Charles N Bernstein","doi":"10.1097/MCG.0000000000002220","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002220","url":null,"abstract":"<p><strong>Goals/background: </strong>We aimed to assess the physical activity (PA) and exercise profiles of persons with IBD, their limitations in undertaking PA/exercise, and how PA correlates with active disease and fatigue in a Canadian population-based sample.</p><p><strong>Study: </strong>A cross-sectional survey study was undertaken by participants in the University of Manitoba IBD Research Registry. The survey included sociodemographic factors, PA/exercise, the International Physical Activity Questionnaire (IPAQ), Inflammatory Bowel Disease Symptom Inventory (IBDSI), and Modified Fatigue Impact Scale (MFIS). Bivariate and logistic regression analyses assessed the association between PA and disease activity and fatigue.</p><p><strong>Results: </strong>The survey was completed by 1257 of 2740 invitees (45.8%). Because of 163 missing age or PA responses, 1094 were included in the data analysis. The mean age of participants was 60.8+/-13.0 years. Activity status was inactive in 42.5%, moderately active in 32.0%, and highly active in 25.5%. Activity levels were similar for those >55 versus those <55 years. Thirty-eight percent reported that IBD never impacted their PA/exercise. Persons with Crohn's disease were more likely to be inactive than persons with ulcerative colitis. Logistic regression analysis showed that the odds of engaging in lower levels of PA were greater for persons with active IBDSI versus persons with non-active IBDSI (aOR: 1.51, 95% CI: 1.11-2.04), with an increase in MFIS score (aOR: 1.02, 95% CI: 1.01-1.03), in females with ulcerative colitis, and in those who smoke.</p><p><strong>Conclusion: </strong>These findings underscore the need for tailored PA/exercise guidelines for individuals with IBD. Future research should explore objective measures of PA to better understand PA/exercise in both younger and older adult populations.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Electronic Frailty Index is Associated With In-hospital Mortality and Unfavorable Prognosis in Hospitalized Elderly Chinese Patients With Gastrointestinal Bleeding.","authors":"Fan Zhang, Yu-Jun Xiong, Xiang-Da Meng, Qing-Feng Luo","doi":"10.1097/MCG.0000000000002222","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002222","url":null,"abstract":"<p><strong>Background: </strong>Frailty is prevalent in older adults with gastrointestinal bleeding (GIB) and is associated with unfavorable prognosis. The electronic Frailty Index (eFI) quantifies cumulative health deficits and may predict mortality and adverse events in this population.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted on 1424 hospitalized patients aged 65 years or older with GIB in Beijing Hospital (2013-2019). The eFI was derived from 45 variables encompassing chronic diseases, nursing assessments, and laboratory data. Restricted cubic spline modeling and Logistic regression analyses assessed the relationships between eFI, unfavorable prognosis, and mortality.</p><p><strong>Results: </strong>Of the 1424 hospitalized patients included, 46.0% experienced unfavorable prognosis and 30.3% died during hospitalization. A nonlinear association was observed between the eFI and both outcomes. Using a threshold of 0.27, patients were classified as frail (eFI ≥0.27) or nonfrail (eFI <0.27). Compared with nonfrail patients, those in the frail group had significantly higher adjusted risks of in-hospital mortality (OR: 3.69, 95% CI: 2.45-5.55) and unfavorable prognosis (OR: 3.51, 95% CI: 2.41-5.11). The area under the curve (AUC) for the eFI was 0.76 for predicting in-hospital mortality and 0.72 for unfavorable prognosis, indicating good discriminative ability.</p><p><strong>Conclusion: </strong>The eFI demonstrated prognostic utility for predicting in-hospital mortality and unfavorable prognosis in older adults with GIB. The threshold of 0.27 offers a practical basis for frailty assessment and risk stratification, underscoring the importance of multidisciplinary approaches to improve outcomes in this high-risk group. Further validation in multicenter and non-Chinese cohorts is warranted.