Journal of Gastroenterology and Hepatology最新文献

{"title":"Optimal Timing of Surgery After Insertion of Self-Expandable Metallic Stent to Obstructive Colorectal Neoplasm as a Bridge to Surgery.","authors":"Dong Hyun Kim, Hyun Lim, Jung-Wook Kim, Yunho Jung, Hyun-Soo Kim, Ki-Hyun Kim, Jin Won Kim, Young-Eun Joo, Bo-In Lee, Han Hee Lee","doi":"10.1111/jgh.16984","DOIUrl":"https://doi.org/10.1111/jgh.16984","url":null,"abstract":"<p><strong>Background and aims: </strong>Colonic stenting using self-expandable metallic stents (SEMS) as a bridge to surgery offers an effective alternative to emergency surgery for the management of malignant colorectal obstruction. However, the optimal timing of elective surgery after stenting remains controversial.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study analyzed 380 patients with obstructive colorectal cancer who were treated with SEMS as a bridge to surgery. Patients were categorized into four groups based on the time from stent insertion to surgery: within 7 days, 8-14 days, 15-21 days, and 22 days or more.</p><p><strong>Results: </strong>The study cohort had a slight male predominance (55.8%), with an average age of 65.8 years. Most surgeries (74.2%) were laparoscopically performed. No significant differences were observed in stoma formation rates or postoperative complications between the different timing groups. Similarly, recurrence-free survival, overall survival, locoregional recurrence, and distant metastasis rates showed no significant variations with the timing of post-stenting surgery. A restricted cubic spline curve indicated that surgery within the 15-21-day period post-SEMS insertion resulted in the lowest incidence of stoma formation.</p><p><strong>Conclusions: </strong>Delaying elective surgery for up to 3 weeks post-SEMS placement for obstructive colorectal cancer is recommended, particularly within the 15-21-day period, to minimize stoma formation rates without compromising on long-term outcomes.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014697","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":"Correction to “Endoscopic Versus Medical Management of Peptic Ulcers With Adherent Clots: Overcoming Hesitation Through Education”","authors":"","doi":"10.1111/jgh.16983","DOIUrl":"10.1111/jgh.16983","url":null,"abstract":"<p>\u0000 <span>Allo, G.</span>, <span>Nierhoff, D.</span>, and <span>Kasper, P.</span> (<span>2023</span>) <span>Endoscopic Versus Medical Management of Peptic Ulcers With Adherent Clots: Overcoming Hesitation Through Education</span>. <i>Journal of Gastroenterology and Hepatology</i>, <span>25</span>: <span>2240</span>, https://doi.org/10.1111/jgh.16665.</p><p>The funding statement for this article was missing. The below funding statement has been added to the article:</p><p>Open Access funding enabled and organized by Projekt DEAL.</p><p>We apologize for this error.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Guidelines and Advances in the Management of Fundic Gland Polyps","authors":"Majed Ali,&nbsp;Lynn Srour,&nbsp;Mustapha Bitar,&nbsp;Karam Karam,&nbsp;Ihab I. El Hajj,&nbsp;Elias Fiani","doi":"10.1111/jgh.16972","DOIUrl":"10.1111/jgh.16972","url":null,"abstract":"<p>Fundic gland polyps (FGPs) are the most common type of gastric polyps, predominantly benign and associated with long-term proton pump inhibitor (PPI) use and familial adenomatous polyposis (FAP). FGPs are primarily found in the gastric fundus and body, with higher prevalence in individuals over 50 and previously thought to have been a consequence of prolonged PPI therapy. Although most FGPs are sporadic and carry minimal malignancy risk, FAP-associated FGPs may exhibit dysplastic changes, warranting closer surveillance. This review provides a comprehensive overview of the current guidelines and recent advances in the management of FGPs, focusing on diagnostic approaches, including endoscopic and imaging techniques, as well as histopathological evaluation. It discusses the pathophysiology of FGP formation, highlighting the role of PPI use, the inverse relationship with <i>Helicobacter pylori</i> infection, and the genetic alterations in the APC and β-catenin genes. Recommendations for the management of FGPs vary by patient population; for those with FAP or on long-term PPI therapy, surveillance strategies include endoscopic monitoring and possible polypectomy in cases of dysplasia. For most patients with sporadic FGPs, conservative management is appropriate. This review aims to provide clarity on the management of FGPs, emphasizing the need for individualized approaches based on risk factors and polyp characteristics.