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Screening for and surveillance of premalignant conditions of the stomach 胃癌前病变的筛查和监测
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.101978
Irina Luzko , Leticia Moreira , Jan Bornschein
{"title":"Screening for and surveillance of premalignant conditions of the stomach","authors":"Irina Luzko ,&nbsp;Leticia Moreira ,&nbsp;Jan Bornschein","doi":"10.1016/j.bpg.2025.101978","DOIUrl":"10.1016/j.bpg.2025.101978","url":null,"abstract":"<div><div>Strategies for population-based screening are thus far only implemented in high incidence countries such as South Korea or Japan with data showing a positive impact on gastric cancer mortality. Screening in most Western countries is deemed not cost-effective as these are mainly classified as low or intermediate risk regions. This is in part due to high costs for endoscopy as the diagnostic gold-standard. Blood testing for serum pepsinogens is implemented as a pre-screening tool in some Asian countries but can better highlight mucosal atrophy than the cancer itself. Endoscopic surveillance of patients with advanced preneoplastic conditions allows detection of early neoplastic lesions that can be treated endoscopically, resulting in better outcome, and is hence now also recommended by several European countries. However, there is no uniform approach, so screening and surveillance strategies need to take regional characteristics into account including gastric cancer incidence and cost for endoscopy among others.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 101978"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167876","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}
引用次数: 0
Cost effectiveness analysis of Barrett's esophagus screening: A systematic review Barrett食管筛查的成本-效果分析：一项系统综述
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.101980
Caroline L. Matchett , Mert Sahinkoc , Jagpreet Chhatwal , John B. Kisiel , Prasad G. Iyer
{"title":"Cost effectiveness analysis of Barrett's esophagus screening: A systematic review","authors":"Caroline L. Matchett ,&nbsp;Mert Sahinkoc ,&nbsp;Jagpreet Chhatwal ,&nbsp;John B. Kisiel ,&nbsp;Prasad G. Iyer","doi":"10.1016/j.bpg.2025.101980","DOIUrl":"10.1016/j.bpg.2025.101980","url":null,"abstract":"<div><div>Barrett's esophagus screening is critical for early detection of esophageal adenocarcinoma, but optimal strategies remain debated. This systematic review analyzed thirteen studies evaluating screening cost-effectiveness through September 2024. Both traditional endoscopic and emerging non-endoscopic methods were cost-effective compared to no screening, with incremental cost-effectiveness ratios below standard willingness-to-pay thresholds. Non-endoscopic approaches, particularly swallowed cell collection devices with biomarkers, demonstrated superior cost-effectiveness versus standard endoscopy. Cost-effectiveness improved in populations with higher disease prevalence. Current evidence supports implementing screening programs, especially using non-endoscopic methods in high-risk populations. Future research should focus on validating risk stratification tools to further optimize screening approaches.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 101980"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167884","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}
引用次数: 0
Novel devices and biomarkers in screening for esophageal squamous cell cancer 用于食管鳞状细胞癌筛查的新设备和生物标志物
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.102005
Wladyslaw Januszewicz , Karol Nowicki-Osuch
{"title":"Novel devices and biomarkers in screening for esophageal squamous cell cancer","authors":"Wladyslaw Januszewicz ,&nbsp;Karol Nowicki-Osuch","doi":"10.1016/j.bpg.2025.102005","DOIUrl":"10.1016/j.bpg.2025.102005","url":null,"abstract":"<div><div>Esophageal squamous cell carcinoma (ESCC) remains a significant global health challenge, with high mortality rates primarily due to late-stage diagnosis. Detecting ESCC at an early stage, when still amenable to endoscopic resection, could potentially improve survival outcomes and help reduce the overall disease burden. However, despite being the gold standard for ESCC diagnosis, conventional endoscopy has several limitations that hinder its widespread implementation for screening purposes. These include high-costs, invasiveness, suboptimal sensitivity in identifying precancerous lesions, and prerequisite specialized personnel and facilities. In this review, we aim to discuss the current ESCC screening practices and explore emerging screening methods incorporating novel diagnostic devices and biomarkers.</div><div>We first present advancements in endoscopic imaging techniques aimed at improving diagnostic accuracy and reducing operator dependency. These include artificial intelligence (AI)-assisted endoscopy, which enhances lesion detection, and confocal laser endomicroscopy, which enables real-time cellular-level assessment. Next, we explore the available non-endoscopic screening modalities such as swallowable cytology-based sampling devices. These minimally invasive tools, when combined with AI-assisted cytological analysis and molecular biomarkers, offer a viable alternative to conventional biopsy for early ESCC detection. We then provide an overview of circulating biomarkers, including circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), microRNAs, and protein-based markers, summarizing the current state of research on liquid biopsies and their potential role in ESCC screening. Additionally, we discuss breath and salivary diagnostics as emerging cost-effective, non-invasive approaches. Finally, we present the latest insights into tissue biomarkers, highlighting their relevance in identifying precancerous lesions and stratifying risk in ESCC screening.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 102005"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167888","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}
