Journal of gastrointestinal oncology最新文献

{"title":"High expression of RBM15 is associated with better prognosis in esophageal squamous cell carcinoma.","authors":"Yingda Liu, Yu Pu, Xunjie Kuang, Yuzhu Jiang, Jiali Liu, Nan Dai, Mengxia Li, Kunkun Li, Mingfang Xu","doi":"10.21037/jgo-24-331","DOIUrl":"10.21037/jgo-24-331","url":null,"abstract":"<p><strong>Background: </strong>Esophageal squamous cell carcinoma (ESCC) is a highly prevalent and malignant form of esophageal tumor associated with high rates of patient mortality for which there remains a persistent lack of effective targets for therapeutic interventional efforts. This study was developed with the goal of exploring the expression and functional role of RBM15 in ESCC.</p><p><strong>Methods: </strong>This study was developed with the goal of exploring the expression and functional role of RBM15 in ESCC. To establish the prognostic and therapeutic significance of RBM15 in this cancer, data from the Gene Expression Omnibus (GEO), The Cancer Genome Atlas (TCGA), and UCSC Xena databases were leveraged. Immunohistochemical analyses were used to assess RBM15 expression in postoperative ESCC tumor tissue samples, and the correlations between such expression and patient outcomes were assessed. The effects of RBM15 on ESCC cell proliferative, migratory, and invasive activity were assessed with Cell Counting Kit-8 (CCK8) and Transwell assay approaches. Together, these experiments revealed RBM15 upregulation in ESCC relative to paracancerous tissues, while confirming that it was associated with favorable patient outcomes. RBM15 was also found to suppress ESCC cell proliferation, migration, and invasivity.</p><p><strong>Results: </strong>We suggest that RBM15 may be a clinically relevant prognostic factor in ESCC such that new therapeutic interventions based on low levels of RBM15 have the potential to be developed for the improved management of ESCC in the future.</p><p><strong>Conclusions: </strong>The results of the present study provide confirmation that high levels of RBM15 expression are protective and associated with better ESCC patient prognostic outcomes. Pan-cancer analyses performed herein also revealed the correlations between RBM15 expression and prognosis in various cancers.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2400-2412"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006587","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":"Mismatch repair deficiency confers worse survival in stage IV colon cancer.","authors":"David Schaub, Joseph Gunderson, Sierra Thompson, Sabina Saeed, Elisabeth Batzli, Rohan Mittal, Daniom Tecle, Katherine Pavleszek, Valentine Nfonsam","doi":"10.21037/jgo-24-387","DOIUrl":"10.21037/jgo-24-387","url":null,"abstract":"<p><strong>Background: </strong>Metastatic colon cancer (MCC) is a debilitating condition with a poor prognosis. Currently, there is limited data that investigates MCC in relation to mismatch repair (MMR) status. The aims of this study are to compare sociodemographic and clinicopathologic features and mortality between patients with MMR-proficient (MMR-P) and MMR-deficient (MMR-D) MCC.</p><p><strong>Methods: </strong>We performed an 8-year retrospective review of the National Cancer Database (NCDB) to identify patients age ≥18 years with MCC and reported MMR status. Data collection included sociodemographic characteristics, primary tumor sites and histopathologic features, and treatment modalities. Outcomes included 90-day, 180-day, 1-year, and 2-year overall mortality. Bivariate logistic regression and multivariate Cox regression identified differences between MMR-P and MMR-D and identified predictors of mortality, respectively.</p><p><strong>Results: </strong>A total of 10,922 MCC cases were identified; 8,796 (80.53%) were MMR-P and 2,126 (19.47%) were MMR-D. MMR-D was independently associated with older age at diagnosis, female sex, mucinous adenocarcinoma, medullary carcinoma, and lymph-vascular invasion. MMR-P was independently associated with perineural invasion and left-sided colonic primary tumor predominance. When adjusted for demographics, histology, and treatment modalities, MMR-D was associated with mortality at 180 days, 1 year, and 2 years.</p><p><strong>Conclusions: </strong>Our study identified several key sociodemographic and clinicopathologic features of MMR-D MCC. MMR-D appears to confer increased overall mortality at 180 days, 1 year, and 2 years after diagnosis in MCC.