Cost-Effectiveness of Screening, Surveillance, and Endoscopic Eradication Therapies for Managing the Burden of Esophageal Adenocarcinoma
The authors conducted a review of the literature of cost-effectiveness analyses regarding management of Barrett ’s esophagus, including screening, surveillance, and treatment strategies. Because of the presence of multiple systematic reviews on this topic, they chose to focus on more recent economic analyses, with an emphasis on comparative modeling because these analyses have been demonstrated to achieve g reater validity and impact when there are multiple competing strategies that are clinically reasonable to pursue. The authors identified areas of consensus across studies regarding management strategies and also a...
Source: Gastrointestinal Endoscopy Clinics of North America - October 26, 2020 Category: Gastroenterology Authors: Joel H. Rubenstein, John M. Inadomi Source Type: research

Advanced Imaging and Sampling in Barrett ’s Esophagus
Because the current Barrett ’s esophagus (BE) surveillance protocol suffers from sampling error of random biopsies and a high miss-rate of early neoplastic lesions, many new endoscopic imaging and sampling techniques have been developed. None of these techniques, however, have significantly increased the diagnostic yield of BE neoplasia. In fact, these techniques have led to an increase in the amount of visible information, yet endoscopists and pathologists inevitably suffer from variations in intra- and interobserver agreement. Artificial intelligence systems have the potential to overcome these endoscopist-dependen...
Source: Gastrointestinal Endoscopy Clinics of North America - October 26, 2020 Category: Gastroenterology Authors: Maarten R. Struyvenberg, Albert J. de Groof, Jacques J. Bergman, Fons van der Sommen, Peter H.N. de With, Vani J.A. Konda, Wouter L. Curvers Source Type: research

Advances in Biomarkers for Risk Stratification in Barrett ’s Esophagus
This report focuses only on those biomarkers that appear most promisi ng based on the availability of multiple published studies corroborating good results, and on the commercial availability of the test. These promising biomarkers include p53 immunostaining, TissueCypher, BarreGEN, and wide-area transepithelial sampling with computer-assisted 3-dimensional analysis ( WATS3D). (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - October 26, 2020 Category: Gastroenterology Authors: Rhonda F. Souza, Stuart Jon Spechler Source Type: research

Current Status of Chemoprevention in Barrett ’s Esophagus
Candidates for chemoprevention in Barrett ’s esophagus have long been suggested and there has been observational data to support many drugs, including statins, hormone replacement therapy, metformin, proton pump inhibitor therapy, and aspirin. Proton pump inhibitor therapy and aspirin are the most promising agents. Data suggest that aspir in and proton pump inhibitor therapy can decrease the risk of neoplastic progression in Barrett’s esophagus. Further, the combination of aspirin and proton pump inhibitor therapy decrease all-cause mortality by approximately 33%. Future guideline groups need to evaluate the ev...
Source: Gastrointestinal Endoscopy Clinics of North America - October 26, 2020 Category: Gastroenterology Authors: Paul Moayyedi, Hashem B. El-Serag Source Type: research

Surgical Management of Barrett ’s-Related Neoplasia
The management of Barrett ’s-related neoplasia has benefited from advances in endoscopic assessment, resection, and ablation, along with improved pathologic and radiographic staging. The development of specialized, high-volume esophageal multidisciplinary teams, with improvements in patient selection, preparation, perioper ative care, minimally invasive operative approaches, and enhanced recovery after surgery programs, has contributed to improved outcomes for patients undergoing esophagectomy for Barrett’s-related neoplasia. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - October 23, 2020 Category: Gastroenterology Authors: Akshay Pratap, Martin D. McCarter, Thomas J. Watson Source Type: research

