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Background: An accurate assessment of the evolution of GI endoscopy volumes is warranted to identify long-term trends and to help anticipate training, infrastructure and human resource needs. The main objective of this longitudinal study was to evaluate the evolution of GI endoscopy in France., Methods: This retrospective study consisted of a cross-sectional analysis repeated each year from 2008 to 2018 using data from a national health database related to hospital admissions. All day-case and hospital stays presenting at least one of the 119 GI endoscopy procedures were extracted., Results: This study showed an increase in day-case and hospital stays including a GI endoscopy procedure of 18.4 %. In addition, day-case endoscopy increased from 67.8 % to 76.9 % of hospital admissions. There was a 19.6 % increase in lower GI endoscopy, with in particular a 247 % increase in endoscopic mucosal resection. EUS and pancreaticobiliary and duodenal endoscopy have seen the most significant increases, 63 % and 70.2 % respectively; notably, therapeutic EUS increased by 476 %., Conclusion: This study shows the good dynamics of GI endoscopy in a European country with a sustained increase over 11 years in day-case and hospital stays of patients undergoing a GI endoscopy while day-case endoscopy is taking on an increasingly important role., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest related to this work., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Background: Colorectal cancer (CRC) screening using fecal immunochemical testing (FIT) aims to detect pre-symptomatic colorectal lesions and reduce CRC mortality., Aims: The objectives of this study were to determine the FIT sensitivity for diagnosis of CRC, the impact of diagnostic circumstances on treatment and survival, and risk factors for interval cancer (IC)., Methods: This population-based study evaluated the 2016-2017 CRC screening campaign in Finistère, France. CRCs were classified according to diagnostic circumstances: screen-detected CRC (SD-CRC), CRC with delayed diagnosis, IC after negative FIT (FIT-IC), post-colonoscopy CRC, CRC in non-responders and CRC in the excluded population., Results: This study included 909 CRCs: 248 SD-CRCs (6% of positive FIT) and 60 FIT-ICs (0.07% of negative FIT). The FIT sensitivity for CRC was 80.5% (CI95%: 76.1-84.9) at the threshold of 30 µg hemoglobin/g feces used in France. In multivariate analysis, proximal (OR:6.73) and rectal locations (OR:7.52) were associated with being diagnosed with FIT-IC rather than SD-CRC. The FIT positivity threshold maximizing the sum of sensitivity and specificity was found to be 17 µg/g, with 14 additional CRCs diagnosed compared to the current threshold., Conclusions: Our study confirms the good sensitivity of FIT. A decrease of the FIT detection threshold could optimize sensitivity., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest related to this work., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background: The identification of early prognostic factors during Crohn's disease (CD) remains needed for physician decision-making to minimize structural bowel damage, which this study aimed to assess in a population-based setting., Methods: All incident cases of CD were prospectively registered from 1994 to 1997 in Brittany, a limited area of France. All charts of patients were reviewed from the diagnosis to the last clinic visit in 2015. Disabling CD course was defined according to the Saint-Antoine criteria., Results: Among the 331 incident cases of CD, 272 (82%) were followed-up for a median time of 12.8 years. The cumulative probability of developing stricturing or fistulizing CD was 66% at 15 years, and 107 (39%) patients underwent surgery. The cumulative probabilities of immunosuppressant and TNF antagonist use at 15 years were 37% and 22%, respectively. The cumulative risks for disabling disease and bowel damage were 74% and 71% at 15 years, respectively. Systemic symptoms and perianal lesions at diagnosis were independently associated with a disabling disease course. Perianal disease and short disease extension were associated with the onset of bowel damage. Deep ulcers was not predictive of any outcome., Conclusions: A disabling disease course and bowel damage occurred early in the course of CD, which suggests the need for early diagnosis and early treatment, particularly for patients with systematic symptoms and perianal disease., Competing Interests: Declaration of Competing Interest ALM, AD, LBH, KC, CB, and CB received lecture fees from IPSEN. CR, BB, and LS received lecture fees from Abbvie, Amgen, Ferring, Janssen, MSD, and Takeda and consultant fees from Takeda. GB received lecture fees from Abbvie, Ferring, MSD, Takeda and Pfizer and consultant fees from Takeda, Janssen, Mylan, and Abbvie. VB and AN declared no conflict of interest., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Background: Survival of patients with colon cancer has increased in recent years due to advances in treatment and the implementation of multidisciplinary team meetings (MDTm). However, the organization of MDTm can be improved. The objectives of this work were to characterize patients with colon cancer who were not presented in MDTm and to analyse the reasons for their non-presentation., Methods: The study was based on a retrospective cohort including patients with colon cancer diagnosed between 2014 and 2016. Risk factors for non-presentation in MDTm were investigated after 1:1 matching on age, gender and tumour location, using multivariate analysis., Results: amongst 1616 patients diagnosed with colon cancer, 20.5% were not presented in MDTm. The most common reasons for non-presentation were 'advanced age or poor general condition' (22.6%) and 'superficial tumour' (20.5%), while 20.8% of non-presentation remained unexplained. Non-presentation in MDTm was associated with ECOG PS of 2 (OR 0.51, 95%CI 0.32-0.81, p = 0.005), best supportive care (OR 0.05, 95%CI 0.00-0.38, p = 0.016) and early death (OR 0.09, 95%CI 0.04-0.19, p<0.001). By contrast, patients with symptomatic tumours were more likely to be presented in MDTm than patients participating in mass screening (OR 2.16, 95%CI 1.09-4.32, p = 0.028). Presentation was significantly associated with diagnosis by a digestive surgeon (OR 2.16, 95%CI 1.22-3.92, p = 0.01) and a high UICC stage., Conclusions: This study identified factors associated with non-presentation in a multidisciplinary team meeting for colon cancer such as an advanced age or a superficial tumour, paving the way for targeted improvements., Competing Interests: Competing interests The authors declare that they have no conflict of interest related to this work., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)