American Journal of Gastroenterology最新文献

{"title":"Incidence and survival of colorectal cancer in the United Kingdom from 2000-2021: a population-based cohort study.","authors":"Patricia Pedregal-Pascual, Carlos Guarner-Argente, Eng Hooi Tan, Asieh Golozar, Talita Duarte-Salles, Andreas Weinberger Rosen, Antonella Delmestri, Wai Yi Man, Edward Burn, Daniel Prieto-Alhambra, Danielle Newby","doi":"10.14309/ajg.0000000000003460","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003460","url":null,"abstract":"<p><strong>Background: </strong>The management of colorectal cancer (CRC) is evolving, with advances in screening and treatment.</p><p><strong>Objective: </strong>To leverage population-based data to generate up-to-date UK estimates of age and sex-specific incidence and overall survival for the period 2000-2021.</p><p><strong>Design: </strong>We analysed nationally representative primary care records from Clinical Practice Research Datalink (CPRD) GOLD and replicated in CPRD Aurum. We calculated incidence rates, and short- and long-term survival stratified by age, sex, and diagnosis year.</p><p><strong>Results: </strong>Overall incidence was 67.4/100,000 person years, increasing in 2000-2011 to drop slightly in 2011-2014, and then plateauing. In contrast, early-onset CRC raised uninterruptedly throughout the study period, from 8.33 to 19.07/100,000 person-years.Overall survival was 78.3%, 51.4% and 38.5% at 1-, 5-, and 10-years respectively, lower in men compared to women. Modest improvements in survival were observed over the study period, particularly for 60-69-year-old patients.</p><p><strong>Conclusion: </strong>Although the overall incidence in the population has plateaued, a worrying increasing trend of early-onset CRC was observed. Moreover, the slight improvement in overall survival suggests that significant progress is still needed. These findings highlight the urgent need for continued research and resource allocation to improve the diagnosis and management of colorectal cancer.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Race and Ethnicity with Healthcare Utilization for Inflammatory Bowel Disease in the United States: A Retrospective Cohort Study.","authors":"Abraham Segura, Colleen Brensinger, Virginia Pate, Shazia M Siddique, Lauren Parlett, Andres Hurtado-Lorenzo, Michael David Kappelman, James D Lewis","doi":"10.14309/ajg.0000000000003438","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003438","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in medical and surgical therapy have improved the outlook for those affected with Crohn's disease and ulcerative colitis; however, it is unclear if Americans from marginalized racial and ethnic backgrounds have adequate and equitable access to care for inflammatory bowel disease. We evaluated the association between race and ethnicity and healthcare utilization in patients diagnosed with inflammatory bowel disease.</p><p><strong>Methods: </strong>This study identified children and adults diagnosed with inflammatory bowel disease in two national data sets from 2016 to 2017. We modeled the association between healthcare utilization and racial and ethnic subpopulations across different age groups using generalized estimating equations adjusted by disease and socioeconomic factors.</p><p><strong>Results: </strong>Among working-age adults, Black Americans had higher emergency department, hospitalization, and steroid use than White patients, however these differences were attenuated after adjusting for socioeconomic factors. Asian and Hispanic Americans were less likely to receive outpatient gastroenterological care and medical therapy even after adjustment. Emergency department use was more likely among elderly Black patients. Hispanic children had increased healthcare utilization for inflammatory bowel disease compared to White children, though these results did not meet statistical significance.</p><p><strong>Discussion: </strong>Healthcare utilization for long-term management of inflammatory bowel disease is lower in historically marginalized racial and ethnic groups compared to White Americans. Further research is needed to identify and address modifiable patient, clinician, and healthcare system barriers to achieve health equity in the management of inflammatory bowel disease.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric Adenocarcinoma and Proximal Polyposis Syndrome (GAPPS): An Early Catch!","authors":"Francisco Avila, Ali Mokhtari, Michael H Frist, Romil Saxena","doi":"10.14309/ajg.0000000000003462","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003462","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence Trends in Upper Gastrointestinal Cancer in Young Adults: A Nationwide Time-Trend Analysis Using 2001-2019 US Cancer Statistics Databases.","authors":"Jeff Liang, Ryan Rastegar, Mohamad El Helou, Kushagra Mathur, Brent K Larson, Kevin Waters, Anila Vasireddy, Navikran Randhawa, Muhammad Mubarak, Rashmi Advani, Arsen Osipov, Jun Gong, Andrew Hendifar, Quin Liu, Kenneth H Park, Rabindra Watson, Stephen J Pandol, Simon Lo, Srinivas Gaddam","doi":"10.14309/ajg.0000000000003068","DOIUrl":"10.14309/ajg.0000000000003068","url":null,"abstract":"<p><strong>Introduction: </strong>Upper gastrointestinal (UGI) cancers, comprising malignancies of the esophagus, stomach, duodenum, pancreas, liver, biliary tract, and gallbladder, are the second leading cause of cancer-related mortality in the United States and are associated with significant comorbidities. Recent studies show a disproportionate rise in pancreatic and stomach cancer among young adults. This study aims to use a nationwide, population-based cohort to (i) evaluate the trend of all UGI cancer as an aggregate and (ii) examine the role of demographics, histology, and tumor stage in UGI cancer incidence among young adults.