Scandinavian Journal of Gastroenterology最新文献

{"title":"Prevalence of gastric epithelial neoplasm of fundic-gland mucosa lineage diagnosed by medical checkup findings and time-course changes.","authors":"Eiko Okimoto, Norihisa Ishimura, Kyoichi Adachi, Yuri Ebisutani, Yuko Matsubara, Manabu Yoshida, Hiroshi Miura, Shunji Ishihara","doi":"10.1080/00365521.2025.2496935","DOIUrl":"10.1080/00365521.2025.2496935","url":null,"abstract":"<p><strong>Background: </strong>This study was performed to investigate the prevalence of gastric epithelial neoplasm of fundic-gland mucosa lineage (GEN-FGML) and time-course changes in endoscopic findings in affected subjects who underwent an esophagogastroduodenoscopy (EGD) examination as part of an annual checkup.</p><p><strong>Methods: </strong>A total of 39,292 EGD examinations (25,228 men, 14,034 women; mean age: 53.6 years) were performed between April 2016 and March 2024. The prevalence of GEN-FGML was analyzed, and time-course changes noted in endoscopic findings of diagnosed tumors were investigated by comparison with previous endoscopic images.</p><p><strong>Results: </strong>During the study period, we identified 19 patients with 20 GEN-FGML diagnosed based on endoscopic and histological results, with a prevalence of 0.048%. Prevalence was not different between <i>Helicobacter pylori</i>-uninfected and -eradicated cases (0.050% and 0.051%, respectively). Endoscopy findings of 16 of these tumors for which time-course changes could be investigated (median observation period: 8.5 years) showed that 15 were unchanged in size in comparison with previous EGD findings, while one showed enlargement. In addition, three lesions diagnosed after <i>H. pylori</i> eradication were unchanged in size compared to before eradication.</p><p><strong>Conclusions: </strong>The prevalence of GEN-FGML by screening EGD was 0.048%, with prevalence not different between <i>H. pylori-</i>uninfected and -eradicated subjects. Enlargement over time was not observed in almost all cases, and <i>H. pylori</i> infection status was considered not to influence changes in tumor size.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"494-501"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978991","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 effects of biologics on ulcerative colitis-related colectomy rate: results of a 22-year study.","authors":"Nur Beyza Tukek, Oguz Kagan Bakkaloglu, Gozde Sen, İbrahim Hatemi, Aykut Ferhat Celik, Yusuf Ziya Erzin","doi":"10.1080/00365521.2025.2497954","DOIUrl":"10.1080/00365521.2025.2497954","url":null,"abstract":"<p><strong>Background: </strong>To assess the impact of the biological era on colectomy rates in ulcerative colitis (UC) patients and identify factors associated with the necessity for colectomy in a large cohort from Eastern Europe.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on UC patients followed at a tertiary care center covering 1999 to 2021. Patients who underwent colectomy due to disease activity were compared to those who did not. Factors related to colectomy and the influence of the biological era were analyzed.</p><p><strong>Results: </strong>Among 1197 patients with a median follow-up of 3.3 years, 18% received biological agents and 5.3% underwent colectomy due to disease activity. The colectomy rate was lower in the biological era compared to the pre-biological era (2% vs. 12%; <i>p</i> < 0.001). Independent predictors of colectomy included steroid dependency, steroid resistance, lack of mucosal remission, and elevated CRP levels. Patients who achieved and maintained mucosal remission and had CRP levels below 3 mg/L had a significantly lower risk of colectomy.</p><p><strong>Conclusions: </strong>The biological era has significantly reduced colectomy rates in UC patients. Achieving mucosal remission and maintaining low CRP levels are essential for preventing colectomy and improving long-term outcomes.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"548-557"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011885","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":"Efficient polyp detection algorithm based on deep learning.","authors":"Xing Sun, Jingang Ma, Yang Li","doi":"10.1080/00365521.2025.2503297","DOIUrl":"10.1080/00365521.2025.2503297","url":null,"abstract":"<p><strong>Objective: </strong>Colon polyp detection is crucial in reducing the incidence of colorectal cancer. However, due to the diverse morphology of colon polyps, their high similarity to surrounding tissues, and the difficulty of detecting small target polyps, false negatives and false positives are common problems.