Measuring Quality in Barrett ’s Esophagus
Endoscopic eradication therapy is a safe and effective therapy that has revolutionized the management of patients with Barrett ’s esophagus (BE)-related neoplasia. Despite this, there remains significant heterogeneity in clinical practice with consequent variation in patient outcomes. The aim of this article was to align consensus statements based on the best available evidence and expert opinion from the United States an d United Kingdom to develop robust and measurable quality indicators that help to ensure patients with BE-related neoplasia receive the highest possible quality of care uniformly. (Source: Gastroint...
Source: Gastrointestinal Endoscopy Clinics of North America - October 23, 2020 Category: Gastroenterology Authors: Vinay Sehgal, Krish Ragunath, Rehan Haidry Source Type: research

Epidemiology of Barrett's Esophagus and Esophageal Adenocarcinoma
In the United States, the incidence of esophageal adenocarcinoma increased markedly since the 1970s with a recent stabilization. Despite evolving screening and surveillance strategies to diagnose, risk triage, and intervene in Barrett ’s esophagus patients to prevent esophageal adenocarcinoma, most cases present with advanced disease and poor resultant survival. Epidemiologic studies have identified the main risk factors for these conditions, including increasing age, male sex, white race, gastroesophageal reflux disease, abdom inal obesity, cigarette smoking, and lack of infection with Helicobacter pylori. This revi...
Source: Gastrointestinal Endoscopy Clinics of North America - October 21, 2020 Category: Gastroenterology Authors: Michael B. Cook, Aaron P. Thrift Source Type: research

Endoscopic Screening for Barrett ’s Esophagus and Esophageal Adenocarcinoma
Barrett ’s esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), a cancer with increasing incidence and poor survival. Risk of EAC in patients with BE is higher compared with the general population. Endoscopic screening for BE is performed to identify patients earlier in the metap lasia-dysplasia-carcinoma sequence from BE to EAC to enable eradication therapy. BE screening should be considered in individuals with multiple risk factors for BE and EAC. Challenges to BE screening include the absence of a cost-effective, widely applicable minimally invasive screening tool, gastro esophageal reflu...
Source: Gastrointestinal Endoscopy Clinics of North America - October 21, 2020 Category: Gastroenterology Authors: Amrit K. Kamboj, David A. Katzka, Prasad G. Iyer Source Type: research

Best Practices in Surveillance for Barrett's Esophagus
Barrett's esophagus is the precursor lesion for esophageal adenocarcinoma. The goals of endoscopic surveillance are to detect dysplasia and early esophageal adenocarcinoma in order to improve patient outcomes. Despite the ongoing debate regarding the efficacy of surveillance, all current gastrointestinal societies recommend surveillance at this time. Optimal surveillance technique includes adequate inspection time, evaluation using high-definition white light and chromoendoscopy, appropriate documentation of the metaplastic segment using the Prague C& M criteria as well as the Paris classification should lesions be fou...
Source: Gastrointestinal Endoscopy Clinics of North America - October 21, 2020 Category: Gastroenterology Authors: Joseph R. Triggs, Gary W. Falk Source Type: research

Advances and Opportunities in Barrett ’s Esophagus
The incidence of esophageal adenocarcinoma continues to increase in the Western population. While outcomes of patients with early esophageal adenocarcinoma has improved significantly, largely due to endoscopic eradication therapies and minimally invasive surgery, the 5-year survival rates for advanced cases remains dismal. Barrett ’s esophagus is the only precursor lesion for esophageal adenocarcinoma, and the last decade has seen significant improvements and innovations in this field. Some of the key advances include high-definition endoscopy, virtual chromoendoscopy, and endoscopic eradication therapies that have t...
Source: Gastrointestinal Endoscopy Clinics of North America - October 21, 2020 Category: Gastroenterology Authors: Sachin Wani Tags: Preface Source Type: research

