Screening for gastrointestinal cancer: an epidemiological review

Article Abstract:

Screening large numbers of people for disease conditions presupposes that early detection will result in better treatment, to the benefit of the patient. Because most people who will be screened for a particular disease will not have the disease, and those who will subsequently develop it are symptom-free at the time of screening, tests must be simple, safe, acceptable, reproducible, and valid. Sensitivity and specificity are two important criteria to be applied to any screening program prior to its adoption. Sensitivity reflects the number of people who actually have (or will develop) the disease who will be identified by the screen (absence of false negatives); specificity measures the ability of the screen to accurately identify patients who will remain disease-free (absence of false positives). Once a screening strategy is implemented, it must be carefully evaluated to determine that the benefit is commensurate with the time and expense involved in screening. Sufficient time must be allowed to pass to adequately evaluate the outcome in cases where screening identified an incipient disease condition which was subjected to treatment. The time required varies from disease to disease; most forms of cancer require at least five years to adequately assess the effectiveness of treatment. In many types of gastrointestinal cancer (including esophageal adenocarcinoma), the natural history of the disease is poorly understood; there is inadequate recognition of early stages of the disease; and the benefit of early treatment is not well established. In such cases, screening is not justified. In contrast, colorectal cancer, a well characterized condition with a dramatically improved prognosis following early detection, is an example of a disease for which screening is indicated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical screening, Health screening, Gastrointestinal diseases

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Towards a true prevalence of peptic ulcer: the Sorreisa gastrointestinal disorder study

Article Abstract:

Peptic ulcer, an inflammatory condition of the lower esophagus, stomach, or intestine, is a painful and potentially very dangerous condition. Reports have characterized this disorder as being more prevalent in men than women, although this varies in different parts of the world. In addition, the interpretation of most investigations into peptic ulcer prevalence are complicated by the use of different criteria for classifying ulcers and reporting symptoms to physicians for treatment, and the fact that some ulcers do not produce any symptoms. To overcome some of these obstacles, a study was carried out in northern Norway involving a total of 2,027 patients between the ages of 20 and 69 years of age. Previous studies conducted in Scandinavia have indicated a higher prevalence of both gastric and duodenal ulcer in men compared with women. Questionnaires were administered to seek out previously diagnosed peptic ulcers, and endoscopy (a diagnostic procedure for viewing the interior of the gastrointestinal tract) was performed on patients complaining of ulcer symptoms as well as apparently healthy patients. The overall prevalence of peptic ulcer in this group was 10.5 percent for men and 9.5 percent for women, a ratio much closer to 1:1 than has previously been reported. In addition, there was a higher rate of duodenal ulcer compared with gastric ulcer incidence than has been found in other studies. Approximately 1 percent of the asymptomatic patients were diagnosed with an ulcer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Norway, Ulcers, Peptic ulcer

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Stress effects on gastrointestinal transit in the rat

Article Abstract:

Previous investigations of the effects of stress on the gastrointestinal system in rats have produced conflicting results. In this study, one type of stress, a 'passive avoidance' situation, was used to investigate the effects of stress on aspects of the gastrointestinal system (gastric emptying, orocaecal and colonic transit). After the rats had been trained to eat a standard amount of semi-solid food, the amount of food remaining in the stomach (gastric emptying), was measured after various periods of rest or exposure to stress. The results indicate that gastrointestinal transit, or movement of the food thorough the digestive system, in different parts of the gastrointestinal tract is affected differently by stimuli from the central nervous system.

Research, Models, Physiological aspects, Stress (Physiology), Animal experimentation, Gastrointestinal system, Digestive system diseases

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