</p><p><strong>Methods: </strong>To address this, we propose a lightweight and efficient colon polyp detection model based on YOLOv10, a deep learning-based object detection method-EP-YOLO (Efficient for Polyp). By introducing the GBottleneck module, we reduce the number of parameters and accelerate inference; a lightweight GHead detection head and an additional small target detection layer are designed to enhance small target recognition ability; we propose the SE_SPPF module to improve attention on polyps while suppressing background noise interference; the loss function is replaced with Wise-IoU to optimize gradient distribution and improve generalization ability.</p><p><strong>Results: </strong>Experimental results on the publicly available LDPolypVideo (7,681 images), Kvasir-SEG (1,000 images) and CVC-ClinicDB (612 images) datasets show that EP-YOLO achieves precision scores of 94.17%, 94.32% and 93.21%, respectively, representing improvements of 2.10%, 2.05% and 1.42% over the baseline algorithm, while reducing the number of parameters by 16%.</p><p><strong>Conclusion: </strong>Compared with other mainstream object detection methods, EP-YOLO demonstrates significant advantages in accuracy, computational load and FPS, making it more suitable for practical medical scenarios in colon polyp detection.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"502-515"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029781","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":"Factors affecting response rates in patient-reported outcome measures in inflammatory bowel disease.","authors":"Vivica Dharmadasa, Lai Mei Yip Lundström, Niki Khatibi, Jessica Hossain, Kanza El Kadiry, Victoria Byman, Anette Storlåhls, Jan Björk, Francesca Bresso, Marjo Kapraali, Charlotte R H Hedin","doi":"10.1080/00365521.2025.2501070","DOIUrl":"10.1080/00365521.2025.2501070","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel diseases, Crohn's disease (CD) and ulcerative colitis (UC), are associated with reduced quality of life (QoL). By using questionnaire tools called patient-reported outcome measures (PROM), patients' well-being and health-status can be measured. The aim of this study was to identify subgroups at risk of being missed in questionnaire monitoring and assess QoL and variability of responses over time.</p><p><strong>Methods: </strong>CD or UC, age ≥18 years, receiving biological treatment subcutaneously or intravenously, 01 August 2018 to 31 January 2020, at Karolinska University Hospital, were included. Patients completed standardised and validated questionnaires for QoL-measurements; Short Health Scale (SHS) and EuroQol 5-dimension-index (EQ5D).</p><p><strong>Results: </strong>412 patients, 287 (70%) Crohn's disease, 125 (30%) ulcerative colitis, 267 (65%) males, median age: 33 (range 18-85). Patients receiving subcutaneous treatment completed PROM questionnaires significantly less frequently compared with intravenous treatment (multiplicative factor 6.5, 5.7-7.5 95% CI). Reduced QoL was seen for intravenous treatment (multiplicative factor 2.0, 0.5-3.5 95% CI) and active disease (multiplicative factor -4.0, -6.1 to -1.9 95% CI). Greater variability in responses was seen in active disease, anaemia, faecal calprotectin ≥ 250 mg/kg.</p><p><strong>Conclusions: </strong>Patients receiving subcutaneous treatment, equivalent to home-based treatment, completed significantly fewer PROM questionnaires and are therefore less monitored. It is therefore important to offer different modes of questionnaire administration when monitoring a heterogeneous patient population especially as we see a shift towards oral forms of therapy.