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of Liver Fibrosis and Hepatocellular Carcinoma Using Antiplatelet Drugs: A Systematic Review and Meta-analysis.","authors":"Rui-Jing Wang, Jie Wang, Xiu-Ying Zhang, Yang Yue, Bo Shen, Yu-Ting Zhang","doi":"10.1097/MCG.0000000000002219","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002219","url":null,"abstract":"<p><strong>Goal: </strong>The aim of our research was to compile and analyze all existing observational data through a meta-analysis, evaluating the relationship between antiplatelet drugs, such as aspirin and clopidogrel, and the risks of liver fibrosis, portal vein thrombosis (PVT), and hepatocellular carcinoma (HCC).</p><p><strong>Background: </strong>The association between antiplatelet drug use, especially the use of agents other than aspirin, and liver fibrosis, PVT, and HCC in patients with liver disease remains unclear.</p><p><strong>Study: </strong>Cochrane Library, Web of Science, EMBASE, and PubMed were searched for all records from their inception through Jul. 20, 2024. Per the defined inclusion and exclusion criteria, we carried out literature screening and data extraction. Following that, the quality of these studies was appraised with the Newcastle-Ottawa Scale. The primary outcomes were liver fibrosis, HCC, and PVT. Statistical analysis was conducted using Stata 17.</p><p><strong>Results: </strong>The final analysis included 29 studies with 13,000 patients. Pooled results showed the HCC incidence after antiplatelet drug treatment was 3.6% (95% CI: 2.4%, 5.2%). The incidence of PVT after antiplatelet drug treatment was 48.6% (95% CI: 29.8%, 67.8%). Compared with the group not using antiplatelet drugs, the risk of liver fibrosis [hazard ratio (HR): 0.65, 95% CI: 0.56, 0.77; P<0.001] and the risk of HCC (HR: 0.63, 95% CI: 0.54, 0.73; P<0.001) were notably reduced in the group using antiplatelet drugs.</p><p><strong>Conclusions: </strong>The use of antiplatelet drugs may help prevent liver fibrosis, PVT, and HCC. Owing to the constraints of existing evidence, high-quality randomized controlled studies are essential to further corroborate these findings.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Substance Use Disorder Among Hospitalized Patients With Inflammatory Bowel Disease: An 11-Year Nationwide Study.","authors":"Melanie Zheng, Lauren DeDecker, Po-Hung Chen, Berkeley N Limketkai","doi":"10.1097/MCG.0000000000002205","DOIUrl":"10.1097/MCG.0000000000002205","url":null,"abstract":"<p><strong>Goals: </strong>We described the temporal trend of substance use disorder (SUD) and SUD subtypes among patients hospitalized with inflammatory bowel disease (IBD), accounting for readmissions within the calendar year.</p><p><strong>Background: </strong>One in six patients with IBD is estimated to have a concomitant SUD. SUD has had mounting morbidity and mortality rates since 2010 and has been shown to adversely affect IBD activity.</p><p><strong>Study: </strong>We performed a retrospective analysis of patients hospitalized at least once with IBD from 2010 through 2020 using the Nationwide Readmissions Database. Multivariable logistic regression analysis evaluated associations between SUD and age, sex, insurance type, income for the ZIP Code, and geographic region.</p><p><strong>Results: </strong>Of 2,532,450 patients hospitalized with IBD, 26.5% and 17.0% involved SUD in Crohn's disease (CD) and ulcerative colitis (UC), respectively. Between 2010 and 2020, the prevalence of patients with SUD increased from 23.8% to 27.9% in CD (Ptrend<0.001) and 14.2% to 19.4% in UC (Ptrend<0.001). Rates of alcohol, opioid, and cannabis use disorders increased (Ptrend<0.001 for all). Patients with SUD were more likely to be male [CD: OR: 1.26; 95% CI: 1.24-1.27; UC: 1.34, (1.31-1.36)], have Medicaid insurance compared with Medicare [CD: 1.59, (1.55-1.63); UC: 1.84, (1.78-1.90)], and be in a lower income quartile [lowest to highest quartile, CD: 1.54, (1.51-1.58); UC: 1.56, (1.52-1.61)].</p><p><strong>Conclusions: </strong>SUD among IBD patients continued to increase over time, with the predominant substances used shifting from alcohol to opioids and cannabis. Rates of SUD among patients hospitalized with CD were consistently higher than those with UC or with non-IBD-related hospitalizations.