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GI Journal Club – October 27th, 2022

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

GI Journal Club – September 20th, 2021

Article 1:

The Optimal Age to Stop Endoscopic Surveillance of Patients With Barrett’s Esophagus Based on Sex and Comorbidity: A Comparative Cost-Effectiveness Analysis
Omidvari et al.
Gastroenterology 2021;161:487–494

DOI: https://doi.org/10.1053/j.gastro.2021.05.003
PDF: Article

Summary: Current guidelines recommend surveillance for patients with nondysplastic Barrett’s esophagus (NDBE) but do not include a recommended age for discontinuing surveillance. This study aimed to determine the optimal age for last surveillance of NDBE patients stratified by sex and level of comorbidity.  Comparative modeling analysis illustrates the importance of considering comorbidity status and sex when deciding on the age to discontinue surveillance in patients with NDBE

Presenter: Anthony Horton

Article 2:

Benchmarking Adenoma Detection Rates for Colonoscopy: Results From a US-Based Registry
Shaukat et al.
The American Journal of Gastroenterology: September 2021 – Volume 116 – Issue 9 – p 1946-1949

DOI: https://doi.org10.14309/ajg.0000000000001358
PDF: Article

Summary: Adenoma detection rate (ADR) is highly variable across practices, and national or population-based estimates are not available. Our aim was to study the ADR, variability of rates over time, and factors associated with detection rates of ADR in a national sample of patients undergoing colonoscopy. The average ADR from a large national US sample standardized to the US population is 39.05% and has increased over time.

Presenter: Claire Dorsey

Prior JC Conferences

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