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"558-571"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994126","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":"Adult-onset inflammatory bowel disease and the risk of venous thromboembolism - a Swedish nationwide cohort study 2007-2021.","authors":"Gabriella Bröms, Anders Forss, Julia Eriksson, Johan Askling, Carl Eriksson, Jonas Halfvarson, Marie Linder, Jiangwei Sun, Eli Westerlund, Jonas F Ludvigsson, Ola Olén","doi":"10.1080/00365521.2025.2488053","DOIUrl":"10.1080/00365521.2025.2488053","url":null,"abstract":"<p><strong>Background: </strong>Earlier studies, mainly prior to the widespread use of advanced therapy and implementation of guidelines for thromboprophylaxis indicate a doubled risk of venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>Using Swedish healthcare registers, we identified a population-based cohort of patients with incident IBD 2007-2021. Patients were matched by age, sex, calendar year of birth and place of residence with up to 10 reference individuals. The primary outcome was VTE, i.e., pulmonary embolism (PE) and deep vein thrombosis (DVT). Incidence rates (IRs) per 1000 person-years, cumulative incidence and hazard ratios (HRs) were calculated for IBD overall and according to clinical characteristics. The temporal trend of the incidence of VTE by calendar year was presented.</p><p><strong>Results: </strong>We followed 55,252 IBD patients and 536,067 reference individuals, for a median of 6.5 years. The incidence of VTE in IBD was 5.03 <i>vs</i>. 2.35 per 1000 person-years among reference individuals, corresponding to a doubled risk of VTE (HR = 2.12; 95% confidence interval [CI] 2.02-2.23). Particularly high risks were seen in the first year of follow-up, and among patients with extensive ulcerative colitis (UC), primary sclerosing cholangitis (PSC), extraintestinal manifestations, perianal disease and hospitalization at diagnosis. The occurrence of VTE in IBD did not decrease across calendar years.</p><p><strong>Conclusions: </strong>IBD remains linked to an elevated risk of VTE, particularly with disease characteristics associated with a higher inflammatory burden and higher age. Our findings underscore the importance of continuous vigilance and individual assessment of VTE risk in patients with IBD.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"526-535"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012659","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":"Proteomic signatures for fibrosis in MASLD: a biopsy-proven dual-cohort study.","authors":"Julia Blomdahl, Mikael Åberg, Michael Fridén, Håkan Ahlström, Paul Hockings, Johannes Hulthe, Niclas Eriksson, Katja Gabrysch, Patrik Nasr, Ulf Risérus, Stergios Kechagias, Fredrik Rorsman, Mattias Ekstedt, Johan Vessby","doi":"10.1080/00365521.2025.2490996","DOIUrl":"10.1080/00365521.2025.2490996","url":null,"abstract":"<p><strong>Objectives: </strong>Predicting disease progression in metabolic dysfunction-associated steatotic liver disease (MASLD) is challenging, and current non-invasive tests (NITs) lack the precision to replace liver biopsy. This study aimed to identify plasma biomarkers for different stages of fibrosis using affinity-based proteomics in two biopsy-proven cohorts. The primary objective was to identify biomarkers capable of distinguishing between low-to-no fibrosis (F0-1) and significant fibrosis (F2-4) in MASLD.</p><p><strong>Materials and methods: </strong>Participants in the discovery cohort were recruited from Uppsala University Hospital and Swedish CArdioPulmonary bioImage Study (SCAPIS), while the validation cohort was included from Linköping University Hospital. All participants diagnosed with MASLD underwent liver biopsy and were categorized by fibrosis stage (F0-1 or F2-4). A total of 276 plasma proteins were analyzed using Olink^® panels, with biomarkers identified through ordinal logistic regression, random forest (RF) analysis and the Boruta algorithm.</p><p><strong>Results: </strong>The discovery cohort included 60 participants, with 60% having fibrosis stage F0-1 and 40% having F2-4. The validation cohort had 59 participants, of whom 35 had fibrosis stage F0-1 (59.3%) and 24 had stage F2-4 (40.7%). Five biomarkers were significantly associated with fibrosis stage in the discovery cohort, with four confirmed in the validation cohort. A model combining angiotensin converting enzyme-2 (ACE2), hepatocyte growth factor (HGF) and insulin-like growth factor-binding protein-7 (IGFBP-7) demonstrated strong predictive performance for significant fibrosis (c-statistics 0.82-0.83), outperforming fibrosis-4 (FIB-4) (c-statistics 0.61-0.72).</p><p><strong>Conclusions: </strong>A biomarker model including ACE2, HGF and IGFBP7 shows promise in distinguishing between low-stage and significant fibrosis.