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Tissue Systems Pathology Test Objectively Risk-Stratifies Patients With Barrett's Esophagus: Results From a Multicenter US Clinical Experience Study.","authors":"Nicolas A Villa, Miguel Ordonez-Castellanos, Michael Yodice, Kirsten Newhams, Shahin Ayazi, Christian Smolko, Meenakshi Arora, Rebecca J Critchley-Thorne, Harshit S Khara, David L Diehl","doi":"10.1097/MCG.0000000000002040","DOIUrl":"10.1097/MCG.0000000000002040","url":null,"abstract":"<p><strong>Background: </strong>Barrett's esophagus (BE) is a diagnosis of esophageal intestinal metaplasia, which can progress to esophageal adenocarcinoma (EAC), and guidelines recommend endoscopic surveillance for early detection and treatment of EAC. However, current practices have limited effectiveness in risk-stratifying patients with BE.</p><p><strong>Aim: </strong>This study aimed to evaluate use of the TSP-9 test in risk-stratifying clinically relevant subsets of patients with BE in clinical practice.</p><p><strong>Methods: </strong>TSP-9 results for tests ordered by 891 physicians for 8080 patients with BE with clinicopathologic data were evaluated. Orders were from nonacademic (94.3%) and academic (5.7%) settings for nondysplastic BE (NDBE; n=7586; 93.9%), indefinite for dysplasia (IND, n=312, 3.9%), and low-grade dysplasia (LGD, n=182, 2.3%).</p><p><strong>Results: </strong>The TSP-9 test scored 83.2% of patients with low risk, 10.6% intermediate risk, and 6.2% high risk, respectively, for progression to HGD/EAC within 5 years. TSP-9 provided significant risk-stratification independently of clinicopathologic features, within NDBE, IND, and LGD subsets, male and female, and short- and long-segment subsets of patients. TSP-9 identified 15.3% of patients with NDBE as intermediate/high-risk for progression, which was 6.4 times more than patients with a pathology diagnosis of LGD. Patients with NDBE who scored intermediate or high risk had a predicted 5-year progression risk of 8.1% and 15.3%, respectively, which are similar to and higher than published progression rates in patients with BE with confirmed LGD.</p><p><strong>Conclusions: </strong>The TSP-9 test identified a high-risk subset of patients with NDBE who were predicted to progress at a higher rate than confirmed LGD, enabling early detection of patients requiring management escalation to reduce the incidence of EAC. TSP-9 scored the majority of patients with NDBE as low risk, providing support to adhere to 3- to 5-year surveillance per guidelines.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"531-536"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of Patency Capsule in Patients With Crohn's Disease.","authors":"Tarek Odah, Christian Karime, Jana G Hashash, Jami A Kinnucan, Michael F Picco, Francis A Farraye","doi":"10.1097/MCG.0000000000002048","DOIUrl":"10.1097/MCG.0000000000002048","url":null,"abstract":"<p><strong>Background: </strong>Video capsule retention is a complication that can have serious consequences in patients with Crohn's disease (CD). The patency capsule was developed to detect small bowel strictures. The usefulness of patency capsules in patients who do not have evidence of small bowel disease on imaging is uncertain.</p><p><strong>Study: </strong>This is a multicenter retrospective study of patients with suspected or confirmed CD who underwent a patency capsule study between January 2017 and February 2023. We excluded patients who were lost to follow-up or did not have computerized tomography or magnetic resonance imaging of the abdomen within 180 days before or after the patency capsule study.</p><p><strong>Results: </strong>A total of 105 patients met the inclusion criteria with 69% having a confirmed CD diagnosis. The majority of patients (95/105; 90.5%) passed their patency capsule. A total of 91 patients had their subsequent video capsule endoscopy (VCE), with 96.7% (88/91) successfully passing the capsule. Out of those who passed the VCE, 2 patients had patency capsule retention. Both had normal small bowel imaging. Meanwhile, the 3 patients who had VCE retention had evidence of small bowel disease in their imaging scans. The presence of abnormal small bowel wall thickening or stricture on imaging had a statistically significant association with VCE retention ( P =0.02).</p><p><strong>Conclusion: </strong>Our study demonstrated a statistically significant association between small bowel disease on imaging and retention of both patency capsules and VCE. Small bowel imaging in patients with suspected or documented CD had a negative predictive value of 100% for VCE retention.