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2521-2532"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006548","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":"Inflammatory pseudotumor-like extranodal classic Hodgkin lymphoma manifesting as bowel perforation in acquired immunodeficiency syndrome patient with disseminated leishmaniasis: a case report and approach to differential diagnosis.","authors":"Joshua Mehr, Sharon Germans, Weina Chen, Sameh Mahsoub, Mingyi Chen","doi":"10.21037/jgo-24-499","DOIUrl":"10.21037/jgo-24-499","url":null,"abstract":"<p><strong>Background: </strong>Classic Hodgkin lymphoma (CHL) is an extremely common non-acquired immunodeficiency syndrome (AIDS) defining malignancy and its incidence is rising. CHL is usually present in the lymph node and extranodal involvement is rare. Primary CHL of the gastrointestinal (GI) tract is exceedingly rare.</p><p><strong>Case description: </strong>In this case, a patient with human immunodeficiency virus (HIV)/AIDS and disseminated leishmaniasis presented with a small bowel mass leading to bowel perforation. Histologically, the small bowel mass showed a transmural infiltrate of scattered large atypical multinucleated cells surrounded by histiocytes and T-cells. Initial differential diagnosis was wide due to the unusual presentation and cytologic atypia of the tumor cells. Identifying the Hodgkins Reed-Sternberg (HRS) cells with their unique immunophenotype was key for diagnosis.</p><p><strong>Conclusions: </strong>It is critical to identify secondary CHL in HIV/AIDS patients especially in the presence of immunodeficiency and disseminated opportunistic infection. Extranodal primary GI tract CHL is exceedingly rare and thus awareness of this entity, which can mimic many other tumors, especially in immunocompromised individuals, is important. Special stains and cultures are helpful for the diagnosis, and antimicrobial therapy will induce successful clinical outcome. Overall, the unusual combination of acute clinical presentation, leishmaniasis, and HIV made the histological recognition of CHL crucial to avoid misdiagnosis and guide successful clinical management.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2684-2691"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006595","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":"Comparison of various liver cancer staging systems in predicting prognosis after initial transcatheter arterial chemoembolization: a retrospective study from China.","authors":"Bin Lan, Chao Luo, Christine Pocha, Qing Wang, Jie Tan","doi":"10.21037/jgo-2024-850","DOIUrl":"10.21037/jgo-2024-850","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) constitutes approximately 75-85% of primary liver cancers and is a heavy burden on public health. Many innovative prediction systems have integrated radiomics, artificial intelligence, pathological information, or even genetic information for the stratification and prognosis prediction of patients with HCC. However, these systems still lack practical and clinical applications. Classical HCC staging systems remain the mainstream tool for stratification and prediction of treatment efficacy to date; although, variable characteristics and emphases between different classical HCC staging systems render its clinical selection inconsistent and therefore may be unreliable. In this study, we aimed to compare the predictive performance of classical liver cancer staging systems, including China Liver Cancer (CNLC), Barcelona Clinic Liver Cancer (BCLC), Hong Kong Liver Cancer (HKLC), modified Japanese Integrated Staging (mJIS), modified Cancer of the Liver Italian Program (mCLIP), and Tumor-Node-Metastasis (TNM) staging system, for the efficacy and prognosis of transcatheter arterial chemoembolization (TACE) in HCC patients.</p><p><strong>Methods: </strong>A total of 148 patients with HCC who received TACE as the initial therapy between 02/01/2019 and 08/31/2022 were retrospectively included. Patients' clinical information, laboratory and imaging data, were collected. Cox regression analysis was applied to identify independent risk factors for progression-free survival (PFS) and overall survival (OS). Six liver cancer staging systems, including the CNLC, BCLC, HKLC, mJIS, mCLIP, and TNM staging system, were applied for the staging of every enrolled patient. The PFS and OS of patients with HCC following initial TACE in different staging systems were assessed, and the predictive performance of different systems was evaluated using the concordance index.</p><p><strong>Results: </strong>The presence of portal vein tumor thrombus (PVT), alpha fetoprotein (AFP) ≥400 ng/mL, and ineffective initial TACE treatment were independent risk factors for overall disease progression, while the presence of PVT and ineffective initial TACE treatment were independent risk factors for death. In the prediction of PFS and OS, CNLC, BCLC, HKLC, mJIS, and mCLIP all showed good predictive ability, but the predictive ability of the TNM staging system was relatively poor.