Gastrointestinal Cancer Prevention Policies: A Qualitative Systematic Review and Meta-Synthesis

Glycoproteomics of Gastrointestinal Cancers and Its Use in Clinical Diagnostics

Cancer is a leading cause of death worldwide, resulting in substantial economic costs. Because cancer is a complex, heterogeneous group of diseases affecting a variety of cells, its detection may sometimes be difficult. Herein we review a large group of the gastrointestinal cancers (oral, esophageal, stomach, pancreatic, liver, and bowel cancers) and the possibility of using glycans conjugated to protein backbones for less-invasive diagnoses than the commonly used endoscopic approaches. The reality of bacterial N-glycosylation and the effect of epithelial mucosa on gut microbiota are discussed. Current advantages, barriers, and advantages in the prospective use of selected glycomic approaches in clinical practice are also detailed.

Addressing equity, diversity, and inclusion in JBI qualitative systematic reviews: a methodological scoping review

OBJECTIVE

The objective of this methodological scoping review was to investigate ways in which qualitative review teams are addressing equity, diversity, and inclusion (EDI) in the process of conducting and reporting qualitative systematic reviews that use JBI guidelines.

INTRODUCTION

To promote health equity, there is a need for evidence synthesis processes and practices to develop approaches that incorporate EDI. Some guidance is available to guide equity-focused review methods and reporting, but this is primarily oriented to quantitative systematic reviews. There is currently limited knowledge about how review teams are addressing EDI within qualitative evidence syntheses.

INCLUSION CRITERIA

This review included English-language qualitative systematic reviews, published in 2022, that used all the stjpg outlined in the JBI guidance for qualitative reviews.

METHODS

A 1-year sample of published reviews was identified from a search undertaken on March 17, 2023, of 2 health care databases: MEDLINE (Ovid) and CINAHL (EBSCOhost). Data extraction followed a framework approach, using an adapted pre-existing equity template. This included attention to i) the reporting of a range of characteristics associated with EDI, ii) search approaches, and iii) analytical approaches (including reflexivity, intersectionality, and knowledge user engagement). Data were analyzed using descriptive statistics and narrative summary.

RESULTS

Forty-three reviews met the inclusion criteria. The majority of the reviews (n = 30) framed their questions and aims in a generic/universal (rather than EDI-focused) way. Six reviews justified their population focus in terms of an EDI-related issue. Only 1 review included a knowledge user. The sociodemographic and other key characteristics of the samples in underpinning studies were poorly reported, making it hard to discern EDI-related issues or to undertake EDI-related analyses. Thirteen of the reviews included non-English-language evidence sources, and 31 reviews included gray literature sources. Ten reviews demonstrated an element of intersectional or otherwise critical approach within their analyses of categories and synthesized findings (whereby issues of power and/or representation were explicitly considered). Only 8 reviews included discussions of review team composition and reflexivity within the review process.

CONCLUSIONS

This EDI-focused methodological enquiry has highlighted some limitations within current qualitative evidence synthesis practice. Without closer attention to EDI, there is a danger that systematic reviews may simply serve to amplify, rather than illuminate, existing gaps, silences, and inequitable knowledge claims based on dominant representations. This review sets out a range of suggestions to help qualitative evidence synthesis teams to more systematically embed EDI within their methods and practices.

REVIEW REGISTRATION

Open Science Framework https://osf.io/wy5kv/.

Epidemiology of gastrointestinal cancers: a systematic analysis from the Global Burden of Disease Study 2021

BACKGROUND

Gastrointestinal cancers comprise nearly one-third of global mortality from cancer, yet the comprehensive global burden of these cancers remains uninvestigated.

OBJECTIVE

We aimed to assess the global, regional and national burden of gastrointestinal cancers.

DESIGNS

Data on oesophagus, gastric, colorectal, liver, pancreas and biliary tract cancers were extracted from the Global Burden of Disease 2021 database. Age-standardised incidence rate (ASIR) and age-standardised death rate (ASDR) were calculated by sex, region and Sociodemographic Index (SDI).

RESULTS

In 2021, there were 5.26 million incidences and 3.70 million deaths from gastrointestinal cancer. The greatest burden is from colorectal, followed by gastric, oesophageal, pancreatic, liver and biliary tract cancer. We noted geographical and socioeconomic differences in ASIR and ASDR across all types of cancers. From 2000 to 2021, ASIR increased for colorectal cancer (annual percent change (APC): 0.10%, 95% CI 0.05% to 0.14%), pancreatic cancer (APC: 0.27%, 95% CI 0.14% to 0.41%), and liver cancer from metabolic dysfunction-associated steatotic liver disease (APC: 0.62%, 95% CI 0.58% to 0.67%) and alcohol-related liver disease (APC: 0.26%, 95% CI 0.22% to 0.30%). ASDR increased for pancreatic cancer (APC: 0.18%, 95% CI 0.02% to 0.34%). Higher SDI countries had higher incidence rates for most types of gastrointestinal cancer.

CONCLUSIONS

Although the ASIR of oesophageal, gastric and biliary tract cancer has decreased, the ASIR still increased in colorectal, pancreatic and liver cancer from steatotic liver disease. Public policies are important for controlling gastrointestinal cancers-most importantly, reducing alcohol consumption, hepatitis B immunisation and tackling the burden of metabolic diseases.