Scandinavian Journal of Gastroenterology最新文献

{"title":"Asymptomatic small gastric subepithelial lesions arising from the muscularis propria: outcomes and surveillance in a medical center.","authors":"Pei-Huan Ho, Chun-Jung Lin, Chao-Wei Hsu, Cheng-Yu Lin, Mu-Hsien Lee, Wey-Ran Lin, Ming-Ling Chang, Tse-Ching Chen, Cheng-Tang Chiu","doi":"10.1080/00365521.2025.2480679","DOIUrl":"10.1080/00365521.2025.2480679","url":null,"abstract":"<p><strong>Background and aims: </strong>Gastric subepithelial lesions (SELs) are frequently identified incidentally during endoscopy, with those originating from the muscularis propria (MP) layer posing diagnostic and management challenges. The optimal surveillance duration for these lesions remains debated. This study aimed to assess size changes in SELs from the MP layer and recommend appropriate surveillance intervals.</p><p><strong>Methods: </strong>We retrospectively reviewed asymptomatic gastric SELs (≤2 cm) diagnosed <i>via</i> endoscopic ultrasound (EUS) from 2013 to 2018, with follow-up data and no excision within 1 year. Significant progression was defined as <i>a</i> > 20% increase in diameter during EUS surveillance. Lesion-related adverse outcomes, size changes, and histological findings were analyzed.</p><p><strong>Results: </strong>A total of 561 patients (median surveillance duration: 80 months) were included. One lesion-related adverse outcome (0.2%), liver metastasis from a gastrointestinal stromal tumor, occurred after 62 months. Among the EUS subgroup (<i>n</i> = 313), no differences were observed in progression rates (22.6% vs. 25%) or size increase rates (0.3 mm/year vs. 0.9 mm/year) between micro-SELs (<10 mm) and mini-SELs (10-20 mm). Progressive lesions exhibited faster growth (2.6 mm/year) and more heterogeneous echotexture (43.8%). Most excised lesions were gastrointestinal stromal tumors or leiomyomas.</p><p><strong>Conclusions: </strong>Over a mean surveillance period of 25.5 months, 13 lesions grew beyond 20 mm. No lesion-related adverse outcomes occurred within the first three years. Histological diagnosis remains the gold standard, but when tissue acquisition is unfeasible, EUS surveillance may be an alternative. Our findings suggest that for asymptomatic micro-SELs (<10 mm) from the MP layer without high-risk features, the surveillance interval can be safely extended to two years.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"405-413"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731473","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":"Diagnostic yield of second-line aetiological workup in patients with presumed idiopathic acute pancreatitis: a retrospective cohort study.","authors":"Ida Saksenborg Kølle, Andreas Svenstrup Hesthaven, Line Davidsen, Rasmus Hagn-Meincke, Asbjørn Mohr Drewes, Inge Søkilde Pedersen, Per Ejstrud, Stine Dam Henriksen, Søren Schou Olesen","doi":"10.1080/00365521.2025.2485135","DOIUrl":"10.1080/00365521.2025.2485135","url":null,"abstract":"<p><strong>Background: </strong>After an aetiological (first-line) workup, the cause of acute pancreatitis remains unidentified in a significant proportion of cases, a condition known as idiopathic acute pancreatitis (IAP).</p><p><strong>Methods: </strong>Retrospective cohort study involving patients with presumed IAP referred for second-line aetiological workup. The completion of first-line aetiological evaluations was assessed upon referral, and the diagnostic outcomes of second-line investigations were evaluated. Over a one-year follow-up period, we documented acute pancreatitis recurrence and patient mortality. Recurrence risk was analysed using an age-adjusted Cox regression model, stratified by treatable versus non-treatable aetiologies.</p><p><strong>Results: </strong>We identified 161 patients with presumed IAP, among whom 81 (50%) had recurrent acute pancreatitis. In total, 115 patients (71%) had a complete first-line aetiological workup. The overall diagnostic yield of the second-line aetiological workup was 25% (95% confidence interval [CI] 18-32%). Among second-line tests, the highest diagnostic yield was found for endoscopic ultrasound (34%, 95% CI 20-50%) and genetic testing (37%, 95% CI 22-53%). The most frequent aetiologies identified were biliary pancreatitis (16 patients [10%]) and pancreatitis with a genetic mutation (15 patients [9%]). Neoplasia was identified in two patients. A treatable aetiology was associated with a numerically reduced pancreatitis recurrence risk (Hazard Ratio 0.50, 95% CI 0.07-3.85, <i>p</i> = 0.51). No patient died during the follow-up period.