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1374-1380"},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16972","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Promise and Uncertainty: PPAR Agonists in IBD Therapy","authors":"Qurat Ul Ain Iftikhar,&nbsp;Muhammad Khubaib Iftikhar,&nbsp;Javed Iqbal,&nbsp;Brijesh Sathian","doi":"10.1111/jgh.16978","DOIUrl":"10.1111/jgh.16978","url":null,"abstract":"<div>\u0000 \u0000 <p>PPARγ/β/δ agonists have emerged as potential therapeutic agents for inflammatory bowel disease (IBD) due to their immunomodulatory effects and ability to influence gut microbiota composition. Li et al. investigated their impact on dextran sodium sulfate (DSS)-induced colitis, demonstrating reduced colonic inflammation and favorable microbiota shifts. However, methodological considerations, including the limitations of DSS-induced colitis as a chronic disease model and the absence of long-term follow-up, warrant further scrutiny. Additionally, alternative therapeutic strategies such as probiotics and dietary interventions have exhibited similar microbiota-modulating and anti-inflammatory benefits, necessitating comparative efficacy studies. Concerns regarding the systemic effects and safety profile of PPAR agonists also require attention, particularly in patients with metabolic comorbidities. To optimize clinical translation, future research should focus on chronic colitis models, human trials, and precision medicine approaches to tailor PPAR-targeted therapies. A comprehensive evaluation integrating host metabolism, immune regulation, and microbiota interactions will be essential to establish their role in IBD management.</p>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1646-1647"},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039738","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":"Small Submucosal Adenocarcinoma Curatively Resected by Minimally Invasive Treatment in the Third Portion of the Duodenum","authors":"Yuko Hara,&nbsp;Akira Dobashi,&nbsp;Kenichi Goda,&nbsp;Miku Maeda,&nbsp;Mayo Nakamura,&nbsp;Masayuki Shimoda,&nbsp;Yuta Takano,&nbsp;Muneharu Fujisaki,&nbsp;Kazuki Sumiyama","doi":"10.1111/jgh.16975","DOIUrl":"10.1111/jgh.16975","url":null,"abstract":"&lt;p&gt;A 74-year-old man presented with nonspecific symptoms. His previous doctor found an 8-mm-diameter polypoid lesion in the third portion of the duodenum by screening endoscopy. A biopsy showed a low-grade adenoma, and the patient was referred to our hospital for treatment. White light endoscopy showed a partial milky-white color change [&lt;span&gt;1&lt;/span&gt;] in the small lesion (Figure 1a). Indigo carmine chromoendoscopy showed a clear demarcation line without irregularities. Magnifying endoscopy with narrow-band imaging (ME-NBI) demonstrated high-density mucosal patterns characterized by heterogeneity in shape and size, as well as dilated vascular patterns exhibiting irregular bending and changes in caliber (Figure 1b). Based on these findings, high-grade adenoma or mucosal adenocarcinoma of an intestinal type was suspected.&lt;/p&gt;&lt;p&gt;The lesion was removed using en bloc endoscopic mucosal resection (EMR). The nonlifting sign were not observed, and no findings suggestive of submucosal invasion were seen during EMR (Figure 1c). Histological analysis revealed a dense proliferation of atypical glands in the mucosal and submucosal layers, with an obscured vertical margin owing to thermal coagulation (Figure 2a). High-power microscopy demonstrated irregularly branching tubular structures with disruption of nuclear polarity, consistent with tubular adenocarcinoma (Figure 2b). Immunohistochemical staining for desmin confirmed muscularis mucosal disruption and submucosal invasion of ≥ 500 μm (Figure 2c). Immunohistochemistry showed that the tumor cells were positive for MUC2 and CD10, while negative for MUC5AC and MUC6, indicative of an intestinal-type adenocarcinoma. Histological examination of the EMR specimen revealed no lymphovascular invasion, with a negative horizontal margin. Additional surgery, minimally invasive sentinel-node navigation surgery (SNNS), was performed because the tumor showed submucosal invasion and the vertical margin could not be assessed owing to thermal effects. Sentinel lymph nodes were identified using local injection of indocyanine green solution near the EMR scar, which revealed lymphatic flows through laparoscopic infrared imaging. Four sentinel lymph nodes were detected and removed; intraoperative rapid pathological diagnosis revealed no cancer metastasis. Subsequently, partial duodenal resection was performed without adverse events (Figure 1d). Histologically, no residual cancer cells were observed in the surgical specimens. No recurrence or metastasis occurred during the 6-year postoperative follow-up.&lt;/p&gt;&lt;p&gt;We found that 10 cases of submucosal cancer measuring ≤ 10 mm have been reported in the literature. To our knowledge, no case of small submucosal cancer &lt; 10 mm and located in the third portion of the duodenum has previously been reported. This case highlights that the distal duodenum (the third or fourth portion) can harbor a small submucosal cancer lesion, and it is not possible to predict submucosal cancer invasion b","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1342-1344"},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16975","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Myths: Mortality Risks and the Clinical Management of Diverticulosis","authors":"Qurat Ul Ain Iftikhar,&nbsp;Muhammad Khubaib Iftikhar,&nbsp;Javed Iqbal,&nbsp;Brijesh Sathian","doi":"10.1111/jgh.16977","DOIUrl":"10.1111/jgh.16977","url":null,"abstract":"<div>\u0000 \u0000 <p>Cameron et al. challenge the traditional view that colonic diverticulosis and uncomplicated diverticulitis increase mortality risk by demonstrating a protective association when confounding factors are controlled. Their findings align with recent epidemiological studies suggesting that diverticulosis is largely benign, necessitating a reassessment of its clinical management. However, residual confounding and the retrospective nature of the study warrant cautious interpretation. Future prospective research should investigate dietary, microbiota, and inflammatory influences. These insights emphasize the importance of individualized patient management and prioritization of comorbid conditions over diverticulosis treatment.