Veterans with multiple risk factors for Barrett's esophagus are infrequently evaluated with upper endoscopy.

Recent guidelines recommend screening for patients with chronic gastroesophageal reflux disease who have three or more additional risk factors for Barrett's esophagus (BE). Failure to screen high-risk individuals represents a missed opportunity in esophageal adenocarcinoma prevention and early detection. We aimed to determine the frequency of upper endoscopy and prevalence of BE and esophageal cancer in a cohort of United States veterans who possessed four or more risk factors for BE.

Colonoscopy after a Positive Stool-based Test for Colon Cancer Screening: Moving Toward a Better Understanding of What to Expect.

Stool-based tests for colorectal cancer, including fecal immunochemical testing (FIT) and multitarget stool DNA testing (mt-sDNA), are among the recommended first-line screening options for patients at average risk for colorectal cancer and offer advantages over colonoscopy. However, stool-based tests have high false-positive rates, and the expected yield of colonoscopy after positive FIT compared with positive mt-sDNA is not well studied. As discussed in this issue of Cancer Prevention Research, the presence of a precancerous lesion in the majority of cases with either positive stool-based test is expected.

Impact of social determinants of health on colorectal cancer screening and surveillance in the COVID reopening phase.

Background/aims: Procedural delays due to the coronavirus disease 2019 (COVID-19) pandemic may exacerbate disparities in colorectal cancer (CRC) preventive care. We aimed to measure racial and socioeconomic disparities in the prioritization of CRC screening or adenoma surveillance during the COVID reopening period.

Methods: We identified CRC screening or surveillance colonoscopies performed during two time periods: (1) 9 June 2019-30 September 2019 (pre-COVID) and (2) 9 June 2020-30 September 2020 (COVID reopening).

Metformin Use Is Inversely Associated with Prevalent, but Not Incident Colorectal Adenomas.

Background: Chemoprevention for colorectal neoplasia has attracted growing interest, with multiple medications investigated. Metformin may decrease the overall incidence of cancer in patients with diabetes and may decrease the incidence of colorectal cancer.

Aims: We aimed to determine the impact of metformin use on the behavior of colorectal adenomas in a US veteran population.

Prevalence of Adenomas on Surveillance Colonoscopies for Patients with a History of Colonic Polyps of Unknown Histology.

Background: Guidelines for surveillance colonoscopy depend on polyp histology. When patients present to a new healthcare system and report a personal history of "colon polyps," however, information on polyp histology is frequently unavailable.

Aims: To assess adenoma prevalence in patients with a history of colonic polyps of unknown histology and to compare it to patients undergoing either screening colonoscopy or surveillance colonoscopy for known adenomatous polyps.

Association of patient gender and gastroenterologists' diagnosis and management choices in gastroesophageal reflux disease.

Symptom severity and prevalence of erosive disease in gastroesophageal reflux disease (GERD) differ between genders. It is not known how gastroenterologists incorporate patient gender in their decision-making process. We aimed to evaluate how gender influences the diagnosis and management recommendations for patients with GERD.

Risk of Adverse Outcomes in Hospitalized Patients With Autoimmune Disease and COVID-19: A Matched Cohort Study From New York City.

Objective: To examine the effect of autoimmune (AI) disease on the composite outcome of intensive care unit (ICU) admission, intubation, or death from COVID-19 in hospitalized patients.

Methods: Retrospective cohort study of 186 patients hospitalized with COVID-19 between March 1, 2020, and April 15, 2020 at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center. The cohort included 62 patients with AI disease and 124 age- and sex-matched controls.

Unsedated Colonoscopy: Impact on Quality Indicators.

Background: In the USA, sedation is commonly used for colonoscopies; though colonoscopy can be successfully performed without sedation, outcomes data in this setting are scarce.

Aims: To determine patient characteristics associated with undergoing unsedated colonoscopy and whether adenoma detection rate (ADR) and cecal intubation rate (CIR) differ between sedated and unsedated colonoscopy.

Methods: Using a single-center electronic endoscopy database, we identified patients who underwent outpatient colonoscopy between 2011 and 2018 with or without sedation.