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"562-568"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastroesophageal Reflux Disease and Amazon.com.","authors":"Richard Wong, Tomas Navarro-Rodriguez, Ronnie Fass","doi":"10.1097/MCG.0000000000002216","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002216","url":null,"abstract":"<p><strong>Background: </strong>Amazon.com is the largest online retailer and marketplace in the United States for electronic commerce. Many people rely on the platform to gain knowledge about many medical disorders and to purchase products based on this understanding. The information presented on this vast electronic-commerce platform is oftentimes misleading and may not be supported by scientific medical evidence.</p><p><strong>Aims: </strong>The aim of this article is to critically and scientifically evaluate the Amazon.com platform as it relates to products that are being marketed for the treatment of gastroesophageal reflux disease (GERD) and to assess the scientific validity of their claims.</p><p><strong>Methods: </strong>Amazon.com was accessed and searched based on titles and subtitles related to GERD. Strength of evidence grades for medical claims of products for purchase on the platform were determined based on the Evidence-based Practice Center (EPC) program of the US Agency for Healthcare Research and Quality (AHRQ), based on published scientific and medical literature.</p><p><strong>Results: </strong>High evidence was only found for weight loss and certain medications such as antacids, H-2 receptor antagonists, proton pump inhibitors, and potassium-competitive acid blockers; Moderate evidence for GERD pillows; low evidence for combination of melatonin with medications (except for omeprazole); and insufficient evidence for GERD teas, supplements, majority of diet books, probiotics, apple cider vinegar, exercises, and nontraditional treatments such as Old Amish Formula.</p><p><strong>Conclusions: </strong>Individual consumers should critically evaluate information from social media, consider scientific evidence, and consult reliable sources of accurate information before deciding to purchase over-the-counter products that are widely marketed to the general public for the treatment of medical disorders such as GERD.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Immunochemical Testing for Colorectal Cancer Screening Outside High-income Countries: A Systematic Review and Meta-Analysis.","authors":"Catherine P Cheney, Luderve Rosier, Sarah Cantrell, Nathan M Thielman, Brian A Sullivan","doi":"10.1097/MCG.0000000000002214","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002214","url":null,"abstract":"<p><strong>Goal: </strong>Investigate fecal immunochemical testing (FIT) for CRC screening outside high-income countries (HIC).</p><p><strong>Background: </strong>Colorectal cancer (CRC) incidence in low- and middle-income countries (LMIC) is rising, but optimal screening strategies in resource-limited settings remain unclear. FIT is an evidence-based, low-cost modality for population-based CRC screening. We performed a systematic review with meta-analysis to better understand the diagnostic performance of FIT for detecting CRC among average-risk individuals living outside HICs.</p><p><strong>Study: </strong>A systematic search of studies conducted in LMICs, defined by the World Bank, was conducted on August 8, 2024. Studies were eligible if they assessed FIT as a diagnostic test for CRC in asymptomatic, average-risk participants. Pooled estimates for FIT sensitivity and specificity were calculated using a bivariate Bayesian statistical analysis (MetaBayesDTA).</p><p><strong>Results: </strong>Our search returned 333 distinct studies. Of these, 263 were excluded after title and abstract screening. We reviewed 61 full texts with 7 meeting inclusion/exclusion criteria. These studies were published between 2015 and 2022 and included 100,619 participants from Argentina, Brazil, China, Iran, and Thailand. Most used a FIT hemoglobin cutoff of 50 ng/mL (n=4). FIT return rate ranged from 78% to 99%, and positivity ranged from 2.1% to 29%. FIT sensitivity ranged from 55% to 92%, specificity from 71% to 94%, PPV from 2% to 16%, and NPV from 98% to 100%. After meta-analysis, pooled estimates for sensitivity and specificity for CRC were 75% (95% CI: 64%-85%) and 89% (95% CI: 77%-95%), respectively.</p><p><strong>Conclusions: </strong>FIT-based CRC screening shows promise, but data was geographically limited to middle-income countries. This highlights the need for research evaluating screening modalities and completion of the screening continuum in LMICs.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}