</p>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1644-1645"},"PeriodicalIF":3.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969413","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":"Second Examination of the Right Colon Using Narrow-Band Imaging Increases Adenoma Detection Rates in the Right Colon: A Multicenter, Randomized Controlled Trial.","authors":"Shin Hee Kim, One Zoong Kim, In Kyung Yoo, Jae Yong Park, Young Joo Yang, Jin Hwa Park, Sang Pyo Lee, Jae Gon Lee","doi":"10.1111/jgh.16964","DOIUrl":"https://doi.org/10.1111/jgh.16964","url":null,"abstract":"<p><strong>Background/aims: </strong>Repeat examination of the right colon increases adenoma detection rates (ADRs) in the right colon. This study aimed to investigate whether a second examination of the right colon using narrow-band imaging (NBI) increases ADRs in the right colon compared with repeat examinations using white light imaging (WLI).</p><p><strong>Methods: </strong>Consecutive patients with routine indications for colonoscopy were enrolled and randomly assigned to two groups. The control arm underwent two repeat forward examinations of the right colon using WLI only (repeat-WLI group), and the intervention arm underwent the first examination of the right colon using WLI and the second examination using NBI (WLI-NBI group). Lesions detected during the first and second examinations in each group were analyzed. The primary outcome was ADR in the right colon.</p><p><strong>Results: </strong>A total of 476 colonoscopies were analyzed, including 240 and 236 in the repeat-WLI and WLI-NBI groups, respectively. The overall ADR in the right colon was significantly higher in the WLI-NBI group than that in the repeat-WLI group (27.1% vs. 17.9%; p = 0.022). The number of adenomas per colonoscopy in the right colon was also significantly higher in the WLI-NBI group than in the repeat-WLI group (mean number of adenomas, 0.36 vs. 0.24; p = 0.042). However, there were no significant differences in the detection rates of advanced adenomas and sessile serrated lesions between the WLI-NBI and repeat-WLI groups (advanced adenoma, 4.7% vs. 2.9%; sessile serrated lesion, 2.5% vs. 3.3%).</p><p><strong>Conclusion: </strong>A second forward examination of the right colon using NBI increased ADRs in the right colon.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988463","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":"Development of an AI-Assisted System for Automatic Recognition and Localization Marking of Colonic Polyps (With Video).","authors":"Jian Chen, Ganhong Wang, Yu Ding, Zihao Zhang, Kaijian Xia, Lu Xu, Xiaodan Xu","doi":"10.1111/jgh.16980","DOIUrl":"https://doi.org/10.1111/jgh.16980","url":null,"abstract":"<p><strong>Background: </strong>Localizing colorectal polyps identified during the initial colonoscopy in minimally invasive endoscopic surgery presents significant challenges. These challenges include imprecise location descriptions, unclear images, a high number of polyps, and polyp characteristics such as flat shapes and low color contrast. To address these issues, we developed an AI-assisted system for the automatic detection and localization of colorectal polyps.</p><p><strong>Methods: </strong>Colonic images and videos from three medical centers, collected between January 2018 and August 2024, were categorized based on pathology results into normal, adenomatous polyp, and serrated lesion groups. Transfer learning and fine-tuning were conducted on five pretrained CNN models, with performance evaluated using metrics such as accuracy, precision, sensitivity, and AUC. The best-performing model was selected for interpretability analysis and developed into an AI-assisted system capable of both polyp recognition and location marking.</p><p><strong>Results: </strong>Among the five models, EfficientNetV2 performed the best, achieving accuracy, precision, sensitivity, and F1 scores of 0.933, 0.917, 0.916, and 0.917, respectively, on the validation set. On the test set, the model's overall weighted average precision, specificity, and AUC were 0.903, 0.946, and 0.983, respectively. Two representative colonoscopy case videos predicted by the model further demonstrated the feasibility of this AI system in clinical practice.</p><p><strong>Conclusions: </strong>The AI system we developed for the automatic recognition and localization marking of colonic polyps in colonoscopy aids in the rapid localization of polyps during minimally invasive endoscopic surgery.