Gastroenterology & Hepatology

June 2021 - Volume 17, Issue 6

Letter From the Editor: The Importance of Early Detection of Pancreatic Cancer

Gary R. Lichtenstein, MD, AGAF, FACP, FACG

In the United States, pancreatic cancer is the fourth leading cause of cancer-related deaths and is expected to rise to the second leading cause by 2030. In this month’s issue of Gastroenterology & Hepatology, a review article focusing on pancreatic cancer highlights that early detection of this disease is of paramount importance for improving long-term survival. Dr Tara Keihanian, Dr Jodie A. Barkin, and Dr Enrico O. Souto emphasize that patients with pancreatic cancer frequently present with advanced disease, and many have unresectable disease at the time of their initial presentation leading to a poor prognosis. The authors describe the main environmental, patient-related, and hereditary risk factors for pancreatic cancer, and discuss which patients need to undergo screening and when. They also compare different radiographic and endosonographic screening methods, including magnetic resonance imaging/magnetic retrograde cholangiopancreatography, endoscopic ultrasound, and computed tomography, as well as biomarkers such as carbohydrate antigen 19-9.

Our other review article this month focuses on patients with inflammatory bowel disease (IBD) who have frailty, defined as an age-related decline in multiple physiologic systems. Dr Ashwin N. Ananthakrishnan points out that almost 20% of the US population will be 65 years of age or older by 2040, and up to 1 in 5 patients who are newly diagnosed with IBD may be older than 60 years of age, even though IBD has traditionally been seen as a disease of young people. He discusses potential mechanisms to explain the relationship between IBD and frailty, and reviews clinical studies on frailty in patients with IBD. He also examines frailty in other immune-mediated diseases.

Our coverage of IBD continues with our Advances in IBD column on Janus kinase (JAK) signaling. Dr Benjamin L. Cohen discusses the role of JAK signaling in the pathogenesis of IBD, the advantages of this therapeutic approach, tofacitinib and various JAK inhibitors currently in phase 2 and 3 studies, and whether selective JAK inhibition may be beneficial, among other issues.

Our Advances in Hepatology column focuses on the timely issue of COVID-19 and the liver. Dr Dushyantha Jayaweera discusses various issues, such as how the liver may be affected by COVID-19, how common these hepatic manifestations are, their main causes, how patients should be treated, and whether preexisting chronic liver disease predisposes patients with COVID-19 to poor outcomes.

Finally, our Advances in Endoscopy column features an interview with Dr Karthik Ravi on endoscopic impedance planimetry, which uses the endoscopic functional luminal imaging probe known as EndoFLIP. Among other issues, he discusses how EndoFLIP works and how it has evolved since its introduction, how it complements other technologies, its use in the screening of patients, and which patients are ideal candidates.

May this issue provide you with helpful information that you can put to good use in your clinical practice.


Gary R. Lichtenstein, MD, AGAF, FACP, FACG

Millennium Medical Publishing, Inc