Best Practice & Research Clinical Gastroenterology最新文献_第4页

Developments in the roll-out and performance of CRC screening in Europe 在欧洲推广和实施CRC筛查的进展。

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-08-05 DOI: 10.1016/j.bpg.2025.102043

Giulia Carbotti , Danica MN. van den Berg , Andre L. Carvalho , Carlo Senore , Eveline AM. Heijnsdijk , Harry J. de Koning , Iris Lansdorp-Vogelaar , CanScreen-ECIS data providers, of ICSN CRC interest group COVID-19 survey data providers and of the EUCanScreen consortium

{"title":"Developments in the roll-out and performance of CRC screening in Europe","authors":"Giulia Carbotti , Danica MN. van den Berg , Andre L. Carvalho , Carlo Senore , Eveline AM. Heijnsdijk , Harry J. de Koning , Iris Lansdorp-Vogelaar , CanScreen-ECIS data providers, of ICSN CRC interest group COVID-19 survey data providers and of the EUCanScreen consortium","doi":"10.1016/j.bpg.2025.102043","DOIUrl":"10.1016/j.bpg.2025.102043","url":null,"abstract":"<div><div>The heterogeneous implementation of colorectal cancer screening programs across Europe makes performance comparison challenging.</div><div>This study computed and analyzed seven key indicators of screening performance for eighteen European programs between 2011 and 2022. Trends in colorectal cancer incidence and mortality were also examined in relation to when each screening program was introduced.</div><div>Coverage indicators showed considerable variation across programs but generally increased until the onset of the COVID pandemic. Yield indicators remained stable overall, whereas jumps were associated to protocol changes. In most countries, a decline in incidence followed the introduction of the screening program, whereas the connection of screening with mortality was less evident.</div><div>The analysis of comparable screening performance indicators over time allows for cross-country and longitudinal monitoring of the programs. The observed decline in incidence following the implementation of fully rolled-out programs highlights the importance and effectiveness of well-organized screening in reducing the burden of the disease.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"80 ","pages":"Article 102043"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273792","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

Role of CADx in colonoscopy: lessons from real-life studies CADx在结肠镜检查中的作用：来自现实生活研究的教训。

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-05-23 DOI: 10.1016/j.bpg.2025.102020

Marco Bustamante-Balén

引用次数: 0

Mechanical auxiliary devices to expose mucosal surface in colonoscopy 结肠镜检查中显露粘膜表面的机械辅助装置。

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-05-08 DOI: 10.1016/j.bpg.2025.102015

Sara Schiavone , Federico Iacopini , Cesare Hassan , Giulio Antonelli

{"title":"Mechanical auxiliary devices to expose mucosal surface in colonoscopy","authors":"Sara Schiavone , Federico Iacopini , Cesare Hassan , Giulio Antonelli","doi":"10.1016/j.bpg.2025.102015","DOIUrl":"10.1016/j.bpg.2025.102015","url":null,"abstract":"<div><div>Colonoscopy<span> is a cornerstone of colorectal cancer (CRC) prevention, with adenoma detection rate (ADR) serving as a critical quality metric. However, substantial variability in ADR persists across operators, and a significant proportion of colorectal neoplasia—particularly flat, serrated, and right-sided lesions—continues to be missed. These limitations are often attributable to suboptimal mucosal exposure, especially in anatomical regions hidden behind haustral folds and flexures.</span></div><div>To address this, a variety of mechanical auxiliary devices—collectively termed <em>behind-folds visualizing techniques and technologies</em><span> (BFTs)—have been developed to enhance mucosal exposure during withdrawal. These include both add-on devices (e.g., caps, Endocuff, EndoRings) and integrated technologies (e.g., G-EYE, FUSE, Third Eye), each with varying levels of evidence and practicality.</span></div><div>This review critically appraises current data on BFTs, highlighting their efficacy in improving ADR, particularly among endoscopists with lower baseline performance. Meta-analyses suggest that simple, low-cost devices such as Endocuff and caps offer the most favorable balance of effectiveness, accessibility, and ease of use. Furthermore, emerging data indicate that combining mechanical exposure devices with artificial intelligence-based systems may yield additive benefits.</div><div>BFTs represent pragmatic tools to optimize colonoscopy quality and reduce post-colonoscopy CRC. Their selective implementation—especially in low-performing settings—should be considered a key component of modern endoscopic practice.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"80 ","pages":"Article 102015"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273835","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

Risk-based screening for early detection of colorectal cancer: an overview 基于风险的结直肠癌早期检测筛查综述

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-05-08 DOI: 10.1016/j.bpg.2025.102014

Chiara C. Brück , Lucy W. Mwangi , Francine van Wifferen , Li Hsu , Minta Thomas , Ulrike Peters