Barrett ’s Esophagus: Current Management and New Approaches
Barrett ’s esophagus stands as the primary indicator for an increased risk of esophageal adenocarcinoma. Endoscopic eradication of Barrett’s esophagus with dysplasia has been clearly demonstrated in randomized controlled trials and multiple additional studies to markedly decrease the risk of developing adenocarcinoma of the esophagus. A paradigm shift in clinical practice and national and international guidelines has taken place with strong recommendations for endoscopic eradication therapy for early neoplasia in Barrett’s esophagus, replacing esophagectomy in most patients. (Source: Gastrointestinal Endo...
Source: Gastrointestinal Endoscopy Clinics of North America - October 21, 2020 Category: Gastroenterology Authors: Charles J. Lightdale Tags: Foreword Source Type: research

Outbreak Investigations
This article summarizes important aspects of outbreak investigations for physicians who do not frequently manage these investigations and gives practical advice for how gastroenterologists can help identify outbreaks and manage these investigations successfully. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - September 2, 2020 Category: Gastroenterology Authors: Annabelle de St. Maurice, Zachary A. Rubin Source Type: research

Endoscopy in the Era of Antibiotic Resistant Bacteria
GASTROINTESTINAL ENDOSCOPY CLINICS OF NORTH AMERICA (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - September 2, 2020 Category: Gastroenterology Authors: Jacques Van Dam Source Type: research

Copyright
ELSEVIER (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - September 2, 2020 Category: Gastroenterology Source Type: research

Contributors
CHARLES J. LIGHTDALE, MD (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - September 2, 2020 Category: Gastroenterology Source Type: research

Contents
Charles J. Lightdale (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - September 2, 2020 Category: Gastroenterology Source Type: research

Forthcoming Issues
Advances in Barrett's Esophagus (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - September 2, 2020 Category: Gastroenterology Source Type: research

Quality Systems Approach for Endoscope Reprocessing
This article reviews monitoring as part of a quality management system that includes manual cleaning, dry storage, and culture to detect endoscope contamination. The published data for rapid tests that detect organic residuals and adenosine triphosphate to monitor manual cleaning are reviewed. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - August 7, 2020 Category: Gastroenterology Authors: Michelle J. Alfa Source Type: research

The Endoscopy Patient as a Vector and Victim
Patient and procedural factors can increase the risk of infectious adverse events during endoscopy. Prophylactic antibiotic use must be judicious and individualized in the era of antibiotic resistance. New and emerging procedures require high-quality studies to elucidate appropriate risk profiles. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - August 2, 2020 Category: Gastroenterology Authors: Brian P.H. Chan, Tyler M. Berzin Source Type: research

Gastrointestinal Endoscopy in the Era of Antibiotic Resistant Bacteria
What happened? How could it all go so terribly wrong? Where do we go from here? (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - August 2, 2020 Category: Gastroenterology Authors: Jacques Van Dam Tags: Preface Source Type: research

The Centers for Disease Control and Prevention Guidance on Flexible Gastrointestinal Endoscopes
Flexible endoscopes require cleaning, high-level disinfection, and sterilization between each patient use to reduce risk of transmitting pathogens. Public health investigations have identified concerns, including endoscope damage, mishandling, and reprocessing deficiencies, placing patients at risk for transmission of bacterial, viral, and other pathogens. Findings from outbreak investigations and other studies have led to innovations in endoscope design, use, and reprocessing, yet infection risks related to contaminated or damaged endoscopes remain. Strict adherence to infection control guidelines and manufacturer instruc...
Source: Gastrointestinal Endoscopy Clinics of North America - July 31, 2020 Category: Gastroenterology Authors: Isaac Benowitz, Heather A. Moulton-Meissner, Lauren Epstein, Matthew J. Arduino Source Type: research

Antimicrobial Resistance
Antimicrobial resistance is developing rapidly and threatens to outstrip the rate at which new antimicrobials are introduced. Genetic recombination allows bacteria to rapidly disseminate genes encoding for antimicrobial resistance within and across species. Antimicrobial use creates a selective evolutionary pressure, which leads to further resistance. Antimicrobial stewardship, best use, and infection prevention are the most effective ways to slow the spread and development of antimicrobial resistance. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - July 31, 2020 Category: Gastroenterology Authors: Lindsay Morrison, Teresa R. Zembower Source Type: research

