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Colorectal Cancer Screening in a Changing World
Early detection of colorectal neoplasia significantly reduces mortality from colorectal cancer (CRC), and numerous screening options exist. Guidelines for CRC screening from US and international professional societies provide menus of options based on strength of evidence. Despite availability of screening and its proven impact, 40% of guideline-eligible patients are not screened as recommended in the United States. Adherence to or uptake of CRC screening is especially poor among underserved populations, including those with low income and African American and Hispanic populations. Consideration of screening options must n...
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Robert S. Bresalier Source Type: research

Cancer in Inflammatory Bowel Disease
Inflammatory bowel diseases (IBD), including Crohn disease and ulcerative colitis, are chronic inflammatory conditions of the gastrointestinal tract. Individuals with IBD are at increased risk for several malignancies originating in the intestine, such as colorectal cancer, small bowel adenocarcinoma, intestinal lymphoma, and anal cancer. There are also several extraintestinal malignancies associated with IBD and IBD therapies, including cholangiocarcinoma, skin cancer, hematologic malignancies, genitourinary cancer, cervical cancer, and prostate cancer. The authors summarize the risk of cancer in patients with IBD, diagno...
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Adam S. Faye, Ariela K. Holmer, Jordan E. Axelrad Source Type: research

Approach to Familial Predisposition to Colorectal Cancer
The traditional approach of one-size-fits-all for colorectal cancer has been replaced by personalized interventions to an individual's unique genetic, molecular, and environmental profile, seeking to identify high-risk individuals who would benefit from individualized screening and surveillance. This change in approach is due, in part, to emerging technologies, such as next-generation DNA sequencing. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Veroushka Ballester, Marcia Cruz-Correa Source Type: research

Gastroenteropancreatic Neuroendocrine Tumors
This article reviews the presentation, diagnosis, and management of both localized and advanced GEP-NETs, with increased emphasis on the role of endoscopy, to enable gastroenterologists and other practitioners to have the necessary tools for the care of patients with these tumors. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Conrad J. Fernandes, Galen Leung, Jennifer R. Eads, Bryson W. Katona Source Type: research

Endoscopic Evaluation and Management of Cholangiocarcinoma
This article focuses on summarizing the various tools currently available for endoscopic evaluation and management of cholangiocarcinoma. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Rohit Das, Aatur D. Singhi, Adam Slivka Source Type: research

Management of Dysplastic Barrett ’s Esophagus and Early Esophageal Adenocarcinoma
While patients with Barrett ’s esophagus without dysplasia may benefit from endoscopic surveillance, those with low-grade dysplasia may be managed with either endoscopic surveillance or endoscopic eradication. Patients with Barrett’s esophagus with high-grade dysplasia and/or intramucosal adenocarcinoma will generally requ ire endoscopic eradication therapy. The management of Barrett’s esophagus with dysplasia and early esophageal adenocarcinoma is predominantly endoscopic, with multiple effective methods available for the resection of raised neoplasia and ablation of flat neoplasia. High-dose proton-pump inhibitor t...
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Cary C. Cotton, Swathi Eluri, Nicholas J. Shaheen Source Type: research

Squamous Cell Carcinoma of the Esophagus
Esophageal squamous cell carcinoma (ESCC) is common in the developing world with decreasing incidence in developed countries and carries significant morbidity and mortality. Major risk factors for ESCC development include significant use of alcohol and tobacco. Screening for ESCC can be recommended in high-risk populations living in highly endemic regions. The treatment of ESCC ranges from endoscopic resection therapy or surgery in localized disease to chemoradiotherapy in metastatic disease, and prognosis is directly related to the stage at diagnosis. New immunotherapies and molecular targeted therapies may improve the di...
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: D. Chamil Codipilly, Kenneth K. Wang Source Type: research

Familial Pancreatic Cancer
Individuals at increased risk of developing pancreatic cancer, including those with a significant family history of the disease and those with pancreatic cancer susceptibility gene variants, can benefit from pancreas surveillance. Most pancreatic cancers diagnosed during surveillance are early-stage and such patients can achieve long-term survival. Determining who should undergo pancreas surveillance is still a work-in-progress, but the main tools clinicians use to estimate an individual ’s risk of pancreatic cancer are patient’s age, the extent of their family history of pancreatic cancer, and whether or not they have...
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Helena Saba, Michael Goggins Source Type: research

The Microbiome in Gastrointestinal Cancers
The human microbiome has been recognized as increasingly important to health and disease. This is especially prescient in the development of various cancers, their progression, and the microbiome ’s modulation of various anticancer therapeutics. Mechanisms behind these interactions have been increasingly well described through modulation of the host immune system as well as induction of genetic changes and local inactivation of cancer therapeutics. Here, we review these associations for a variety of gastrointestinal malignancies as well as contemporary strategies proposed to leverage these associations to improve cancer ...
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Michael G. White, Jennifer A. Wargo Source Type: research

Pancreatic Cystic Neoplasms
Early detection of high-risk pancreatic cystic lesions enables potentially curative surgical resection, and early detection of lesions without worrisome features may lead to appropriate surveillance. Regrettably, differentiating premalignant and malignant cysts from nonmalignant ones remains challenging. However, emerging additional diagnostic tools, including the needle biopsy with microforceps and needle-based confocal laser endomicroscopy, are of exciting potential along with cyst fluid analysis ” (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Sahin Coban, Omer Basar, William R. Brugge Source Type: research

A Gastroenterologist ’s Approach to the Diagnosis and Management of Gastrointestinal Stromal Tumors
This article provides a gastroenterologist ’s perspective on the diagnosis and management of GISTs. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Raquel E. Davila Source Type: research

Recent Advancements in the Diagnosis and Treatment of Gastrointestinal Cancers
Approximately 19.3 million new cases of cancer were diagnosed worldwide in 2020, of which 5 million were cancers of the gastrointestinal (GI) tract. Furthermore, GI cancers were the cause of more than one-third of all cancer-related deaths.1 In 2022, the estimated incidence of cancers of the digestive system (343,040) in the United States will surpass the incidence of breast cancers (290,560) and cancers of the respiratory system (254,850).2 Although recent trends in incidence and mortality rates have been encouraging for cancers of the colorectum and stomach, no improvements have been observed in cancers of the esophagus,...
Source: Gastroenterology Clinics of North America - August 29, 2022 Category: Gastroenterology Authors: Raquel E. Davila, Marta L. Davila Tags: Preface Source Type: research

Some Thoughts About Crohn's Disease
The diagnosis, natural history, and management of Crohn ’s disease have changed substantially just during my career. We used to have only steroids, thiopurines, and surgery. The development of new imaging modalities, including enterography and video capsule, along with balloon endoscopy for tissue acquisition has advanced the way we diagnose and monito r patients with disease limited to the small bowel. The obvious game changer has been the introduction of biologics to our treatment strategies. It was a pipe dream to think that we could heal mucosa, and now we consider that standard of care. (Source: Gastroenterology Cli...
Source: Gastroenterology Clinics of North America - May 18, 2022 Category: Gastroenterology Authors: Sunanda V. Kane Tags: Preface Source Type: research

Foreword
Some 20 years ago, Britney Spears sang “I cannot hold it! I cannot control it!” in the chorus of “I’m a Slave for You.” That was largely the case for Crohn’s disease at the time as well. We have learned so much, and we have come so far. We can now hold it, and we can control it—to some extent at least. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 18, 2022 Category: Gastroenterology Authors: Alan L. Buchman Source Type: research

Medical and Surgical Management of Crohn ’s Disease
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 18, 2022 Category: Gastroenterology Authors: Sunanda V. Kane Source Type: research