Patient and Physician Factors Associated with Adenoma and Sessile Serrated Lesion Detection Rates.

Background And Aims: Sessile serrated lesions (SSLs) have been increasingly recognized as precursors to colorectal cancer. Unlike adenoma detection rate (ADR), there is currently no agreed-upon benchmark for SSL detection rate (SSLDR), and data on factors that impact SSL detection are limited. We aimed to identify patient, endoscopist, and procedural factors associated with SSL and adenoma detection.

Symptoms and demographic factors associated with early-onset colorectal neoplasia among individuals undergoing diagnostic colonoscopy.

Background: The incidence and mortality of colorectal cancer (CRC) are increasing in adults under 50 years. Risk factors associated with early-onset colorectal neoplasia (CRN) are uncertain. We aimed to identify clinical predictors associated with the presence of CRN detected by diagnostic colonoscopy in symptomatic individuals under 50 years of age.

Outcomes of patients with submucosal (T1b) esophageal adenocarcinoma: a multicenter cohort study.

Background And Aims: The treatment of submucosal (T1b) esophageal adenocarcinoma (EAC) remains in evolution, with some evidence supporting endoscopic management of low-risk lesions. Using a multicenter cohort, we evaluated outcomes of patients with T1b EAC and predictors of survival.

Methods: Patients diagnosed between 2001 and 2016 with T1b EAC were identified from 3 academic medical centers in the United States.

Anesthesia Assistance in Screening Colonoscopy and Adenoma Detection Rate Among Trainees.

Background And Aims: The use of anesthesia assistance (AA) for screening colonoscopy has been increasing substantially over the past decade, raising concerns about procedure safety and cost without demonstrating a proven improvement in overall quality indicators such as adenoma detection rate (ADR). The effect of AA on ADR has not been extensively studied among trainees learning colonoscopy. We aimed to determine whether type of sedation used during screening colonoscopy affects trainee ADR.

No Increased Risk of Colorectal Adenomas in Spouses of Patients with Colorectal Neoplasia.

Although genetic factors such as family history have been associated with increased risk of developing colorectal cancer (CRC), multiple lifestyle and environmental risk factors for CRC have been identified, including smoking, diet, obesity, and physical activity. Although couples typically have different genetic backgrounds, spouses are likely to share lifestyle and environmental exposures over the course of years, including similar home environments, geographical locations of residence, dietary exposures, and smoking exposures. As such, one might expect that an increased CRC incidence would be seen among spouses of patients with CRC; however, studies on this topic have inconsistent results.

Substantial Increase in Anesthesia Assistance for Outpatient Colonoscopy and Associated Cost Nationwide.

Background And Aims: The use of anesthesia assistance (AA) for outpatient colonoscopy has been increasing over the past decade, raising concern over its effects on procedure safety, quality, and cost. We performed a nationwide claims-based study to determine regional, patient-related, and facility-related patterns of anesthesia use as well as cost implications of AA for payers.

Methods: We analyzed the Premier Perspective database to identify patients undergoing outpatient colonoscopy at over 600 acute-care hospitals throughout the United States from 2006 through 2015, with or without AA.

Nonceliac Gluten Sensitivity.

Nonceliac gluten sensitivity (NCGS) refers to a clinical phenotype in which patients experience intestinal and extraintestinal symptoms related to ingesting a gluten-containing diet after a diagnosis of celiac disease (CD) or wheat allergy has been excluded. CD, an autoimmune disease characterized by villous atrophy triggered by the ingestion of gluten, has increased in prevalence in recent decades, although the majority of patients remain undiagnosed. There is now an increasing public awareness of NCGS and growing interest in the health effects of gluten among health professionals and the lay public.

Ethnic Variations in Duodenal Villous Atrophy Consistent With Celiac Disease in the United States.

Background & Aims: Celiac disease is a common disorder with a worldwide distribution, although the prevalence among different ethnicities varies. We aimed to measure the prevalence of duodenal villous atrophy among patients of different ethnicities throughout the United States.

Methods: We performed a cross-sectional study of all patients who had duodenal biopsies submitted to a national pathology laboratory between January 2, 2008 and April 30, 2015.