引用次数: 0
Artificial intelligence in early screening for esophageal squamous cell carcinoma 人工智能在食管鳞状细胞癌早期筛查中的应用
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.102004
Si-yan Yan , Xin-yu Fu , Yan Yang , Liu-yi Jia , Jia-wei Liang , Ying-hui Li , Ling-ling Yan , Ying Zhou , Xian-bin Zhou , Shao-wei Li , Xin-li Mao
{"title":"Artificial intelligence in early screening for esophageal squamous cell carcinoma","authors":"Si-yan Yan ,&nbsp;Xin-yu Fu ,&nbsp;Yan Yang ,&nbsp;Liu-yi Jia ,&nbsp;Jia-wei Liang ,&nbsp;Ying-hui Li ,&nbsp;Ling-ling Yan ,&nbsp;Ying Zhou ,&nbsp;Xian-bin Zhou ,&nbsp;Shao-wei Li ,&nbsp;Xin-li Mao","doi":"10.1016/j.bpg.2025.102004","DOIUrl":"10.1016/j.bpg.2025.102004","url":null,"abstract":"<div><div>Esophageal squamous cell carcinoma (ESCC) remains a significant global health burden with high incidence and mortality rates, particularly in developing regions. Early detection is crucial for improving patient survival, yet conventional screening methods such as endoscopy and non-endoscopic techniques face limitations in accuracy, cost, and dependency on clinician expertise. This review explores the transformative role of artificial intelligence (AI) in ESCC screening. AI technologies, including machine learning, deep learning, and transfer learning, demonstrate remarkable potential for early ESCC screening by targeting high-risk populations, optimizing screening modalities, refining screening intervals, and enhancing cost-effectiveness. AI-driven systems improve lesion detection, vascular pattern recognition, and risk prediction by integrating imaging, genomic, and clinical data. Additionally, AI applications in liquid biopsy analysis enable non-invasive detection of circulating tumor cells and DNA, further advancing early diagnosis. Despite these advancements, challenges such as dataset variability, model generalizability, algorithm transparency, and ethical and legal concerns require resolution to fully harness AI's capabilities. This paper highlights the current applications, persistent challenges, and future directions for AI in revolutionizing ESCC screening.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 102004"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167889","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}
引用次数: 0
Early diagnosis of gastric cancer: Endoscopy and artificial intelligence 胃癌早期诊断：内镜与人工智能
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.101979
N. Gonçalves , J. Chaves , I. Marques- Sá , M. Dinis-Ribeiro , D. Libânio
{"title":"Early diagnosis of gastric cancer: Endoscopy and artificial intelligence","authors":"N. Gonçalves ,&nbsp;J. Chaves ,&nbsp;I. Marques- Sá ,&nbsp;M. Dinis-Ribeiro ,&nbsp;D. Libânio","doi":"10.1016/j.bpg.2025.101979","DOIUrl":"10.1016/j.bpg.2025.101979","url":null,"abstract":"<div><div>Early diagnosis of gastric cancer enables effective, minimally invasive and organ-sparing treatment throughout endoscopic resection. This technique offers low rates of adverse events, improved quality of life compared to surgery, and excellent disease-free survival when curative criteria are met.</div><div>Upper gastrointestinal endoscopy with biopsies is the gold standard for diagnosing either pre-malignant conditions or gastric cancer but high-quality endoscopy is paramount to avoid missing lesions. Also, adequate endoscopic assessment of a gastric lesion is crucial to select patients for endoscopic resection and remains the best predictor for curative resection. However, curative resection rates have been stable at around 80–85 % in recent years, so there is room for improvement in patient/lesion selection for endoscopic resection.</div><div>This review intends to address strategies that can be pursued to optimize upper gastrointestinal endoscopy quality, improve gastric lesion detection and characterization, and unveil how Artificial Intelligence can contribute to this process in the near future.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 101979"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167878","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}
引用次数: 0
Preface to special edition: Screening and Early diagnosis of upper gastrointestinal neoplastic lesions 特刊前言：上消化道肿瘤病变的筛查与早期诊断
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.101983
J. Honing , M. Dinis-Ribeiro
{"title":"Preface to special edition: Screening and Early diagnosis of upper gastrointestinal neoplastic lesions","authors":"J. Honing ,&nbsp;M. Dinis-Ribeiro","doi":"10.1016/j.bpg.2025.101983","DOIUrl":"10.1016/j.bpg.2025.101983","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 101983"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167882","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}
引用次数: 0
Barrett's esophagus screening: Current modalities, risk-based approaches, and future perspectives 巴雷特食管筛查：当前模式，基于风险的方法，和未来的前景
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.101989
Nanda Provoost , Rebecca C. Fitzgerald , Judith Honing