{"title":"Risk-based screening for early detection of colorectal cancer: an overview","authors":"Chiara C. Brück , Lucy W. Mwangi , Francine van Wifferen , Li Hsu , Minta Thomas , Ulrike Peters","doi":"10.1016/j.bpg.2025.102014","DOIUrl":"10.1016/j.bpg.2025.102014","url":null,"abstract":"<div><div>Screening programs for colorectal cancer (CRC) reduce CRC incidence and mortality, while balancing benefits and harms of the population. However, benefits vary widely among individuals. Low-risk individuals may face unnecessary burdens, while high-risk individuals could benefit from more intensive screening. Risk-based screening addresses these issues by tailoring screening strategies using risk factors such as age, sex, race, ethnicity, lifestyle factors, genetic predisposition<span>, and previous screening results. Potential benefits of risk-based screening include improved cost-effectiveness, efficient resource use and reduced unnecessary procedures<span>. Challenges include a lack of validated risk stratification<span> tools, data availability, healthcare capacity, and ethical considerations. Several countries started to evaluate risk-based screening programs with optimistic results. While promising, further research is necessary to address the remaining challenges. Nevertheless, risk-based screening has the potential to enhance patient experiences, optimize the balance of individual-level benefits and harms, and positively impact the overall burden and costs associated with CRC screening.</span></span></span></div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"80 ","pages":"Article 102014"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273898","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

Resect and discard – Is it implementable in the world? 删除和丢弃——它在世界上是可实现的吗？

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-05-08 DOI: 10.1016/j.bpg.2025.102013

Roupen Djinbachian , Daniel von Renteln

{"title":"Resect and discard – Is it implementable in the world?","authors":"Roupen Djinbachian , Daniel von Renteln","doi":"10.1016/j.bpg.2025.102013","DOIUrl":"10.1016/j.bpg.2025.102013","url":null,"abstract":"<div><div>The resect-and-discard strategy for colorectal cancer prevention<span> involves real-time optical diagnosis during colonoscopy<span><span> to eliminate the need for histopathological analysis of diminutive colorectal polyps (1–5 mm). Although endorsed by international </span>gastroenterology societies and supported by extensive evidence of diagnostic accuracy, implementation remains limited due to barriers including clinician confidence, medico-legal concerns, and procedural complexities. The emergence of artificial intelligence (AI)-based diagnostic systems has renewed interest in this strategy by potentially improving accuracy and clinician acceptance. While early real-world data indicate high patient approval and significant cost and environmental benefits, critical questions remain unanswered, including optimal techniques for accurate polyp size estimation and AI-based differentiation of specific histological features. Additionally, uncertainties regarding medico-legal liability and standardization of quality assurance processes require further clarification. This review highlights current evidence, identifies major implementation barriers, and proposes areas of future research necessary to facilitate widespread adoption of the resect-and-discard strategy.</span></span></div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"80 ","pages":"Article 102013"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273878","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

Is blood the new stool? Status of blood tests for CRC screening 血是新的大便吗？筛查结直肠癌的血液检查情况。

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-09-08 DOI: 10.1016/j.bpg.2025.102049

Erin L. Symonds , Maddison Dix , Molla M. Wassie , Norma B. Bulamu , Graeme P. Young , Jean M. Winter

引用次数: 0

Optical diagnosis of histopathology– is it implementable in the world of artificial intelligence? 组织病理学的光学诊断——在人工智能的世界里是否可行？

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-08-07 DOI: 10.1016/j.bpg.2025.102044

Abraham Z. Cheloff, Prahan Chetlur, Emily B. Kagan, Seth A. Gross

{"title":"Optical diagnosis of histopathology– is it implementable in the world of artificial intelligence?","authors":"Abraham Z. Cheloff, Prahan Chetlur, Emily B. Kagan, Seth A. Gross","doi":"10.1016/j.bpg.2025.102044","DOIUrl":"10.1016/j.bpg.2025.102044","url":null,"abstract":"<div><div>Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the United States, with colonoscopy serving as the gold standard for both diagnosis and early intervention. While diminutive polyps (<5 mm) constitute most findings, only a small fraction exhibit advanced histological features. Optical diagnosis, which enables real-time classification of polyp histology through new technologies and the support of new strategies to leave low risk polyps in place (diagnose-and-leave) or resect without sending for formal pathology (resect-and-discard) have been studied as a cost-saving and effective strategy for diminutive polyps. There have been advances in imaging, such as narrow band imaging (NBI), but widespread adoption has yet to occur. The integration of artificial intelligence (AI), particularly computer-aided diagnosis (CADx) systems, has emerged as a promising tool to standardize optical diagnosis, reduce interobserver variability, and improve adherence to surveillance guidelines. However, barriers to widespread implementation persist, including concerns about medicolegal liability, financial disincentives, and skepticism of CADx accuracy. The goal of article is to review the current evidence surrounding optical diagnosis, review diagnostic accuracy, and evaluate the challenges of widespread clinical adoption.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"80 ","pages":"Article 102044"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273790","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

