Longer colonoscopy waits linked to higher CRC

Patients who have an abnormal FIT/FOBT have a higher risk of colorectal cancer incidence, death, and late-stage disease if the time to colonoscopy exceeds one year, a US study has shown

In an analysis of 204,733 patients who had a positive FOBT/FIT result, the risk of colorectal  was significantly higher (HR 1.13) for those who had received a colonoscopy at 13 to 15 months compared to those who had one within three months.

The risk of CRC increased over time, being23-28% higher up to 24 months after the positive FIT/FOBT, according to findings published in Gastroenterology. Mortality risk was higher in patients who received a colonoscopy at 19 to 21 months (HR 1.52;) and 22 to 44 months (HR 1.39) after a positive results, while the odds for late-stage CRC increased at 16 months.

Gastroenterologist’s autobiography a winner with BMJ

The autobiography of Irish gastroenterologist Dr Seamus O’Mahony has proved a hit with the BMJ, which has described the retired specialist’s book The Ministry of Bodies as “disturbing, funny, enjoyable, and beautifully written”.

Former BMJ editor DR Richard Smith says the book provides an entertaining but sobering account of Dr O’Mahony’s disillusion over his final years in practice as a consultant gastroenterologist in Cork, where he had hoped to bring the latest endoscopic techniques but was forced by necessity to work as a general physician.

The book outlines the realities of modern hospital work, featuring impossible caseloads, burnout, battles with bureaucracy and colleagues and the struggle between being a specialist and generalist.

His observations include lines such as: “The protocols governing colonoscopy mandate the removal of all colonic polyps in all patients. These protocols were based on three delusions: that resources are limitless, that complications never occur, and that people live forever.”

Dr Smith recommends it as “ideal for those who would like a deeper understanding than most books and television programmes offer of what goes on in hospitals.”

Community screening picks up chronic liver disease

Community screening programs can pick up  people at high risk of viral hepatitis and chronic liver disease, Australian research shows.

A NSW nurse-led program that targeted 926 people with transient elastography and/or serology testing identified 13% as having had evidence of chronic liver disease. Chronic viral hepatitis was diagnosed in almost 10% of patients, whilst NAFLD was diagnosed in 14 participants. Advanced fibrosis was detected in 5% of subjects with available liver stiffness measures (LSM), according to study researchers from St George’s Hospital, Sydney.