Background and Study Aims: Our goal was to compare the updated European Society of Gastrointestinal Endoscopy (ESGE) and United States Multi-Society Task Force on Colorectal Cancer (USMSTF) high risk groups in predicting metachronous advanced neoplasia on first follow-up colonoscopy and long term colorectal cancer (CRC). Patients and Methods: We compared advanced metachronous neoplasia risk (serrated polyps (SPs) (>/=1 cm or with dysplasia), advanced adenomas ((>/=1 cm, villous, HGD), CRC) on first surveillance colonoscopy in patients with ESGE versus the USMSTF high risk findings. In addition, we compared the positive and negative predictive values (PPV/NPV) of both guidelines for metachronous neoplasia. Results: The risk for metachronous neoplasia in our sample (n=20,458) was higher in the high risk USMSTF (3 year) (13.6%; 95% CI: 12.3-14.9) and ESGE groups (13.6%;95% CI:12.3-15.0) as compared to the lowest risk USMSTF (5.1%;95%CI:4.7-5.5;p<0.001) and ESGE categories (6.3%;95%CI:4.7-5.5;6.0-6.7p<0.001) respectively. Adding other groups such as USMSTF 5-10 and 3-5 year groups to the 3 year category resulted in minimal change in the PPV/NPVs for metachronous advanced neoplasia. High risk ESGE (HR:3.03,95%CI:1.97-4.65) and USMSTF (HR:3.07,95%CI:2.03-4.66) designations were associated with similar long term CRC risk (CRC per 100,000 person-years : USMSTF 3 year group :3.54;95%CI:2.68-4.68 and ESGE high risk group: 3.43; 95%CI:2.57-4.59). Conclusion: Performance characteristics for the ESGE and USMSTF recommendations are similar in predicting metachronous advanced neoplasia and long term CRC. Furthermore, the addition of risk groups such as the USMSTF 5-10/3-5 year groups to the USMSTF 3 year category did not alter the PPV or NPV significantly.

of this research is that specific gut microbes could be analyzed to risk stratify COVID-19 patients. Furthermore, if additional studies support the contention that the gut microbiota play an important role in the pathogenesis of COVID-19, then modification of gut species (or their metabolites) may serve as a novel approach to mitigating severe disease. Indeed, multiple clinical trials are currently exploring the impact of probiotics on COVID-19

No abstract

Bleijenberg AGC, IJspeert JEG, Hazewinkel Y, et al. The long-term outcomes and natural disease course of serrated polyposis syndrome: over 10 years of prospective follow-up in a specialized center. Gastrointest Endosc 2020;1-10.