Gastroenterology

MetALD and ALD carry much higher mortality and liver event risk than MASLD, with distinct fibrosis patterns

In 2551 biopsy-proven steatotic liver disease patients, MetALD and ALD had substantially higher all-cause mortality versus non-SLD controls after adjustment. MetALD and ALD also showed markedly increased liver-related event risk compared with non-SLD, independent of other factors. Among patients with advanced fibrosis (≥F3), ALD carried higher mortality and liver event risk than MASLD at similar fibrosis stage. AI-based second harmonic generation imaging revealed greater periportal and zone 2 collagen in MetALD and ALD than MASLD, despite comparable stage. 1

Adenoma recurrence risk is time-varying and modified by histology, obesity, and sex

Among 59,667 patients after first polypectomy, about 30% had adenoma recurrence within five years. High-grade dysplasia conferred very high early recurrence risk that attenuated over time, suggesting benefit from intensified early surveillance. Villous histology showed a biphasic pattern, with elevated early risk and renewed excess risk more than ten years later. Obesity modestly but consistently increased recurrence risk across all time intervals, indicating a persistent modifier. 2

Biennial FIT maintains clinically meaningful CRC yield through seven rounds; early cessation is not supported

This biennial FIT program followed 2.81 million invitees through seven screening rounds from 2010 to 2023. Nearly half never participated, but roughly 30% were fully adherent, enabling assessment of repeated negative testing. The first round had the highest FIT positivity, positive predictive values for CRC and high-risk precursors, and CRC detection per 1000 participants. After about three rounds, positivity and detection stabilized at lower levels than in age-matched first-time screeners, reflecting removal of prevalent neoplasia. 3

Advanced Crohn disease therapies show similar risks of serious infection, VTE, and MACE

This claims-based cohort included 12,245 Crohn disease patients initiating TNF antagonists, vedolizumab, ustekinumab, risankizumab, or upadacitinib between 2016 and 2022. Serious infection incidence ranged from about 5.5 to 9.0 per 100 person-years across therapies. After propensity score weighting, there were no statistically significant differences in serious infection risk between any advanced therapy classes. Adjusted risks of venous thromboembolism and major adverse cardiovascular events were also similar across treatments. 4