Gastrointestinal Flexible Endoscopes
Flexible endoscopes require cleaning, high-level disinfection, and sterilization between each patient use to reduce risk of transmitting pathogens. Public health investigations have identified concerns, including endoscope damage, mishandling, and reprocessing deficiencies, placing patients at risk for transmission of bacterial, viral, and other pathogens. Findings from outbreak investigations and other studies have led to innovations in endoscope design, use, and reprocessing, yet infection risks related to contaminated or damaged endoscopes remain. Strict adherence to infection control guidelines and manufacturer instruc...
Source: Gastrointestinal Endoscopy Clinics of North America - July 31, 2020 Category: Gastroenterology Authors: Isaac Benowitz, Heather A. Moulton-Meissner, Lauren Epstein, Matthew J. Arduino Source Type: research

Recent Actions by the US Food and Drug Administration
In addition to technological advancements, engagement and collaboration among the wider community of stakeholders will be beneficial toward reducing the risk of infection from reprocessed duodenoscopes. Such a community can raise awareness of the importance of duodenoscope cleaning, work to improve reprocessing training, identify the most pressing unanswered questions that merit further research, and develop tools that can be used by health care facilities to improve the quality of reprocessing at their sites. The Food and Drug Administration looks forward to working with the community to further reduce the risk of infecti...
Source: Gastrointestinal Endoscopy Clinics of North America - July 29, 2020 Category: Gastroenterology Authors: Shanil P. Haugen, Ann Ferriter, Jian Connell, Lauren J. Min, Hanniebey D. Wiyor, Stephanie Cole Source Type: research

Nosocomial Infections
This article reviews the history, prevalence, economic costs, morbidity and mortality, and risk factors associated with HAIs. Types of infections described include bacterial, fungal, viral, and multidrug resistant infections that contribute to the most common causes of HAIs, which include catheter- associated urinary tract infections, hospital-acquired pneumonias, bloodstream infections, and surgical site infections. Most nosocomial infections are preventable and monitoring and prevention strategies are described. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - July 29, 2020 Category: Gastroenterology Authors: Jia-Yia Liu, Jana K. Dickter Source Type: research

Novel Algorithms for Reprocessing, Drying and Storing Endoscopes
After outbreaks of duodenoscope-transmitted infection with multidrug-resistant organisms, it has become clear that institutions must optimize their endoscope reprocessing programs. Standard endoscope reprocessing practices may not represent the ideal approach for preventing transmission of infection related to endoscopy. We discuss multiple approaches to enhance and optimize reprocessing, drying, and storage of standard duodenoscopes. The optimal enhanced duodenoscope reprocessing modality remains to be determined. Acknowledging the challenges and limitations in effectively reprocessing duodenoscopes, the FDA issued a safe...
Source: Gastrointestinal Endoscopy Clinics of North America - July 29, 2020 Category: Gastroenterology Authors: Monique T. Barakat, Subhas Banerjee Source Type: research

Society Guidelines —Where Is the Consensus?
This article critically analyzes currently available national and international duodenoscope reprocessing guidelines. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - July 29, 2020 Category: Gastroenterology Authors: David S. Vitale, Karl K. Kwok, Quin Y. Liu Source Type: research

Reducing the Risk of Infection from Reprocessed Duodenoscopes —Recent Actions by the US Food and Drug Administration
In addition to technological advancements, engagement and collaboration among the wider community of stakeholders will be beneficial toward reducing the risk of infection from reprocessed duodenoscopes. Such a community can raise awareness of the importance of duodenoscope cleaning, work to improve reprocessing training, identify the most pressing unanswered questions that merit further research, and develop tools that can be used by health care facilities to improve the quality of reprocessing at their sites. The Food and Drug Administration looks forward to working with the community to further reduce the risk of infecti...
Source: Gastrointestinal Endoscopy Clinics of North America - July 29, 2020 Category: Gastroenterology Authors: Shanil P. Haugen, Ann Ferriter, Jian Connell, Lauren J. Min, Hanniebey D. Wiyor, Stephanie Cole Source Type: research

