What’s happening in gastroenterology in 2018? GESA president Professor Narci Teoh, from the ANU and the Canberra Hospital, provided her perspective.
What are the major issues in 2018?
The overarching issue in and really extending beyond 2018 is the prevention and early detection of gastrointestinal tract cancers. This includes bowel cancer and pancreatic cancer – which has poor prognosis due to late detection – as well as hepatocellular carcinoma (HCC).
The incidence of HCC in Australia has escalated significantly to more than double in the past decade. Death from HCC has increased by more than 20% in Australia. Obesity and type 2 diabetes interact with other risk factors for liver disease e.g. chronic viral hepatitis infection, excessive alcohol, and exacerbates HCC risk by 10 to up to 100 fold. This relationship has been and still is greatly under-appreciated.
Where do the ongoing clinical challenges lie?
- Prevention, prevention, prevention. Lifestyle modification and exercise to keep lean and fit, better uptake of cancer screening and harm minimization e.g. reduction of risk factors such as hazardous alcohol intake.
- Providing optimal care for Australians who live in remote and regional areas; their lack of easy access to specialist GI/Liver services remains a concern. GESA continues to work at improving in both these areas.
Is there anything you are particularly excited about?
The Australian Commission on Safety and Quality in Health Care’s “Colonoscopy Clinical Standard” (CCS) will be released later this year. This Standard has been, and still is, a mammoth, coordinated and multi-disciplinary effort to continually improve and ensure best possible quality and safety of patient care in colonoscopy in Australia.
The CCS is evidence-based and all-encompassing in its breadth and depth and covers all relevant aspects related to patient care pre- and post-colonoscopy. This professional standard will apply to all proceduralists nationally who perform colonoscopy and every Australian health care institution/centre/jurisdiction that is involved in this form of service delivery.
What are the research promises on the (near) horizon?
Fatty liver and liver cancer preventive therapies