</p><p><strong>Conclusion: </strong>A second-line aetiological workup can identify the aetiology in 25% of patients with presumed IAP. The most frequent aetiologies are biliary pancreatitis and pancreatitis with a genetic mutation.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"485-493"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754434","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":"Temporal trends in characteristics and management of inflammatory bowel disease.","authors":"Jessica C Young, Lise M Helsingen, Erle Refsum, Amanda Högdén, Vera Perrin, Magnus Løberg, Rasmus H Gantzel, Michael Bretthauer, Anita Berglund, Øyvind Holme, Henriette Cecilie Jodal, Tore Grimstad, Stephan A Brackmann, Weimin Ye, Hans-Olov Adami, Lone Larsen, Miguel A Hernan, Tine Jess, Johannes Blom, Mette Kalager","doi":"10.1080/00365521.2025.2478166","DOIUrl":"10.1080/00365521.2025.2478166","url":null,"abstract":"<p><strong>Background and aims: </strong>Inflammatory bowel disease (IBD) requires complex clinical management. Despite substantial advancements in endoscopy and in pharmacotherapies for patients with IBD, it remains unclear how these developments have influenced IBD incidence and clinical care. We aim to describe changes in diagnostic and therapeutic practices in IBD management.</p><p><strong>Methods: </strong>All individuals diagnosed with IBD between 1987 and 2016 were identified from nationwide registries in Norway and Sweden. We performed detailed chart abstractions for a random sample of the cohort. We describe patient characteristics, disease extent, endoscopic practices, pathology diagnostics, pharmacological therapy and surgical management, stratifying by Crohn's disease (CD) and ulcerative colitis [UC], comparing patients diagnosed before (pre-biologic period, 1987-1999), and after the introduction of biologic drugs (biologic period, 2000-2016).</p><p><strong>Results: </strong>Chart abstraction was completed for 791 individuals (UC: 58.8%, Crohn's disease: 40.2%, unclassified IBD: 1.0%). Comparing the biologic period to the pre-biologic period, we observed an increase in endoscopies after diagnosis, more frequent colonoscopies, and a decrease in colon resection rates. Among those diagnosed in 2007 or later compared with those diagnosed between 2000 and 2006, there was a higher treatment initiation rate of azathioprine, infliximab and adalimumab within 1 year after diagnosis.</p><p><strong>Conclusions: </strong>Our findings suggest a shift towards more frequent endoscopy, increased use of immunosuppressants and biologics, and decreased colon resection rates in recent periods.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"421-429"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692982","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":"Evaluating the role of kynurenine/tryptophan ratio as an indicator of disease activity in Indian patients with inflammatory bowel disease. A case-control study.","authors":"Khushboo G Upadhyay, Devendra C Desai, Tester F Ashavaid, Alpa J Dherai","doi":"10.1080/00365521.2025.2491784","DOIUrl":"https://doi.org/10.1080/00365521.2025.2491784","url":null,"abstract":"<p><strong>Background: </strong>Tryptophan (T), an essential amino acid, is primarily metabolized (∼90%) to kynurenine (K) by indoleamine 2,3-dioxygenase 1 (IDO1) mainly in intestinal cells. In inflammatory bowel disease (IBD), there is an increase in IDO1 activity which would increase Kynurenine levels and Kynurenine/Tryptophan (K/T) ratio. We hypothesize that alteration in K/T may be an indicator of disease severity in IBD.</p><p><strong>Methods: </strong>55 healthy controls (HC), 55 Ulcerative colitis (UC) (35 active and 20 remission) and 30 Crohn's disease (CD) (20 active and 10 remission) were enrolled from November 2020 to March 2023. Plasma Kyn & Trp were simultaneously estimated using ultra-high-pressure liquid chromatography (UPLC). K/T ratio was correlated with disease activity and fecal calprotectin. In 25 patients follow-up samples were also collected with change in disease activity.</p><p><strong>Results: </strong>Median K/T ratio was significantly higher in patients with active disease as compared to those in remission and HC (<i>p</i> < .0001). A cut-off of ≤41 distinguished remission/healthy controls with a sensitivity of 92.73%, specificity of 76.36%, and an AUC of 0.9 (95% CI: 0.83-0.95, <i>p</i> < .001). The K/T ratio correlated with FC levels at a diagnostic cut-off of 250 µg/g. A significant reduction in K/T ratio with disease activity was noted in 80% of follow-up patients.</p><p><strong>Conclusion: </strong>The K/T ratio with a cut-off of 41, correlated with the disease activity in 82% of patients, suggesting that the K/T ratio alters remarkably with disease activity in IBD patients. These findings can be further assessed for disease marker in a larger cohort of IBD patients.