Duke GI Journal Club

Article 1:

Presenter: Jeremy Gillespie

Faculty Discussant: Brian Sullivan

Title: Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death

Authors:  M. Bretthauer, M. Løberg, P. Wieszczy, M. Kalager, L. Emilsson, K. Garborg, M. Rupinski, E. Dekker, M. Spaander, M. Bugajski, Ø. Holme, A.G. Zauber, N.D. Pilonis, A. Mroz, E.J. Kuipers, J. Shi, M.A. Hernán, H.-O. Adami, J. Regula, G. Hoff, and M.F. Kaminski, for the NordICC Study Group*

NEJM – October 9, 2022

Summary: Randomized trial involving presumptively healthy men and women 55 to 64 years of age drawn from population registries in Poland, Norway, Sweden, and the Netherlands between 2009 and 2014. The participants were randomly assigned in a 1:2 ratio to either receive an invitation to undergo a single screening colonoscopy (the invited group) or to receive no invitation or screening (the usual-care group). The primary end points were the risks of colorectal cancer and related death, and the secondary end point was death from any cause.
Conclusions: In this randomized trial, the risk of colorectal cancer at 10 years was lower among participants who were invited to undergo screening colonoscopy than among those who were assigned to no screening

Link: https://doi.org/10.1056/NEJMoa2208375

PDF: nejmoa2208375

Article 2:

Presenter: Josh Lee

Faculty Discussant: David Leiman

Title: Comparative Outcomes of Cap Assisted Endoscopic Resection and Endoscopic Submucosal Dissection in Dysplastic Barrett’s Esophagus

Authors: D. Chamil Codipilly,*,a Lovekirat Dhaliwal,*,a Meher Oberoi,* Parth Gandhi,* Michele L. Johnson,* Ramona M. Lansing,* W. Scott Harmsen,‡ Kenneth K. Wang,* and Prasad G. Iyer*

Clinical Gastroenterology and Hepatology 2022;20:65–73

Summary: We queried a prospectively maintained database of all patients undergoing cEMR and ESD followed by ablation at our institution from January 2006 to March 2020. Our primary outcomes included the rate of complete remission of dysplasia (CRD): absence of dysplasia on surveillance histology, and complete remission of intestinal metaplasia (CRIM): absence of intestinal metaplasia. Our secondary outcome included complication rates.
Conclusions: BE patients with dysplasia or intramucosal adenocarcinoma undergoing ESD reach CRD at higher rates than those treated with cEMR, although CRIM rates at 2 years and complication rates were similar between the 2 groups.

Link: https://doi.org/10.1016/j.cgh.2020.11.017

PDF: Codipilly-2022-Comparative-outcomes-of-cap-assiste_CGH_2022