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"597-605"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011880","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":"Serum uric acid may be a mediator of risk factors in metabolic dysfunction associated steatotic liver disease.","authors":"Xueying Wang, Song Leng","doi":"10.1080/00365521.2025.2490994","DOIUrl":"10.1080/00365521.2025.2490994","url":null,"abstract":"<p><strong>Background: </strong>In recent years, we have witnessed a sharp growth of metabolic dysfunction associated steatotic liver disease (MASLD). How to achieve early prevention of MASLD is imminent. We aimed to determine the dietary pattern and other factors influencing MASLD, to explore whether it mediated by serum uric acid (SUA) or not.</p><p><strong>Methods: </strong>A total of 4,038 adults attending the Health Management Center of the Second Affiliated Hospital of Dalian Medical University between October 2018 and May 2019 were surveyed using a questionnaire and underwent physical measurements. Structural equation model (SEM) was used to verify the risk factors and determine the path affecting MASLD.</p><p><strong>Results: </strong>A total of 3,589 participants were studied. The standardized prevalence of MASLD was 47.8%. Three dietary patterns were identified using factor analysis. The SEM showed that SUA was positively associated with MASLD (standardization coefficient 0.285). In rank order, sex, SUA, dyslipidemia, age, a high-protein diet, and a fast-food diet were risk factors for MASLD. Sex, dyslipidemia, and a fast-food diet had positive and indirect effects on NAFLD through SUA, while age and a high-protein diet had negative and indirect effects on MAFLD through SUA.</p><p><strong>Conclusions: </strong>SUA may be an important mediator of the risk of MASLD. People with abnormal SUA, especially men, should limit their intake of fried and cured foods and desserts; have their blood lipid profiles monitored carefully; appropriately increase their consumption of high-quality protein sources, such as eggs, milk, and beans; and be aware of their MASLD risk.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"581-587"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027995","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":"Non-liver comorbidity in patients with hepatocellular carcinoma and curative treatments - a Swedish national registry study.","authors":"Malin Sternby Eilard, Madeleine Helmersson, Magnus Rizell, Juan Vaz, Fredrik Åberg, Helena Taflin","doi":"10.1080/00365521.2025.2487539","DOIUrl":"10.1080/00365521.2025.2487539","url":null,"abstract":"<p><strong>Objectives: </strong>Treatment decisions for hepatocellular carcinoma (HCC) involve considering tumour stage, liver function and performance status, including comorbidities, although rarely analysed specifically. This study examines the patterns and prognostic impact of comorbidities in HCC patients.</p><p><strong>Methods: </strong>We included patients diagnosed with HCC before undergoing transplantation, resection or ablation, registered in the Swedish Registry for Cancers in the Liver and Bile ducts (SweLiv) 2008-2016. Data were cross-linked with the Swedish National Patient Registry (NPR) to capture International Classification of Diseases (ICD) codes reflecting comorbidities within 10 years before the HCC treatment decision. The Charlson Comorbidity Index (CCI), excluding the liver disease category (CCI-P), was used to estimate accumulated comorbidity.</p><p><strong>Results: </strong>We identified 980 HCC patients with transplantation (225), resection (425) or ablation (330). The comorbidity burden, assessed using the CCI-P, was highest in ablation patients and lowest in the transplanted group (<i>p</i> < 0.001). The CCI-P category distribution varied across treatment groups. After adjusting for age and tumour burden, several CCI-P categories were associated with 5-year mortality, including heart failure, cerebrovascular disease, pulmonary disease, ulcers, and renal disease. ICD diagnoses not included in the CCI, such as trauma, infection, psychiatric disease, anaemia, and obesity, were also linked to 5-year mortality.</p><p><strong>Conclusions: </strong>Comorbidity burden and patterns differed between HCC treatment groups, with CCI-P significantly associated with mortality. Preoperative attention to cardiovascular disease is important, but other comorbid conditions may require vigilance. Given the higher prevalence of comorbidities in ablation and resection patients, efforts to optimize comorbidity in these groups may be warranted.