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":"60 5","pages":"454-462"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015547","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":"Meckel's diverticulum discovered by capsule endoscopy: a systematic review of case reports.","authors":"Lea Østergaard Hansen, Camilla Thorndal, Alexandra Agache, Anastasios Koulaouzidis","doi":"10.1080/00365521.2025.2487536","DOIUrl":"10.1080/00365521.2025.2487536","url":null,"abstract":"<p><strong>Objectives: </strong>Capsule endoscopy has achieved its place as a diagnostic tool in a clinical setting, especially in the small bowel. The most frequent malformation of the gastrointestinal tract (Meckel's Diverticulum) has therefore been discovered incidentally by capsule endoscopies multiple times. However, it is still not a regular diagnostic modality when the pathology is suspected. In this review of case reports, we aim to evaluate the knowledge and rationales of using capsule endoscopy as a diagnostic tool for Meckel's diverticulum.</p><p><strong>Methods: </strong>We performed a search through Pubmed and Embase to find all publications describing cases of Meckel's diverticulum diagnosed by capsule endoscopy. All data was collected, and a stratification based on age group (adult versus pediatric patients) was performed.</p><p><strong>Results: </strong>The search resulted in 43 cases of Meckel's diverticulum diagnosed with capsule endoscopy, reported in 33 publications. The majority of the patients were male, with a median age of 20 years, and had an average of three negative investigations performed prior to capsule endoscopy. The three most commonly used investigations were upper and lower endoscopy and Meckel's scan. The most frequent finding on capsule endoscopy was the double lumen sign.</p><p><strong>Conclusion: </strong>The case reports indicate that capsule endoscopy can and has been used as a diagnostic tool for Meckel Diverticulum going back as far as 2002, with the most common finding being the double lumen sign. But it also highlights that patients too often go through multiple negative investigations before having a capsule endoscopy performed.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"414-420"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812232","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":"Iron deficiency should not be accepted in patients with inflammatory bowel disease - a Scandinavian expert opinion.","authors":"Trond Espen Detlie, Johan Burisch, Jørgen Jahnsen, Ole Bonderup, Per M Hellström, Stefan Lindgren, Svein Oskar Frigstad","doi":"10.1080/00365521.2025.2487907","DOIUrl":"10.1080/00365521.2025.2487907","url":null,"abstract":"<p><strong>Aim: </strong>In this paper, we aim to explain the reason why iron deficiency (ID) is common in patients with inflammatory bowel disease (IBD), how to better apply diagnostic tools to uncover the state of ID as well as how to interpret the results, and not least, how to treat ID in this group of patients.</p><p><strong>Methods: </strong>This article is an expert review and opinion paper on a topic that is too often forgotten in clinical practice. We have not performed a systematic review, but we present the most important research allocated to the topic to substantiate an expert opinion.</p><p><strong>Results: </strong>This position paper summarises the pathophysiology of ID and gives recommendations on the monitoring and treatment of ID in IBD. ID with or without concurrent anaemia (IDA) is the most common systemic complication in patients with IBD, related to both disease activity and severity. It has consequences both for health-related quality of life and future course of disease of the IBD patient. Intravenous iron is an efficacious and well tolerated, but still underused, therapy for ID and IDA. Iron deficiency should be treated before symptoms of anaemia appear and quality of life is impacted. However, there is still limited awareness of how to detect and treat ID in clinical practice. Uncertainty regarding which diagnostic tests to use and how to interpret the results may also be responsible for variations in clinical practice. In addition, opinions on how to correct ID and IDA differ, in relation to both clinical efficacy and safety.</p><p><strong>Conclusion: </strong>The consequences of ID in patients with IBD are significant. Guidelines on diagnosis, treatment and follow-up of ID should be implemented. IDA is a manifestation of severe ID and preventive strategies focusing on efficient treatment of ID regardless of the level of haemoglobin should therefore be explored.