Adherence to Clinical Practice Guidelines for Management of Epithelial Precancerous Conditions and Lesions in the Stomach in Europe.

Background And Aims: The first international guideline for managing preneoplastic conditions of the stomach (MAPS I) was published in 2012, followed by an update (MAPS II) in 2019. As adherence to these guidelines remains uncertain, we evaluated adherence by comparing the management of preneoplastic gastric conditions before and after the introduction of MAPS I and II in selected European centers.

Methods: Patients data were retrieved from nine endoscopy units in seven European countries during three periods: pre-MAPS I (2010/2011), post-MAPS I (2017/2018), and post-MAPS II (2022/2023).

Safety of surveillance endoscopy and EUS of the esophagus after neoadjuvant chemoradiotherapy: Results from the (pre)SANO trial.

Background And Study Aims: Active surveillance has been proposed for patients with esophageal cancer and a clinical complete response after neoadjuvant chemoradiotherapy (nCRT). This strategy involves repeated esophagogastroduodenoscopy (EGD) with bite-on-bite biopsies and endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) to detect tumor regrowth or residual disease. The aim of this study was to assess safety of endoscopic procedures during active surveillance.

Evaluation of Pepsinogen I, II, Gastrin 17 and Helicobacter pylori IgG in Atrophic Gastritis: A Head-To-Head Comparison of Lateral Flow and Enzyme-Linked Immunosorbent Assays.

Background: A lateral flow assay (LFA) incorporating several biomarkers, including pepsinogen I (PGI), pepsinogen II (PGII), Gastrin-17 (G-17), and Helicobacter pylori IgG, enables the rapid non-invasive detection of atrophic gastritis (AG). However, its diagnostic performance compared to conventional enzyme-linked immunosorbent assay (ELISA) has not been established.

Methods: This head-to-head comparison study included participants from a prospective and multicenter cohort.

Cost-effectiveness of colon capsule endoscopy in colorectal cancer screening: a modeling study.

The most used primary colorectal cancer (CRC) screening tests are the fecal immunochemical test (FIT) and colonoscopy. However, colonoscopy is an invasive procedure with possible (fatal) complications and FIT has shortcomings in test sensitivity. Colon capsule endoscopy (CCE) could be an alternative, but long-term effects are unknown.

Two-sample fecal immunochemical testing as a tool to avert colonoscopy in symptomatic patients: a prospective multicenter cohort study.

In most colonoscopies performed for bowel symptoms, no significant lesions are found. To decrease the number of unnecessary colonoscopies, we evaluated the performance of two-sample fecal immunochemical testing (FIT) in ruling out significant lesions.Symptomatic patients referred for colonoscopy were instructed to perform two FITs from separate bowel movements prior to colonoscopy.

External multicenter validation of the FAMISH score for predicting metachronous gastric lesions after endoscopic submucosal dissection.

Background And Objectives: Surveillance after gastric endoscopic submucosal dissection (ESD) is crucial due to the high risk of metachronous gastric lesions (MGL), although this risk may differ between patients. We sought to validate the FAMISH score - a prediction score to estimate MGL risk after gastric ESD - within a multicentric framework.

Materials And Methods: Performance measures of the FAMISH score were assessed in a retrospective analysis of a multicenter cohort, which included consecutive adult patients undergoing ESD for a primary gastric superficial lesion at 15 international centers, with a minimum endoscopic follow-up of at least 3 years.

Rethinking Post-colonoscopy Colorectal Cancer Risk: Endoscopist Performance Versus Presence of High-risk Polyps.

Background And Aims: Current post-polypectomy guidelines set intervals based solely on features of resected polyps. Despite the well-known inverse relationship between both adenoma detection rate (ADR) and proximal serrated polyp detection rate (PSPDR) with post-colonoscopy colorectal cancers (PCCRCs), both quality indicators are not considered when determining surveillance intervals.

Methods: We used colonoscopy data from 2014 to 2020 performed for a positive fecal immunochemical test in the Dutch colorectal cancer screening program.

