Search

Simple Summary: Individuals with Lynch syndrome (LS) are at increased risk of colorectal cancer and undergo regular lower endoscopic procedures to detect and remove precancerous lesions. However, the frequency of colonic neoplasia detection in LS is not well characterized. In this study, we analyzed over 1200 colonoscopies and sigmoidoscopies from 352 individuals with LS. Detection rates for adenomas and other colorectal lesions were influenced by factors such as age and clinical history, while genotype, sex, and race showed no association. Our findings may provide benchmarks for endoscopists caring for individuals with LS and offer insight into lesion detection patterns. Further research is needed to assess how these rates affect colorectal cancer risk and outcomes, with the goal of optimizing surveillance strategies for this high-risk population. Background: The expected and optimal adenoma detection rate (ADR) is not well characterized in Lynch syndrome (LS). The aim of this study is to determine the ADR, the overall colorectal neoplasia detection rate (CNDR), proximal serrated detection rate (PSDR), and CRC detection rate (CRCDR) in an LS cohort. Methods: A retrospective study was performed of individuals with LS who were evaluated at a single tertiary care center from May 2001 to September 2023 (n = 542). Data from procedure and pathology reports were collected along with relevant demographic, clinical history, and family history data. Fisher's exact test and the Kruskal–Wallis test were used to assess factors associated with colorectal neoplasia. Results: Amongst 542 individuals with LS, 352 met the inclusion criteria, and their 1296 colonoscopies/sigmoidoscopies were used for analysis. The cohort was primarily female (64.5%), white (87.5%), and privately insured (76.1%), with a near even distribution across genotypes. CNDR was 27.9%, ADR was 21.4%, PSDR was 7.7%, and CRCDR was 1.5%. Advanced age, Medicare insurance, prior colonic resection, and prior history of non-CRC were significantly associated with an increased CNDR and ADR (p < 0.05). PSDR remained constant with age. There was no association with genotype, biological sex, race, smoking, BMI, aspirin use, nor family history. Conclusions: Despite frequent colonoscopies/sigmoidoscopies, individuals with LS maintain a high rate of colorectal neoplasia, primarily driven by increased detection of adenomas with advancing age. Neoplasia rates may serve as helpful "ballpark rates" for endoscopists performing colonoscopies/sigmoidoscopies in LS. However, further studies need to determine whether neoplasia rates are predictive of CRC risk and outcomes in LS. [ABSTRACT FROM AUTHOR]

This study aims to assess oculomotor and vestibular endurance by utilizing the Oculomotor and Vestibular Endurance Screening (MoVES) assessment in athletes' pre-season and post-season and after a suspected head injury to detect impairment. Athletes (N = 311, 19.4 ± 1.3 years) were recruited to perform the following seven tasks: (1) horizontal saccades, (2) vertical saccades, (3) vergence jumps, (4) horizontal vestibular-oculomotor reflex (VOR), (5) vertical VOR, (6) amplitude of accommodation (AoA), and (7) near point of convergence (NPC). At pre-season, the observed number of eye movements in 60 s are horizontal saccades (74 ± 13 initial 30 s; 67 ± 11 latter 30 s), vertical saccades (70 ± 13; 66 ± 10), vergence jumps (48 ± 12; 45 ± 13), horizontal VOR (38 ± 11; 38 ± 11), and vertical VOR (8 ± 11; 38 ± 11). These results establish a normative database for eye movements within the MoVES assessment and show consistency in the number of movements from pre-season to post-season. The initial results show a trending decrease in the number of eye movements in the initial days post-head injury, which improves to pre-season measures 14–21 days post-injury. This foundation can be used by future studies to explore the extent of binocular and vestibular endurance dysfunctions caused by head injuries that subside within two weeks. [ABSTRACT FROM AUTHOR]

Simple Summary: This study explores the psychosocial impact of pancreatic cancer (PC) surveillance in individuals at high-risk (HRIs) of developing PC. The primary objective was to understand the attitudes and beliefs of HRIs undergoing PC surveillance and assess the immediate and sustained psychosocial effects. By investigating factors such as perceived benefits, self-efficacy, and emotions before and after surveillance, the study aims to shed light on the overall experience of PC surveillance. The findings suggest that PC surveillance can yield lasting psychosocial benefits for HRIs. This insight not only enhances our understanding of the social and psychological aspects of surveillance, but also has implications for how the medical community approaches and supports individuals in high-risk PC surveillance programs. Objectives: Pancreatic cancer (PC) surveillance of high-risk individuals (HRIs) downstages PC and improves survival. However, it remains less clear whether PC surveillance has a positive psychosocial impact on HRIs. Herein, we aimed to define the attitudes and beliefs of HRIs undergoing PC surveillance, and the immediate and sustained psychosocial impact of PC surveillance in HRIs. Methods: 100 HRIs undergoing PC surveillance by endoscopic ultrasound (EUS) completed three surveys addressing different components of the psychosocial impact of PC surveillance. Logistic regression analyses were performed to identify predictive factors relating to these components. Results: Most HRIs reported increased perceived benefits of PC surveillance, self-efficacy, and perceived severity of PC. HRIs reported few negative emotions prior to surveillance and frequent positive emotions after surveillance. Compared to prior to surveillance, there was a 53.5% decrease in the level of distress reported by HRIs after surveillance, which was sustained for 4–6 weeks post-surveillance. Family history of PC and lower self-reported mental health were identified as predictors for increased perceived susceptibility to PC (p < 0.01) and greater change in distress pre- to post-surveillance (p < 0.01), respectively. Conclusions: Our findings suggest that PC surveillance can lead to sustained psychosocial benefits in HRIs. [ABSTRACT FROM AUTHOR]

BRCA1 and BRCA2 carriers may be at increased risk for gastric cancer; however, the mechanisms of gastric carcinogenesis remain poorly understood. We sought to determine the prevalence of gastric cancer risk factors Helicobacter pylori (H. pylori) infection and gastric intestinal metaplasia (GIM) among BRCA1/2 carriers to gain insight into the pathogenesis of gastric cancer in this population. A total of 100 unselected BRCA1/2 carriers who underwent endoscopic ultrasound from March 2022 to March 2023 underwent concomitant upper endoscopy with nontargeted gastric antrum and body biopsies. The study population (70% women; mean age 60.1 years) included 66% BRCA2 carriers. H. pylori was detected in one (1%) individual, 7 (7%) had GIM, 2 (2%) had autoimmune atrophic gastritis, and no gastric cancers were diagnosed. Among BRCA1/2 carriers, H. pylori prevalence was low and GIM prevalence was similar to that in the general population; however, identification of H. pylori or GIM may help inform future gastric cancer risk management strategies in BRCA1/2 carriers. Prevention Relevance: Evaluating the burden of H. pylori infection and GIM among BRCA1/2 carriers is warranted to better understand the mechanisms of gastric carcinogenesis and to help inform risk management strategies for gastric cancer among this at-risk population., (©2024 American Association for Cancer Research.)