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"430-438"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812231","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":"Global prevalence of biologic drugs use in inflammatory bowel diseases: a systematic review and meta-analysis.","authors":"Caroline Tianeze de Castro, Douglas da Silva Oliveira, Fabrício Freire de Melo, Mauricio Lima Barreto, Carlos Antonio de Souza Teles Santos, Djanilson Barbosa Dos Santos","doi":"10.1080/00365521.2025.2491013","DOIUrl":"https://doi.org/10.1080/00365521.2025.2491013","url":null,"abstract":"<p><strong>Objectives: </strong>Biologics are increasingly essential in managing inflammatory bowel diseases (IBDs) worldwide, as they can modify disease progression and improve patients' quality of life. This study aimed to analyze the global prevalence of and geographic variations in the use of biological drugs for IBD.</p><p><strong>Materials and methods: </strong>Articles published up to 21 July 2024, were identified from the PubMed/MEDLINE, Web of Science, Scopus, Embase, IBECS, WPRIM, BRISA/RedETSA and LILACS databases. Population-based studies (cohort, case-control and cross-sectional) and studies using administrative databases with data on the prevalence of biological medicine use in patients with IBD were included. Two reviewers independently screened the studies, extracted data, and assessed methodological quality. Estimates were pooled using a random-effects meta-analysis, whereas heterogeneity was evaluated using Cochran's <i>Q</i> test and <i>I</i>².</p><p><strong>Results: </strong>Of the 8239 titles, 68 (<i>n</i> = 3,482,385 patients) were included. An increase in the number of studies on the subject has been reported since 2017, and these studies have been mostly concentrated in high-income countries. A 15.06% (95% CI 11.84-18.28%) prevalence of biologic use in IBD worldwide was reported, predominantly concentrated in the use of anti-TNF agents 15.01% (95% CI 10.35-19.67%). Furthermore, patients with Crohn's disease (CD) had a greater prevalence of biologic use (21.41%; 95% CI 16.31-26.50%) than ulcerative colitis (UC) patients (9.70%; 95% CI 6.20-13.18%).</p><p><strong>Conclusions: </strong>Further studies using population-based and administrative data and stratifying their analyses by disease type are required to confirm our findings. Future studies should be conducted in Latin America, Asia and Africa.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":"60 5","pages":"439-453"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023888","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":"PD-1 inhibitors improve the efficacy of tyrosine kinase inhibitors combined with transcatheter arterial chemoembolization in advanced hepatocellular carcinoma: a meta-analysis and trial sequential analysis.","authors":"Jiahui Yu, Yong Li, Yuting Yang, Hao Guo, Yimiao Chen, Pengsheng Yi","doi":"10.1080/00365521.2025.2479193","DOIUrl":"10.1080/00365521.2025.2479193","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis and trial sequential analysis (TSA) aimed to evaluate the efficacy and safety of triple therapy with tyrosine kinase inhibitors (TKIs) combined with transcatheter arterial chemoembolization (TACE) plus programmed death 1 (PD-1) inhibitors (T-T-P) and dual therapy with TKIs combined with TACE (T-T) for the treatment of advanced unresectable hepatocellular carcinoma (uHCC).</p><p><strong>Methods: </strong>Literature related to the efficacy of TKIs combined with TACE plus PD-1 inhibitors in uHCC was searched using the Embase, PubMed, and Cocrane libraries. TSA was used to reduce false positive results due to random error.</p><p><strong>Results: </strong>Seventeen articles were included in this meta-analysis, including 2,561 patients. In the T-T-P group, OS [HR 0.45, 95% confidence interval (CI) 0.39-0.52; <i>p</i> = 0.000], PFS [HR 0.43, 95% CI 0.38 - 0.48; <i>p</i> = 0.000], were significantly prolonged compared to those in the T-T group; ORR (RR 1.59 [95% CI 1.39-1.81]; <i>p</i> = 0.000) and DCR (RR 1.26 [95% CI 1.15-1.37]; <i>p</i> = 0.000) were significantly higher. TSA analysis showed early results without further testing. Prognostic factor analysis demonstrated that portal vein tumor thrombus (PVTT) and extrahepatic metastasis were common independent risk factors for OS and PFS. Regarding grade 3/4 adverse events results showed no statistically significant differences in any of them.