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Previous studies examining the relationship between HFE mutations and severity of nonalcoholic steatohepatitis (NASH) have been limited by small sample size or ascertainment bias. The aim of this study was to examine the relationship between HFE mutations and histological severity in a large North American multicenter cohort with NASH. Data from 126 NASH patients were collected from 6 North American centers. Liver biopsy and genotyping for the C282Y and H63D HFE mutations were performed in all subjects. Serum transferriniron saturation and ferritin levels as well as hepatic iron content were recorded whenever available. Univariate and multivariate logistic regression analyses were performed to identify factors associated with advanced hepatic fibrosis.

Endoscopic screening of carefully selected members of familial pancreatic cancer kindreds appears to increase patient life expectancy in a cost-effective manner. Screening should be performed in centers that have experience with endoscopic screening for pancreatic dysplasia. The cost-effectiveness of repeated screening remains to be determined.

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Laboratory studies suggest that antidepressants affect the risk of some cancers, including colorectal cancer. To investigate whether selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are associated with colorectal cancer risk, we conducted a case-control study among enrollees of an integrated healthcare delivery system in Washington State. Cases were first diagnosed with invasive colorectal cancer between 2000 and 2003; controls were randomly selected from Group Health enrollees and matched to cases on age, sex and length of enrollment before diagnosis/reference date. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for colorectal cancer in relation to use of any antidepressant, SSRIs only or TCAs only, among 649 cases and 656 controls. Use of any antidepressant was associated with a reduced risk of colorectal cancer (OR 5 0.7, 95% CI 5 0.5-0.9). Associations were similar for persons who used SSRIs exclusively (OR 5 0.7, 95% CI 5 0.4-1.1) and TCAs exclusively (OR 5 0.7, 95% CI 5 0.5-1.2); however, this reduction in risk appeared limited to persons without a prior cancer at another site. Our data support findings from previous epidemiologic and animal studies that suggest antidepressants may reduce the risk of colorectal cancer. Future studies with larger sample sizes should further examine individual drugs as well as dose, duration and recency of use.Antidepressant use is on the rise in the United States, 1 and it is important to determine what role, if any, these medications might play in altering the risk of diseases such as cancer. There have been several reports of null associations between use of antidepressants and the risk of breast 2,3 and ovarian 4-6 cancers. However, there is a lack of research on these relatively commonly used medications in relation to other major causes of cancer mortality, including colorectal cancer. A large epidemiologic study reported that serotonin reuptake inhibitors (SSRI) use reduced risk of colorectal cancer but observed no association with use of tricyclic antidepressants (TCA). 7 Another large study observed an increased risk of colon cancer with >4 years use of non-SSRI antidepressants. 8 A recent study noted a reduced risk of colorectal cancer associated with SSRI use and a nonsignificant reduction with TCA use. 9 Laboratory evidence suggests a decreased risk of colorectal cancer associated with SSRI use. In mice xenografted with human colorectal carcinomas, administration of antiserotoninergic agents, including the SSRIs fluoxetine and citalopram, 10 reduced colorectal tumor growth, as measured by tumor volume, compared with controls. [10][11][12] In rats, the mitotic rate of chemically induced colonic tumors was lower in those subsequently treated with antiserotoninergic agents compared with controls injected with saline. 10,13 These studies, along with in vitro studies of human colorectal cancer cell lines treated with SSRIs, 14,15 suggest that SSRIs may impede growth of colorectal tumors.Ev...