</p><p><strong>Conclusions: </strong>The CNLC, BCLC, HKLC, mJIS, and mCLIP staging systems provide comparable predictive value for the prognosis after the initial TACE, while the TNM staging system has poor predictive ability due to its exclusion of hepatic function.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2599-2612"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006464","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":"A case report: spleen Epstein-Barr virus-positive inflammatory follicular dendritic cell sarcoma.","authors":"Yafang Chen, Xiangrong Yu","doi":"10.21037/jgo-24-483","DOIUrl":"https://doi.org/10.21037/jgo-24-483","url":null,"abstract":"<p><strong>Background: </strong>Epstein-Barr virus-positive (EBV⁺) inflammatory follicular dendritic cell sarcoma (IFDCS) is a rare stroma-derived neoplasm of lymphoid tissues. It typically involves the spleen and liver, and is often associated with the presence of EBV. Because of its nonspecific clinical and imaging findings, making a correct diagnosis at the time of initial diagnosis is challenging. Therefore, we report this misdiagnosis case in order to help decrease the rate of making wrong diagnoses in the future.</p><p><strong>Case description: </strong>We report a case of 71-year-old woman in whom a splenic space-occupying lesion was incidentally found during a chest computed tomography (CT) scan. After laparoscopic partial splenectomy and histopathological examination, the lesion was diagnosed as splenic EBV⁺ IFDCS.</p><p><strong>Conclusions: </strong>EBV⁺ IFDCS is an extremely uncommon tumor. To date, there are no well-recognized imaging features for EBV⁺ IFDCS. We report a case of EBV⁺ IFDCS and focus on its imaging characteristics. The magnetic resonance imaging (MRI) of the lesion in this case report shows nodular enhancement in the arterial and portal phase and reversal enhancement in the delayed phase. This is a new enhancement pattern that has not been previously reported. Nonetheless, at present, the definitive diagnosis still relies on histopathological and immunohistochemical staining. By sharing this case, we aim to improve awareness of this rare entity and its imaging manifestations, which may aid in earlier and more accurate diagnosis.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2706-2711"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006447","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 potential role of tumor deposits in the prognosis and TNM staging for colorectal cancer.","authors":"Xinhong Shi, Lin Lu, Zihan Wang, Yingying Dai, Shuyi Hu, Zipeng Wu, Ruofan Yu, Tianyi Liu, Yingying Jiang, Yuxin Ma, Bo Shen, Guoren Zhou, Emerson Y Chen, Cheng Chen, Lili Zhao, Yue Shi, Xiaohua Wang","doi":"10.21037/jgo-24-786","DOIUrl":"10.21037/jgo-24-786","url":null,"abstract":"<p><strong>Background: </strong>Tumor deposits (TDs) can impact proper staging of cancer, which is crucial for discussing prognosis and determining the appropriate treatment plan. Our study aimed to correlate how TDs influence prognosis of resected colorectal cancer (CRC) and how to optimize tumor-node-metastasis (TNM) staging with respect to TDs for clinical decision-making.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 611 patients with CRC treated in Jiangsu Cancer Hospital from January 1, 2010 to December 31, 2020 among whom 197 had TDs. The influence and distribution characteristics of TDs on the median overall survival (mOS) of patients with CRC were quantitatively and qualitatively analyzed, and the differences in mOS between different subgroups were also analyzed.</p><p><strong>Results: </strong>Patients with TDs had a shorter mOS (only 60.3±3.9 months) than did patients without TDs. TDs had a more significant association with the survival of M0 patients, and there were significant differences in the prognosis of M0 patients with stage pN0 and pN1c or stage pN0, pN1, and pN2. The combination of lymph node metastases (LNMs) and TDs was associated with mOS. The proportion of rectal cancer, papillary tissue type, and nerve invasion was higher in the TD-positive group, and proportion of metastasis to the brain, spleen, lung, and bone in this groups was also higher. Subgroup analysis showed that the degree of tumor differentiation, the depth of tumor invasion, vascular invasion, nerve invasion, liver metastasis, lung metastasis, bone metastasis, peritoneal metastasis, ovarian metastasis, pelvic and abdominal metastasis, and the number of distant metastases were associated with the prognosis of patients with CRC.