{"title":"Barrett's esophagus screening: Current modalities, risk-based approaches, and future perspectives","authors":"Nanda Provoost ,&nbsp;Rebecca C. Fitzgerald ,&nbsp;Judith Honing","doi":"10.1016/j.bpg.2025.101989","DOIUrl":"10.1016/j.bpg.2025.101989","url":null,"abstract":"<div><div>Barrett's Esophagus (BE) is a precursor lesion of esophageal adenocarcinoma (EAC). To enable early detection of neoplasia, BE patients undergo regular endoscopic surveillance. However, more than 90 % of EAC patients were not previously diagnosed with the precursor BE, indicating that detection practices are inadequate. Screening for BE could be a strategy to detect BE in the general population, bridging the gap in early diagnosis. Given the limitations of affordable and accessible endoscopy methods for widespread use, efforts should prioritize targeted screening of at-risk individuals using less invasive approaches. For instance, the use of cell collection devices coupled with biomarker assays in patients with GERD could offer a more cost-effective solution to identify undiagnosed cases. In this review, we provide a comprehensive overview of the at-risk population for BE, current screening modalities, and future perspectives to pave the way for effective and practical BE screening.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 101989"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167890","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}
引用次数: 0
Screening and surveillance of hereditary upper GI cancers 遗传性上消化道肿瘤的筛查和监测
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.102018
Lianlian Wu , Massimiliano di Pietro
{"title":"Screening and surveillance of hereditary upper GI cancers","authors":"Lianlian Wu ,&nbsp;Massimiliano di Pietro","doi":"10.1016/j.bpg.2025.102018","DOIUrl":"10.1016/j.bpg.2025.102018","url":null,"abstract":"<div><div>Upper GI cancer has poor prognosis. Of all upper GI malignancies, 1–3 % have a well-defined germline genetic cause. Hereditary upper GI cancers include squamous cell carcinoma as part of Tylosis, signet ring cell carcinoma of the stomach occurring in the context of hereditary diffuse gastric cancer syndrome, gastric adenocarcinoma affecting individuals with familial adenomatous polyposis syndrome (FAP), Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS), Lynch, Juvenile Polyposis and Peutz-Jeghers Syndromes, and duodenal adenocarcinoma, for which individuals with FAP and Lynch syndromes are at increased risk. This review will discuss the management of people with suspected or confirmed hereditary syndromes related to increased risk of upper GI cancers, with particular reference to indication for genetic testing, age of start of endoscopic screening, best practice in relation to endoscopic surveillance and indication for surgery.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 102018"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167879","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}
引用次数: 0
Advances towards gastric cancer screening: Novel devices and biomarkers 胃癌筛查的新进展：新设备和生物标志物
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.102009
Catarina Lopes , Carina Pereira
{"title":"Advances towards gastric cancer screening: Novel devices and biomarkers","authors":"Catarina Lopes ,&nbsp;Carina Pereira","doi":"10.1016/j.bpg.2025.102009","DOIUrl":"10.1016/j.bpg.2025.102009","url":null,"abstract":"<div><div>Gastric cancer is a pressing global health issue that ranks fifth as the most commonly diagnosed malignancy and leading cause of cancer-related deaths. Early detection is critical for improving patient outcomes, with five-year survival rates exceeding 90 % when diagnosed at initial stages. Current screening modalities, primarily reliant on upper gastrointestinal endoscopy, are highly accurate, but not without limitations, such as invasiveness, high cost, low adherence and accessibility.</div><div>Hence, this review aligns with the ongoing efforts to answer the pressing need for innovative approaches, emphasising novel devices and biomarker advancements over the last decade. We highlight non-endoscopic methods such as magnetically controlled capsule endoscopy and point-of-care testing. Additionally, we will provide an overview into the field of liquid biopsies and emerging biomarkers in GC detection, towards accurate, less invasive and costly screening tools that hold the promise for greater accessibility and citizen involvement.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 102009"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167877","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}
引用次数: 0
Increased risk of oesophageal squamous cell carcinoma development 增加发展为食管鳞状细胞癌的风险
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2025-03-01 DOI: 10.1016/j.bpg.2025.101984
Annemijn D.I. Maan, Laurèlle van Tilburg, Arjun D. Koch
{"title":"Increased risk of oesophageal squamous cell carcinoma development","authors":"Annemijn D.I. Maan,&nbsp;Laurèlle van Tilburg,&nbsp;Arjun D. Koch","doi":"10.1016/j.bpg.2025.101984","DOIUrl":"10.1016/j.bpg.2025.101984","url":null,"abstract":"<div><div>The incidence of oesophageal squamous cell carcinoma accounts for almost 85 % of all oesophageal cancers worldwide. Patients with oesophageal cancer can present with clinical symptoms including dysphagia, weight loss, retrosternal discomfort or regurgitation. Nevertheless, most cancers remain asymptomatic and thereby undetected until the cancer has reached advanced or even incurable stages. This results in poor prognosis and relatively low long-term survival rates. The identification of patients at high risk for oesophageal cancer development is therefore an important cornerstone in the detection of oesophageal cancer in early and curable stages. This group contains patients with a history of cancer in the aerodigestive tract, squamous dysplasia, certain lifestyle aspects, three types of genetic syndromes, caustic or radiation induced injury to the oesophagus and achalasia. In this review, we evaluate different risk factors for the development of oesophageal squamous cell carcinoma and discuss whether screening of these patients might be justified.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"75 ","pages":"Article 101984"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167887","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}
引用次数: 0
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