Elements of screening and early diagnosis of lower GI neoplastic lesions – an overview 下消化道肿瘤病变的筛查和早期诊断要素综述。

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-09-30 DOI: 10.1016/j.bpg.2025.102052

B. Sheridan , L. Rabeneck , E. Toes-Zoutendijk

{"title":"Elements of screening and early diagnosis of lower GI neoplastic lesions – an overview","authors":"B. Sheridan , L. Rabeneck , E. Toes-Zoutendijk","doi":"10.1016/j.bpg.2025.102052","DOIUrl":"10.1016/j.bpg.2025.102052","url":null,"abstract":"<div><div>Dobrow's 12 consolidated principles were applied to evaluate the extent to which colorectal cancer (CRC) screening programmes align with these established screening principles. The principles within the first domain – <em>disease and conditions</em> – are fully met. CRC represents a significant global public health burden with a well-understood natural history, including a long preclinical phase. These features make CRC suitable for population-based screening. Current guidelines recommend screening average-risk individuals, with starting ages as early as 45 years and stopping ages up to 85 years in some programs, although most programs target those aged 50–75 years.</div><div>For Dobrow's second domain – <em>test or intervention</em> - we found that established CRC screening methods (faecal immunochemical testing (FIT), colonoscopy, and flexible sigmoidoscopy) have known and acceptable sensitivity and specificity. These tests have clear thresholds for interpretation and follow-up and are associated with reductions in both CRC incidence and mortality, confirming their clinical effectiveness in organised programmes.</div><div>Dobrow's third domain - <em>programme or system</em> - addresses how screening programmes should be structured, implemented, and integrated into health systems. Unlike the other domains, this is fully achieved in only a small minority of programmes. While implementation may vary from country to country, the principles provide benchmarks for well-organised programmes. CRC screening is generally cost-effective and widely accepted by patients, providers, and society. Successful programmes require dedicated teams, infrastructure, and systems for coordination and quality assurance.</div><div>Before implementation, a CRC screening initiative must meet, or have a clear plan to meet 12 principles. In summary, robust infrastructure and governance are essential for organised CRC screening programmes to align with the Dobrow principles and achieve long-term success.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"80 ","pages":"Article 102052"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273819","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

Copyright Information 版权信息

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2026-02-20 DOI: 10.1016/S1521-6918(26)00006-5

引用次数: 0

Global impact of COVID-19 on organized CRC screening programs: lessons learned COVID-19对有组织的结直肠癌筛查项目的全球影响：经验教训。

IF 4 3区医学

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-09-05 DOI: 10.1016/j.bpg.2025.102047

Lucie de Jonge , Iris Lansdorp-Vogelaar , V. Paul Doria-Rose , Isabel Portillo , Dominika Novak Mlakar , Andrea Buron , Cécile Quintin , Josep A. Espinàs , Julie Plaine , Ana Lucija Škrjanec , Tatjana Kofol Bric , Gemma Binefa , Rebeca Font , Jean-Luc Bulliard , Jessica Chubak , Rebecca Ziebell , Bronwen R. McCurdy , Linda Rabeneck , Carlo Senore , International Cancer Screening Network Colorectal Cancer working group

{"title":"Global impact of COVID-19 on organized CRC screening programs: lessons learned","authors":"Lucie de Jonge , Iris Lansdorp-Vogelaar , V. Paul Doria-Rose , Isabel Portillo , Dominika Novak Mlakar , Andrea Buron , Cécile Quintin , Josep A. Espinàs , Julie Plaine , Ana Lucija Škrjanec , Tatjana Kofol Bric , Gemma Binefa , Rebeca Font , Jean-Luc Bulliard , Jessica Chubak , Rebecca Ziebell , Bronwen R. McCurdy , Linda Rabeneck , Carlo Senore , International Cancer Screening Network Colorectal Cancer working group","doi":"10.1016/j.bpg.2025.102047","DOIUrl":"10.1016/j.bpg.2025.102047","url":null,"abstract":"<div><div>Using a standardized data template, this study retrospectively collected data about colorectal cancer (CRC) screening activity in 2020 and 2021 to estimate the impact of the COVID-19 pandemic compared to the pre-pandemic period (2018 or 2019). Data were collected from 17 programs in 14 countries of which 15 were population-based programs. Invitation coverage was decreased by up to 53.7 % in 2020. Participation among those invited was similar in both periods for all programs. The maximum backlog in invitations was less than 7.4 months in 2020 and 3.3 months for 2021. Nine out of 15 programs observed a decrease in the number of detected CRCs in 2020. Four programs showed a positive percentage change in CRCs detected in 2021 relative to the pre-pandemic period. Half of the countries observed a worse stage-distribution in 2020/2021. Overall, organized CRC screening programs operated at lower screening activity, but screening outcomes were similar compared to the pre-pandemic period.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"80 ","pages":"Article 102047"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273807","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