</p><p><strong>Conclusions: </strong>TDs were closely correlated with the poor prognosis of patients with CRC. Greater attention should be paid to improving the quality of pathological reports in clinical decision-making and the comprehensive assessment of patients' baseline characteristics so that accurate prognosis and corresponding treatment plan can be properly communicated with patients.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2473-2495"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006249","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":"First-line induction or consolidation chemotherapy combined with concurrent chemoradiotherapy for esophageal squamous cell carcinoma.","authors":"Yan Zhao, Huiqing Li, Hua Li, Ziling Zhang, Junpeng Wen, Juan Li","doi":"10.21037/jgo-24-599","DOIUrl":"https://doi.org/10.21037/jgo-24-599","url":null,"abstract":"<p><strong>Background: </strong>The RTOG 85-01 trial established that definitive concurrent chemoradiotherapy (CCRT) is the standard treatment for inoperable, locally advanced esophageal carcinoma, as well as for patients who decline surgery. The present study aims to compare the impact of three treatment modalities, CCRT, induction chemotherapy (ICT) followed by CCRT (ICT + CCRT), and CCRT followed by consolidation chemotherapy (CCT) (CCRT + CCT), on the survival of patients with inoperable esophageal squamous cell carcinoma (ESCC).</p><p><strong>Methods: </strong>This retrospective analysis was conducted with 391 patients with ESCC who underwent radical CCRT with induction or CCT or CCRT only from January 2016 to October 2020 at the Fourth Hospital of Hebei Medical University in Shijiazhuang, Hebei province, China. Propensity score matching (PSM) analyses were performed. The primary outcome measure was efficacy included overall survival (OS) and progression-free survival (PFS). The final follow-up date ended on 31 May 2024.</p><p><strong>Results: </strong>It showed a significantly better survival curve for OS in the CCRT + CCT group than the CCRT group (P=0.02, χ²=5.503). It showed a significantly better survival curve for PFS in the CCRT + CCT group than the CCRT group (P=0.002, χ²=9.788). It showed a significantly better survival curve for OS in the CCRT + CCT group than the ICT + CCRT group (P=0.046, χ²=3.986). It showed a significantly better survival curve for PFS in the CCRT + CCT group than the ICT + CCRT group (P=0.01, χ²=6.610). No significant differences were showed in treatment-related adverse events. Lesion length, N-staging, and combination of radiotherapy and chemotherapy were the independent prognostic factors for OS and PFS.</p><p><strong>Conclusions: </strong>For inoperable ESCC patients, CCRT + CCT showed the best OS and PFS rates than ICT + CCRT and CCRT. There were no significant differences in treatment-related adverse events. Lesion length, N-staging, and combination of radiotherapy and chemotherapy were the independent prognostic factors for OS and PFS.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2389-2399"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006576","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":"Cancer metastasis to the upper gastrointestinal tract-a case series.","authors":"Mohamed Bakry, Hasib Ahmadzai, Mitali Fadia, Geoffrey Peters, Yada Kanjanapan, Shivakumar Chitturi, Ganesalingam Pranavan","doi":"10.21037/jgo-24-532","DOIUrl":"10.21037/jgo-24-532","url":null,"abstract":"<p><strong>Background: </strong>Metastasis of non-gastrointestinal (non-GI) cancers to the upper GI tract is a rare occurrence, with limited cases reported in the literature. Recognising this type of metastasis is crucial, as it presents unique diagnostic and therapeutic challenges. This case series adds to the literature by discussing seven rare cases of non-GI cancer metastasising to the upper GI tract, emphasising the complications and clinical manifestations. These cases highlight the importance of early recognition and interdisciplinary management to optimise patient outcomes.</p><p><strong>Case description: </strong>This retrospective series spans from 2016 to 2024 and includes seven consecutive patients from a tertiary hospital. The primary cancers include renal clear cell carcinoma, non-small cell lung cancer, prostate cancer, and melanoma. Each patient presented with unique patterns of metastasis to the GI tract, manifesting as complications such as upper GI bleeding, melaena, bowel perforation, abdominal pain and weight loss. Interventions ranged from gastroscopy and biopsy to surgical resection, and outcomes varied from disease control to progression with palliative interventions and fatality in some cases, despite targeted treatments. Follow-up of some of the cases highlights the difficulties in managing recurrent bleeding and perforation in these patients.