</p><p><strong>Methods: </strong>Individuals diagnosed with UGI cancer in the United States from 2001 to 2019 were identified and obtained from the Surveillance, Epidemiology, and End Results-National Program of Cancer Registries database. The primary outcomes were incidence rates of UGI cancer (calculated per 100,000, age-adjusted to the year 2000 US population), stratified by sex and age (< 55 years for young adults and ≥ 55 years for older adults). Trends, annual percentage change, and average annual percentage change were calculated using the parametric method. Sensitivity analysis was performed according to primary site and histology; further analysis examining race and cancer stage was performed in the young adult subgroup.</p><p><strong>Results: </strong>A total of 2,333,161 patients with UGI cancer were identified. Most cases were male, and 14.3% were < 55 years of age. Incidence of UGI cancer increased most in women younger than 55 years, driven primarily by pancreatic and stomach cancers, as well as neuroendocrine tumor and gastrointestinal stromal tumor histology. African American race and localized tumors and malignancy with distant spread are also contributing to the disparate increase among young women. UGI mortality rates have not changed significantly in young adults.</p><p><strong>Discussion: </strong>The overall incidence rate of upper gastrointestinal cancer is increasing significantly in young women compared with men. Increased endoscopic procedures and disparate exposure to risk factors are likely contributing to these trends.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"890-904"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Device Malfunction Reporting.","authors":"Tilak Shah, Shivakumar Vignesh, Saurabh Chawla","doi":"10.14309/ajg.0000000000003127","DOIUrl":"10.14309/ajg.0000000000003127","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"694-696"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Xanthomas and Ichthyosis: A Mild Phenotype of CHILD Syndrome (NSDHL Gene Mutation).","authors":"Do Han Kim, Michael Marble, Juan E Corral","doi":"10.14309/ajg.0000000000003138","DOIUrl":"10.14309/ajg.0000000000003138","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"702"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Treatment of Multiple Bleeding Small-Bowel Phlebectasias Using Argon Plasma Coagulation.","authors":"Andrea Michielan, Enrico Gasparini, Martina Cattani Mottes, Johan Holck-Steen, Armando Gabbrielli","doi":"10.14309/ajg.0000000000002918","DOIUrl":"10.14309/ajg.0000000000002918","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"704"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical Factors Associated With the Benefit of Prophylactic Pancreatic Stent Placement During High-Risk Endoscopic Retrograde Cholangiopancreatography: A Secondary Analysis of the SVI Trial Data Set.","authors":"B Joseph Elmunzer, Jingwen Zhang, Gregory A Coté, Steven A Edmundowicz, Sachin Wani, Raj Shah, Ji Young Bang, Shyam Varadarajulu, Vikesh K Singh, Mouen Khashab, Richard S Kwon, James M Scheiman, Field F Willingham, Steven A Keilin, Georgios I Papachristou, Amitabh Chak, Adam Slivka, Daniel Mullady, Vladimir Kushnir, James Buxbaum, Rajesh Keswani, Timothy B Gardner, Nauzer Forbes, Amit Rastogi, Andrew Ross, Joanna Law, Patrick Yachimski, Yen-I Chen, Alan Barkun, Zachary L Smith, Jose Serrano, Bret Petersen, Andrew Y Wang, John R Saltzman, Rebecca L Spitzer, Collins Ordiah, Cathie Spino, Lydia D Foster, Valerie Durkalski-Mauldin","doi":"10.14309/ajg.0000000000003052","DOIUrl":"10.14309/ajg.0000000000003052","url":null,"abstract":"<p><strong>Introduction: </strong>Prophylactic pancreatic stent placement (PSP) is effective for preventing pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high-risk cases, but the optimal technical approach to this intervention remains uncertain.</p><p><strong>Methods: </strong>In this secondary analysis of 787 clinical trial patients who underwent successful stent placement, we studied the impact of (i) whether pancreatic wire access was achieved for the sole purpose of PSP or naturally during the conduct of the case, (ii) the amount of effort expended on PSP, (iii) stent length, (iv) stent diameter, and (v) guidewire caliber. We used logistic regression models to examine the adjusted association between each technical factor and post-ERCP pancreatitis (PEP).</p><p><strong>Results: </strong>Ninety-one of the 787 patients experienced PEP. There was no clear association between PEP and whether pancreatic wire access was achieved for the sole purpose of PSP (vs occurring naturally; odds ratio [OR] 0.82, 95% confidence interval [CI] 0.37-1.84), whether substantial effort expended on stent placement (vs nonsubstantial effort; OR 1.58, 95% CI 0.73-3.45), stent length (>5 vs ≤5 cm; OR 1.01, 95% CI 0.63-1.61), stent diameter (≥5 vs <5 Fr; OR 1.13, 95% CI 0.65-1.96), or guidewire caliber (0.035 vs 0.025 in; 0.83, 95% CI 0.49-1.41).</p><p><strong>Discussion: </strong>The 5 modifiable technical factors studied in this secondary analysis of large-scale randomized trial data did not appear to have a strong impact on the benefit of prophylactic PSP in preventing PEP after high-risk ERCP. Within the limitations of post hoc subgroup analysis, these findings may have important implications in procedural decision making and suggest that the benefit of PSP is robust to variations in technical approach.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"811-815"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Zhou.","authors":"Hajime Yamazaki, Martin Heni, Róbert Wagner, Brian Z Huang","doi":"10.14309/ajg.0000000000003160","DOIUrl":"10.14309/ajg.0000000000003160","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"927-928"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Eurytremiasis Mimics Pancreatic Intraductal Papillary Mucinous Neoplasm.","authors":"Ying-Jie Peng, Ting Dai, Ya-Qiong He","doi":"10.14309/ajg.0000000000003037","DOIUrl":"10.14309/ajg.0000000000003037","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"697"},"PeriodicalIF":8.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}