Endoscopes and Antibiotic-Resistant Bacteria: Controlling the Risk
Threats to highly valuable systems abound in modern society. Think of airplanes for example. Changes are made, and innovations are developed, resulting in improved safety, only to be challenged by new risks. In the history of medicine, there have been many instances where inadvertent transmission of infection by physicians was identified, and corrective measures were taken. In modern times, antibiotic-resistant bacteria are among the latest microscopic terrorists. For interventional gastrointestinal endoscopists, the most prized instruments are duodenoscopes used mostly for endoscopic retrograde cholangiopancreatography. (...
Source: Gastrointestinal Endoscopy Clinics of North America - July 28, 2020 Category: Gastroenterology Authors: Charles J. Lightdale Tags: Foreword Source Type: research

Introduction to Transmission of Infection
Pathogen contamination of endoscopes depends on pathogen factors, surface factors, and environmental conditions. The most common pathogens associated with transmission and infections associated with gastrointestinal endoscope contamination are Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. Biofilm production together with disruption to device surfaces play an outsized role in the risk of contamination. Sampling schemes are limited by these factors, and further developments are needed to improve the accuracy of sampling. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - July 19, 2020 Category: Gastroenterology Authors: Graham M. Snyder Source Type: research

Methods for Endoscope Reprocessing
Over the past 2  decades, in hospital centers worldwide, there have been numerous outbreaks of multidrug-resistant organisms that have since been attributed to endoscopic transmission of the infections between patients, primarily from duodenoscopes. These outbreaks have focused the attention of endoscope manufactu rers, professional societies, and regulatory agencies on improving the reprocessing of these devices. The key steps in this process are point-of-use precleaning, leak testing, manual cleaning, high-level disinfection, and finally drying and storage. The promise of these initial efforts suggest that the aim o...
Source: Gastrointestinal Endoscopy Clinics of North America - July 19, 2020 Category: Gastroenterology Authors: Neil B. Marya, Raman V. Muthusamy Source Type: research

Duodenoscope as a Vector for Transmission
This article reviews the historical context for these outbreaks, technical aspects of scope design contributing to this risk, and innovations in endoscope technology that have the potential to overcome these shortcomings. Also reviewed are interim solutions and the data that support use of some of these interventions. Still needed are a validated manufacturer-recommended schedule for routine duodenoscope and echoendoscope maintenance with reprocessing protocols that can be implemented in endoscopy units. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - July 14, 2020 Category: Gastroenterology Authors: Jennifer T. Higa, Andrew S. Ross Source Type: research

Forthcoming Issues
Endoscopy in the Era of Antibiotic Resistant Bacteria (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - June 30, 2020 Category: Gastroenterology Source Type: research

Colorectal Cancer Screening
Colorectal cancer (CRC) screening is unquestionably effective in reducing CRC mortality. In the United States, CRC incidence rates have been falling for over four decades, and the rate of incidence decline accelerated to 3% to 4% per year in 2000. At least half this decline appears to result from screening. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 19, 2020 Category: Gastroenterology Authors: Douglas K. Rex Tags: Preface Source Type: research

Colorectal Cancer Screening
GASTROINTESTINAL ENDOSCOPY CLINICS OF NORTH AMERICA (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 19, 2020 Category: Gastroenterology Authors: Douglas K. Rex Source Type: research

Copyright
ELSEVIER (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 19, 2020 Category: Gastroenterology Source Type: research

Contributors
CHARLES J. LIGHTDALE, MD (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 19, 2020 Category: Gastroenterology Source Type: research

Contents
Charles J. Lightdale (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 19, 2020 Category: Gastroenterology Source Type: research