Reducing outpatient visits for FIT-positive participants of colorectal cancer screening programs with home-based digital counselling.

Digital counselling can alleviate the burden on healthcare systems and patients. While it has been evaluated as a supplement to standard care or a substitute for follow-up visits, its use for initial triaging and counselling remains unstudied. We developed a Digital Intake Tool (DIT) to facilitate the entire pre-colonoscopy counselling process for FIT-positive participants of a colorectal cancer screening program digitally, replacing the need for physicians.

Computed Tomography Colonography in Fecal Immunochemical Test Positives in a Colorectal Cancer Screening Program.

Background & Aims: In the Dutch colorectal cancer (CRC) screening program, fecal immunochemical test (FIT)-positives are offered computed tomography colonography (CTC) instead of colonoscopy in case of comorbidities or patient refusal. Literature on CTC in FIT-positives is scarce, and the risk of post-CT interval CRC (PCT-CRC) in this population is unknown.

Methods: In this cohort study, we assessed CTC yield, clinical management, and risk of PCT-CRC in FIT-positives who underwent CTC between 2014 and 2019 in the Dutch CRC screening program.

The Optimal Age of Helicobacter pylori Screen-and-Treat for Gastric Cancer Prevention in the United States.

Background: Recent American College of Gastroenterology (ACG) guidelines recommend screening and eradicating Helicobacter pylori (H. pylori) in high-risk racial groups to prevent gastric cancer (GC), but do not provide guidance on the age to screen. We aimed to determine the optimal age for H.

The clinicopathological features of breast cancer in Peutz-Jeghers syndrome: results from an international survey.

Background: Female patients with Peutz-Jeghers syndrome (PJS) have an increased risk of breast cancer (BrCa), and surveillance is recommended. However, clinicopathological features of their tumors and prognosis are lacking. To facilitate more precise future guideline development, we evaluated these data.

Diagnostic Accuracy of an Add-On, Blood-Based Screening Test for Colorectal Cancer in Two Established Screening Programmes.

Background: CELTiC is a blood-based test consisting of a panel of four mRNAs (CEACAM6, LGALS4, TSPAN8 and COL1A2) associated with colorectal cancer (CRC). CELTiC has a high sensitivity (90%) for detecting advanced neoplasia (AN) when compared to faecal immunochemical test (FIT)-negative subjects.

Aims: To evaluate the diagnostic accuracy of CELTiC as an add-on test following a positive FIT in two existing CRC screening programmes.

Active surveillance in patients with a complete clinical response after neoadjuvant chemoradiotherapy for esophageal- and gastroesophageal junction cancer.

Neoadjuvant chemoradiotherapy in patients with esophageal- and gastroesophageal junction cancer induces tumor regression. In approximately one fourth of patients, this leads to a pathological complete response in the resection specimen. Hence, active surveillance may be an alternative strategy in patients without residual disease after neoadjuvant chemoradiotherapy.

Neoadjuvant chemoradiotherapy followed by active surveillance versus standard surgery for oesophageal cancer (SANO trial): a multicentre, stepped-wedge, cluster-randomised, non-inferiority, phase 3 trial.

Background: A substantial proportion of individuals with oesophageal cancer have a pathological complete response after neoadjuvant chemoradiotherapy and oesophagectomy. We aimed to investigate whether active surveillance could be an alternative for individuals with a clinical complete response after neoadjuvant chemoradiotherapy.

Methods: We performed a multicentre, stepped-wedge, cluster-randomised, non-inferiority, phase 3 trial in 12 Dutch hospitals.

Management of epithelial precancerous conditions and early neoplasia of the stomach (MAPS III): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG) and European Society of Pathology (ESP) Guideline update 2025.