</p><p><strong>Conclusions: </strong>Metastasis of non-GI primary tumours to the upper GI tract-although rare, requires clinicians to maintain a high index of suspicion when encountering unexplained GI symptoms in patients with a history of malignancy. This case series highlights the diverse presentations and complications of upper GI metastasis from non-GI cancers and underscores the need for personalised management strategies. Early recognition and tailored interventions can improve patient outcomes and reduce morbidity.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2728-2734"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006541","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":"Pancreatic cancer: a haystack of needles.","authors":"Nicholas L Michael, Robert W Krell","doi":"10.21037/jgo-24-697","DOIUrl":"https://doi.org/10.21037/jgo-24-697","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2743-2744"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006562","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":"Colorectal cancer: local results and significance in Hungary.","authors":"Stefan Longobardi","doi":"10.21037/jgo-24-318","DOIUrl":"https://doi.org/10.21037/jgo-24-318","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Colorectal cancer (CRC) causes substantial morbidity and mortality internationally. In Hungary, the incidence and mortality of CRC are among the world's highest. Fortunately, CRC is a highly preventable disease, since there is a long asymptomatic phase before neoplastic transformation. Numerous countries have instituted programs for CRC screening. However, Hungary did not implement population-based screening programs until December 2018, consisting of a voluntary 2-step screening program based on the fecal immunochemical test (FIT) and if positive, referral to colonoscopy. Asymptomatic individuals aged over 50 years were invited to participate in the 2-step program. This study aims to analyze the results of these colonoscopies and raise public awareness of the CRC disease process and prevention, especially in Hungary.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Various literature sources were reviewed, and external information was gathered and consolidated based on CRC etiopathogenesis, management options, screening options, cost, benefits, modalities, and quality control. Semmelweis University Department of Internal Medicine and Hematology's database was accessed for the cross-sectional study results of 168 screening colonoscopies within the 2-step program from 2019 to 2020. I quantified and compared the results obtained during the colonoscopies with that of said literature within Hungary and worldwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Colonoscopy was performed in 168 patients of average age 63.4 years. The incidence of CRCs in the population was 4.76%. Among the CRC cases, 75% were in the rectosigmoid area and 25% were in the remaining colon. The total adenoma detection rate (ADR) in the study was 57.1%, higher than the recommended 25% for adequate screening colonoscopy. The total number of resected polyps was 270; 8.1% were adenomas with high-grade dysplasia and 0.76% contained CRC. Out of the 185 resected adenomas, 141 were tubular, 34 were tubulovillous, and 10 were villous. Adenoma localizations included 14.6% rectum, 38.4% sigmoid, 11.9% descending colon, 8.6% transverse colon, 17.8% ascending colon, and 8.6% cecum. The average age of CRC patients was 63.9 years (range, 56-68 years) with a slight female predominance (5 females, 3 males). The ADR of the different endoscopists did not seem to correlate with experience. Optimal participation rate of the screening program would be &gt;60%. Population outreach through mailed FIT is evidence-based and shown to increase CRC screening rates in underserved populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Hungary would benefit immensely in most aspects from mandatory, population-based CRC screening with this 2-step program. This alternative is proposed in lieu of 1-step screening, because of the limited capacity for colonoscopy in the country and the limited participation rates in the screened population. To reach maximum cost-benefit, the participation rate of the screened populatio","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2552-2577"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006457","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}