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988562","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":"Gender Parity in Authorship of Gastroenterology Publications: Some Way yet Over the Horizon","authors":"Sundramoorthy Mahendra Raj,&nbsp;Sharmila Sachithanandan","doi":"10.1111/jgh.16981","DOIUrl":"10.1111/jgh.16981","url":null,"abstract":"&lt;p&gt;It is poignant that as the Trump administration in the United States dials back on policies effecting diversity, equity, and inclusion (DEI) [&lt;span&gt;1&lt;/span&gt;], this issue of the journal carries a paper by Ng et al. that examined gender disparity in the authorship of Gastroenterology Clinical Practice Guidelines in the United States [&lt;span&gt;2&lt;/span&gt;]. The key finding was that in 2019–2022, men outnumbered women as first authors of guidelines by 3 to 1, and as senior authors by more than 5 to 1. Even more telling was that when compared to retired guidelines on the same topics, female author representation had not improved between 2010 and 2020. Furthermore, the overwhelming majority of male first and senior authors held the faculty rank of professor in stark contrast to female authors among whom only a minority were professors. A marginally brighter picture emerged when the authorship of articles cited in the guidelines was analyzed. Between 1980 and 2020, there was an increase in the number of cited articles with women as first and senior authors, perhaps simply a reflection of the overall proliferation of research publications over time. However, while women still constituted a minority of first and senior authors, there was an encouraging increase in female representation over the period. A closer look at the data on cited articles gives more insight into the publication landscape. Women were even more underrepresented as first or senior authors in cited articles that were randomized controlled trials, systemic reviews or meta-analyses than of articles that were observational studies. As an extension of that, cited articles of which women were first or senior authors were much less likely to support a strong recommendation than articles authored by men. First and senior female authors of cited articles were again substantially less likely to hold the faculty rank of professor than their male counterparts.&lt;/p&gt;&lt;p&gt;While a similar study in the Asia Pacific region has not been conducted, it is more than likely that the gender disparity would be even more pronounced. There is already data showing that female participation as speakers, chairpersons, and organizing committee members of gastroenterology, hepatology, and endoscopy conferences in Asia is low [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Twenty-five years after the turn of the century, it seems anachronistic to have to argue the case for greater participation of women. Sadly, the lack of progress in many parts of the world and indeed regression in some parts, makes it important to revisit some of the arguments for greater female involvement. Moral and ethical considerations aside, there is compelling evidence from the business world that greater gender diversity among company leadership teams is associated with higher performance [&lt;span&gt;4&lt;/span&gt;]. A recent study showed that patients treated by female physicians had lower mortality and readmission rates, an effect even more noticeable among female patients [&lt;spa","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1339-1341"},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16981","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Aspirin Increased the Adenoma Detection Rate and Positive Predictive Value of Fecal Immunochemical Test","authors":"Zhongxue Han,&nbsp;Ruchen Zhou,&nbsp;Yueyue Li,&nbsp;Yanqing Li","doi":"10.1111/jgh.16949","DOIUrl":"10.1111/jgh.16949","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>We aim to evaluate the effect of aspirin on fecal immunochemical test (FIT) performance for advanced colorectal neoplasia (ACRN) including advanced adenoma (AA) and colorectal cancer (CRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter study involved 4887 individuals who were asked to complete a quantitative FIT and subsequent colonoscopy. Aspirin users and nonusers were matched for age and sex. The primary outcome was the positive predictive value (PPV) of FIT compared between users and matched nonusers. Univariable and multivariable logistic regression analyses were also conducted in the entire cohort and expressed as odds ratio (OR) with 95% confidence interval (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For AA, the PPV of FIT was 25.30% in users vs. 14.71% in nonusers (<i>p</i> = 0.005), and the detection rate was 8.28% in users vs. 4.44% in nonusers (<i>p</i> = 0.003). The multivariable OR after adjusting age and sex was 1.52 (95% CI, 1.02–2.22, <i>p</i> = 0.036) for PPV and 1.41 (95% CI, 0.99–1.99, <i>p</i> = 0.052) for the detection rate compared between users and nonusers. Aspirin did not affect the sensitivity and specificity of FIT for AA. Additionally, no significant difference in FIT performance for ACRN and CRC was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of aspirin increased detection rate and PPV of FIT for AA, without impact on FIT performance for ACRN and CRC. Given the risk of cardiovascular events and influence on participation rate of FIT screening, aspirin withdrawal before FIT is unnecessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1461-1471"},"PeriodicalIF":3.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029309","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}