At a population level, the European Society of Gastrointestinal Endoscopy (ESGE), the European and Microbiota Study Group (EHMSG), and the European Society of Pathology (ESP) suggest endoscopic screening for gastric cancer (and precancerous conditions) in high-risk regions (age-standardized rate [ASR] > 20 per 100 000 person-years) every 2 to 3 years or, if cost-effectiveness has been proven, in intermediate risk regions (ASR 10-20 per 100 000 person-years) every 5 years, but not in low-risk regions (ASR < 10).ESGE/EHMSG/ESP recommend that irrespective of country of origin, individual gastric risk assessment and stratification of precancerous conditions is recommended for first-time gastroscopy. ESGE/EHMSG/ESP suggest that gastric cancer screening or surveillance in asymptomatic individuals over 80 should be discontinued or not started, and that patients' comorbidities should be considered when treatment of superficial lesions is planned.

Efficacy of a higher-flexibility duodenal stent for palliation of gastric outlet obstruction.

Background And Study Aims: Duodenal self-expandable metallic stent (SEMS) placement is a common palliative treatment for malignant gastric outlet obstruction symptoms (GOOS). The higher flexibility of the WallFlex Duodenal Soft stent aims to ease stent placement and reduce adverse events (AE). This descriptive study compared the WallFlex Soft stent with other duodenal SEMS designs with regard to efficacy and safety.

The impact of extended invitation intervals on stage distribution of screen-detected and interval cancer within the Dutch colorectal cancer screening program.

This study investigates the impact of extended invitation intervals on the stage distribution of screen-detected and interval colorectal cancers (CRCs) in the Netherlands' fecal immunochemical test (FIT)-based screening program during the COVID-19 pandemic. Using data from individuals with negative FIT results in 2017-2019 and subsequent screening round in 2019-2021, we examined whether delays of up to 6 months affected CRC stage at diagnosis. We performed multivariate logistic regression to assess the association between invitation intervals and cancer stage.

Outcomes of endometrial cancer prevention strategies in patients with Lynch syndrome: a nationwide cohort study in the Netherlands.

Background: Female Lynch syndrome carriers have an increased risk of developing endometrial cancer. Regardless, research on endometrial carcinoma tumorigenesis is scarce and no uniform, evidence-based gynaecological management guidelines exist. We therefore described gynaecological surveillance and surgery outcomes in a nation-wide Lynch syndrome cohort.

Esophageal Candida Infection and Esophageal Cancer Risk in Patients With Achalasia.

Importance: Patients with achalasia face a higher risk of developing esophageal cancer (EC), but the surveillance strategies for these patients remain controversial due to the long disease duration and the lack of identified risk factors.

Objective: To investigate the prevalence of esophageal Candida infection among patients with achalasia and to assess the association of Candida infection with EC risk within this population.

Design, Setting, And Participants: This retrospective cohort study included patients with achalasia diagnosed at or referred for treatment and monitoring to the Erasmus University Medical Center in Rotterdam, the Netherlands, between January 1, 1980, and May 31, 2024.

Interval cancer risk after the upper age limit of screening has been reached: Informing risk stratification in FIT-based colorectal cancer screening.

Upper age limits are currently fixed for all fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening programs. A risk-stratified upper age limit may be beneficial. Therefore, we assessed differences in interval CRC risk among individuals who had reached the upper age limit of screening (75 years).

Survival of Patients with Resected Microsatellite Instability-High, Mismatch Repair Deficient, and Lynch Syndrome-Associated Pancreatic Ductal Adenocarcinomas.

Background: Pancreatic ductal adenocarcinoma (PDAC) remains a challenging disease due to its aggressiveness, late-stage diagnosis, and limited treatment options. Microsatellite instability-high (MSI-H) cancers are susceptible to immune checkpoint inhibitors. Survival outcomes for patients with MSI-H PDAC are unknown as the disease is rare.

Gastric Cancer Risk among Immigrants and Socioeconomic Groups in the Netherlands.

Background: Identification of groups at a high risk of gastric cancer could facilitate targeted screening in countries with a low gastric cancer incidence. Our aim was to identify such high-risk groups based on individual-level population data on migration history and socioeconomic status (SES) in the Netherlands.

Methods: In this retrospective cohort study, patient data from the Netherlands Cancer Registry were linked to demographic data of Statistics Netherlands in the period 2010 to 2022.