Gastrointestinal Endoscopy Clinics of North America
Endoscopy in the Era of Antibiotic Resistant Bacteria (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - May 19, 2020 Category: Gastroenterology Source Type: research

What Is Organized Screening and What Is Its Value?
Most screening in the United States occurs in an opportunistic fashion, although organized screening occurs in some integrated health care systems. Organized colorectal cancer (CRC) screening consists of an explicit screening policy, defined target population, implementation team, health care team for clinical care delivery, quality assurance infrastructure, and method for identifying cancer outcomes. Implementation of an organized screening program offers opportunities to systematically assess the success of the program and develop interventions to address identified gaps in an effort to optimize CRC outcomes. There is ev...
Source: Gastrointestinal Endoscopy Clinics of North America - April 15, 2020 Category: Gastroenterology Authors: Jason A. Dominitz, Theodore R. Levin Source Type: research

Risk Stratification Strategies for Colorectal Cancer Screening
Risk stratification is a system by which clinically meaningful separation of risk is achieved in a group of otherwise similar persons. Although parametric logistic regression dominates risk prediction, use of nonparametric and semiparametric methods, including artificial neural networks, is increasing. These statistical-learning and machine-learning methods, along with simple rules, are collectively referred to as “artificial intelligence” (AI). AI requires knowledge of study validity, understanding of model metrics, and determination of whether and to what extent the model can and should be applied to the pati...
Source: Gastrointestinal Endoscopy Clinics of North America - April 15, 2020 Category: Gastroenterology Authors: Thomas F. Imperiale, Patrick O. Monahan Source Type: research

Multitarget Stool DNA for Average Risk Colorectal Cancer Screening
After 2 screen-setting studies showing high sensitivity for colorectal cancer and advanced precancerous lesions, multitarget stool DNA testing was endorsed by the US Preventative Services Task Force as a first-line colorectal cancer screening test. Uptake has increased exponentially since approval by the US Food and Drug Administration and Centers for Medicare and Medicaid Services. Adherence to testing is approximately 70%. Patients with positive results have high diagnostic colonoscopy completion rates in single-center studies. The positive predictive value for colorectal neoplasia in postapproval studies is high. Next-g...
Source: Gastrointestinal Endoscopy Clinics of North America - April 15, 2020 Category: Gastroenterology Authors: John B. Kisiel, Jason D. Eckmann, Paul J. Limburg Source Type: research

Colorectal Cancer Screening Decisions in the Opportunistic Setting
Colorectal cancer incidence and mortality have decreased in the United States in recent decades, largely through opportunistic screening. Although certain organizations have improved internal screening rates by implementing programmatic screening, most of the United States undergoes opportunistic screening. Much effort and resources have been expended comparing screening tests to determine the most effective; however, deeper analysis of the US population has revealed subsets of ethnicities may be grossly underscreened. The most effective screening test remains the test that is completed and adhered to, and a better questio...
Source: Gastrointestinal Endoscopy Clinics of North America - April 15, 2020 Category: Gastroenterology Authors: Andrew Han, Jennifer Maratt, Charles Kahi Source Type: research

The National Colorectal Cancer Roundtable
(NCCRT) is an organization of organizations with staffing, funding and leadership provided by the American Cancer Society (ACS) and guidance and funding by the Centers for Disease Control and Prevention (CDC). In 2014, ACS, CDC, and the NCCRT launched the 80% by 2018 campaign. This highly successful initiative activated hundreds of organizations to prioritize colorectal cancer screening, disseminated smart, evidence-based interventions, and ultimately led to 9.3 million more Americans being up to date with screening compared with the precampaign rate. It's new campaign, 80% in Every Community, is designed to address persi...
Source: Gastrointestinal Endoscopy Clinics of North America - April 15, 2020 Category: Gastroenterology Authors: Richard Wender, Durado Brooks, Katherine Sharpe, Mary Doroshenk Source Type: research