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"572-580"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992752","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":"Comparison of different scoring systems for predicting 28-day mortality in critically ill patients with acute pancreatitis: a retrospective cohort study.","authors":"Zeyu Zhang, Zheng Wang, Fei Li, Xing Liu","doi":"10.1080/00365521.2025.2504077","DOIUrl":"10.1080/00365521.2025.2504077","url":null,"abstract":"<p><strong>Background: </strong>This study compared eight scoring systems for predicting 28-day and 1-year all-cause mortality in critically ill patients with acute pancreatitis (AP).</p><p><strong>Methods: </strong>Data from the Medical Information Mart for Intensive Care IV were used to conduct a comparative analysis of several predictive scoring systems. Predictive performance for 28-day and 1-year mortality was assessed using receiver operating characteristic (ROC) curves (area under the curve [AUC]), restricted cubic splines (RCS) for nonlinearity testing, and multivariable logistic regression for independent predictor analysis.</p><p><strong>Results: </strong>A total of 694 patients were included (28-day mortality: 15.56%; 1-year mortality: 24.78%). Acute Physiology Score III (APSIII) demonstrated the highest accuracy for 28-day mortality (AUC: 0.847, 95% confidence interval (CI): 0.808-0.886), followed by Bedside Index for Severity in Acute Pancreatitis (BISAP) (AUC: 0.835, 95% CI: 0.794-0.875). Linear relationships between scores and 28-day mortality were confirmed (all <i>p</i> for nonlinear > 0.05). Multivariable regression identified APSIII and BISAP as independent 28-day mortality predictors. For 1-year mortality, APSIII, BISAP, and Simplified Acute Physiology Score II (SAPS II) were independent predictors.</p><p><strong>Conclusions: </strong>Both APSIII and BISAP were identified as independent predictors of 28-day mortality, while APSIII, BISAP, and SAPSII were associated with 1-year mortality. Among them, APSIII showed the best overall discriminative ability for both short- and long-term outcomes. However, BISAP remains an attractive alternative for its simplicity and comparable performance.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"608-616"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994125","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":"Effects of aspirin at diagnosis on the survival of colorectal cancer patients: a 20-year population-based study.","authors":"Arnar S Agustsson, Sigurdis Haraldsdottir, Helgi Birgisson, Sigrun H Lund, Arnar B Ingason, Johann P Hreinsson, Einar S Björnsson","doi":"10.1080/00365521.2025.2499126","DOIUrl":"10.1080/00365521.2025.2499126","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have produced conflicting results regarding whether aspirin affects survival in colorectal cancer (CRC) patients. This study examines the relationship between regular aspirin use and survival in CRC patients within a nationwide cohort.</p><p><strong>Methods: </strong>All patients diagnosed with CRC in Iceland from 2000 to 2019 were identified through the Icelandic Cancer Registry. Clinical variables, including medications, were extracted from medical records. Overall survival (OS) and cancer-specific survival (CSS) were calculated. The follow-up period ended on 1 October 2022. The Charlson comorbidity index was used to assess comorbidity burden, and propensity score matching was employed to balance patient characteristics.</p><p><strong>Results: </strong>Of the 2,561 eligible patients, 22% (<i>n</i> = 559) had been taking aspirin before their CRC diagnosis. Aspirin users were generally older and more frequently male (63% vs. 51%), with a higher comorbidity burden (15% vs. 4.7%). The median follow-up period was 51 months (IQR 14-110). Aspirin users were less likely to receive a stage IV diagnosis. After matching, overall survival (OS) was comparable between aspirin and non-users (HR: 0.94, 95% CI (0.83-1.06), <i>p</i> = 0.30). However, cancer-specific survival (CSS) was significantly better for aspirin users (HR: 0.79, 95% CI (0.65-0.95), <i>p</i> = 0.01). This benefit was not observed in patients with stages I-III CRC or those diagnosed due to gastrointestinal bleeding.</p><p><strong>Conclusion: </strong>Aspirin use was linked to improved CSS but not OS. The findings suggest aspirin's potential role in slowing or hindering progression to stage IV cancer.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"516-525"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023867","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}