</p><p><strong>Conclusions: </strong>Compared with T-T treatment group, the T-T-P treatment group exhibited a notable improvement in OS and PFS, particularly in cases of PVTT and extrahepatic metastasis. Furthermore, it can markedly enhance the ORR and DCR in patients with uHCC.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"472-484"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731476","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":"Long-term use of colchicine is associated with incident cirrhosis: a real-world cohort study.","authors":"Mohammad E Naffaa, Fadi Hassan, Helana Jeries, Dikla Dror, Vered Rozenberg, Gabriel Chodick, Michal Carmiel","doi":"10.1080/00365521.2025.2475488","DOIUrl":"10.1080/00365521.2025.2475488","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic effect of colchicine on the liver was not studied enough. We aimed to examine the association between long term colchicine use and incident cirrhosis among new colchicine initiators.</p><p><strong>Study: </strong>Using database of Maccabi Healthcare Services (MHS), we included all patients aged ≥18 years old who initiated colchicine between 1 January 2000 and 31 December 2018 and followed them until the earliest of the following: incident cirrhosis, leaving MHS, death or 31 December 2020. Incident cirrhosis was diagnosed according to ICD-9 code. We defined incident decompensated cirrhosis as the first presentation of cirrhosis, once ascites, encephalopathy and/or variceal bleeding were diagnosed within a period of 90 days before until 90 days after incident cirrhosis. Exposure to colchicine was evaluated in two manners: proportion of months covered (PMC) and mean daily dose (MDD).</p><p><strong>Results: </strong>A total of 21,773 eligible patients were included. We identified 129 incident cases of cirrhosis. Seventy-six (59%) had decompensated cirrhosis, as a first clinical presentation of cirrhosis. Familial Mediterranean Fever (FMF), BMI > 40, FIBROSIS-4 (FIB-4) score and colchicine PMC were all significantly associated with incident cirrhosis. Patients in '60-80%' PMC group had the highest risk for developing cirrhosis (hazard ratio (HR) 3.68, 95% confidence interval (CI) 2.23-6.07). The risk was higher for patients on colchicine >60 months (HR 6.69, 95% CI 3.56-12.56).</p><p><strong>Conclusions: </strong>long term colchicine use is associated with incident cirrhosis, mainly with decompensation at the time of diagnosis. Long term colchicine treatment should be limited to diseases with no other alternative, such as FMF.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"361-367"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568087","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":"Economic evaluation of preventing gastric cancer by eliminating Helicobacter pylori infection in China.","authors":"Yan Li, Shengwen Zhu, Yashi Liu, Dezhi He, Yanliang Liu, Hongchao Li","doi":"10.1080/00365521.2025.2473020","DOIUrl":"10.1080/00365521.2025.2473020","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the cost-effectiveness of screening <i>Helicobacter pylori</i> (<i>H. pylori</i>) and determine the optimal screening strategy in China.</p><p><strong>Methods: </strong>A Markov model was used to assess the cost-effectiveness of 13 screen-and-treat strategies, varying starting ages (20, 30, 40) and screening frequencies (no screening, once per lifetime, every 2, 3, or 5 years until age 50). For each scenario, 1,000,000 individuals were simulated. Outcomes were costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), and the number needed to treat (NNT) to prevent a gastric cancer. Deterministic and probabilistic sensitivity analyses tested the model's robustness.</p><p><strong>Results: </strong>Compared with no screening, screening at 20, 30, and 40 years of age once per lifetime were all cost-effective, with ICERs of -$40.37, -$78.28, and -$135.69 per QALY gained, respectively. NNT of the three strategies were 72, 63, and 55. Screening with a high frequency was associated with higher cost and QALYs; in the probabilistic sensitivity analyses, no matter the initial screening age, screening every 2 years would be the optimal strategy.</p><p><strong>Conclusion: </strong>Screening for <i>H. pylori</i> is a cost-saving and effective way to prevent gastric cancer in China. To prevent more gastric cancer, the population should take an H. pylori test from the age of 20 with a frequency of every 5 years in low gastric cancer incidence areas or age, with a frequency of every 2 years in high gastric cancer incidence areas or age.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"327-335"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542923","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}