Quality in Colorectal Cancer Screening with Colonoscopy
The goal of colorectal cancer (CRC) screening with colonoscopy is to minimize CRC with minimal risk and cost. In order to continuously improve the quality of colonoscopy, different outcomes must be measured. For this topic, the priority indicators to be measured are (1) frequency of scheduling colonoscopy at appropriate interval based on current guidelines; (2) frequency of identifying adenomas in average-risk individuals undergoing their first screening colonoscopy; and, (3) providing guideline-consistent recommendations for repeat colonoscopy after the procedure. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - April 15, 2020 Category: Gastroenterology Authors: Philip Schoenfeld Source Type: research

Colorectal Cancer in Persons Under Age 50
Early onset colorectal cancer (EOCRC) refers to colorectal cancer (CRC) in individuals under age 50. Although the incidence and mortality due to later onset CRC ( ≥50 years) has been declining over several decades, both are increasing in those under 50. EOCRC is more likely to occur in the distal colon and rectum. There are some unique pathologic and genetic features to these tumors; they are not usually associated with a germline mutation in a gene that p redisposes to cancer, and at least some may have a distinct pathogenesis. Initiating CRC screening at an earlier age (40–45 years of age) would presumably ...
Source: Gastrointestinal Endoscopy Clinics of North America - April 15, 2020 Category: Gastroenterology Authors: Swati G. Patel, Clement Richard Boland Source Type: research

Colorectal Cancer Screening: Where We Are and Moving Forward
As I write the foreword to this issue of Gastrointestinal Endoscopy Clinics of North America devoted to “Colorectal Cancer Screening,” the COVID-19 pandemic continues to rage. Tens of thousands of Americans will die of respiratory complications of the highly contagious coronavirus infection. Mandatory “social distancing” is widely declared in cities and states across the country. In many place s, all elective gastrointestinal (GI) endoscopy procedures have been put on hold, including colonoscopies for colorectal cancer screening. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - April 14, 2020 Category: Gastroenterology Authors: Charles J. Lightdale Tags: Foreword Source Type: research

Update on Flexible Sigmoidoscopy, Computed Tomographic Colonography, and Capsule Colonoscopy
This article reviews alternative colorectal cancer (CRC) screening tests, including flexible sigmoidoscopy (FS), computed tomography (CT) colonography, and colon capsule endoscopy. FS has abundant and convincing evidence supporting its use for CRC screening and is a commonly used CRC test worldwide. CT colonography has demonstrated convincing results for CRC screening, but concerns regarding cost, accuracy for flat or sessile neoplasia, reproducibility, extracolonic findings, and lack of coverage have limited its use and development. Colon capsule endoscopy has demonstrated encouraging results for polyp detection in averag...
Source: Gastrointestinal Endoscopy Clinics of North America - April 14, 2020 Category: Gastroenterology Authors: Seung Won Chung, Seifeldin Hakim, Shaheer Siddiqui, Brooks D. Cash Source Type: research

Fecal Immunochemical Test
This article reviews current understanding of FIT performance as a 1-time test and when applied programmatically. It outlines how to apply the test at the patient level and track performance at the program level. Future prospects for FIT application are highlighted. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - April 14, 2020 Category: Gastroenterology Authors: Douglas J. Robertson, Kevin Selby Source Type: research

Foreword: Colorectal Cancer Screening: Where We Are and Moving Forward
As I write the Foreword to this issue of Gastrointestinal Endoscopy Clinics of North America devoted to “Colorectal Cancer Screening,” the COVID-19 pandemic continues to rage. Tens of thousands of Americans will die of respiratory complications of the highly contagious coronavirus infection. Mandatory “social distancing” is widely declared in cities and states across the country. In many place s, all elective gastrointestinal (GI) endoscopy procedures have been put on hold, including colonoscopies for colorectal cancer screening. (Source: Gastrointestinal Endoscopy Clinics of North America)
Source: Gastrointestinal Endoscopy Clinics of North America - April 14, 2020 Category: Gastroenterology Authors: Charles J. Lightdale Source Type: research