Colorectal cancer (CRC) is the second most common cancer in Germany. Screening colonoscopies have been offered in Germany since 2002. However, validation of screening programs for CRC relies on estimates up to date. The aim of this study was to analyze the influence of the risk factor tumor-suspicious symptoms on the prevalence of CRC and its precursor lesions in patients at least 55 years of age undergoing colonoscopy in comparison with an age-matched and sex-matched control population undergoing screening colonoscopy. Multicenter, prospective, controlled colonoscopy study. Integrated care program of 49 gastroenterological practices in collaboration with a health insurance company and the screening colonoscopy program in Hesse, Germany. In total, 1075 symptomatic and 5375 asymptomatic participants were matched for age and sex (1 : 5) from 1 October 2008 to 30 September 2010. Detection of CRC and its precursor lesions. Overall, the prevalence of CRC was significantly equivalent in both the symptomatic (n=13/1075, 1.21%) and the control group [n=55/5375, 1.02%, 95% confidence interval (CI) for the difference: [−0.46%, 0.83%], P=0.0002, equivalence test with δ=1.5%], respectively. Advanced adenomas were observed in significantly fewer symptomatic patients (61/1075, 5.67%) compared with 432/5375 matched asymptomatic screening participants (8.03%, 95% CI for the difference: [−3.98%, −0.74%], P=0.0094, difference test). Finally, polyps were found significantly less often in symptomatic patients (n=269/1075, 25.0%) than in matched screening participants (n=1807/5375, 33.6%, 95% CI for the difference: [−11.53%, −5.66%], P<0.0001, difference test). The results underline the importance of screening the symptom-free population at least 55 years of age to prevent CRC.

Background: Vedolizumab (VDZ) for subcutaneous (SC) injection was approved for use in Europe in 2020 and the US in 2023. Promising efficacy and tolerability have been proven in pivotal trials. However, real-world data on the SC use of VDZ, especially in patients with active disease, are still lacking. We aimed to determine treatment persistence and the drug’s efficacy in inflammatory bowel disease (IBD) patients with active disease in comparison to patients in clinical remission. Methods: Patients treated for IBD in a tertiary care center from July 2020 to December 2021 were included in this study. Clinical and biochemical parameters and data on treatment adherence were collected. VDZ trough levels and disease activity before and after the switch from intravenous (IV) to SC injections were monitored during routine checkups and were retrospectively analyzed. The patients were followed up until week 20. Results: Eighty-two patients were included in the study. Of them, 35 patients had active disease (35/82 = 43%) at the time of the switch and 47 patients (47/82 = 57%) were in remission. In total, 10 patients experienced switch failure, 5 were switched back to IV VDZ, and 5 were swapped to a different biologic agent. We observed an increase in VDZ trough levels from the switch to week 8 and from the switch to week 20 in the remission group. Vedolizumab trough levels of 7.4, 51.4, and 33.45 ug/mL at the switch, week 8, and week 20 were identified to discriminate between remission and disease activity in our cohort. There was no new safety signal detected during the study period. Conclusions: The switch from IV to SC VDZ proved to be efficient, safe, and even capable of reducing residual disease activity.

Background: Colorectal cancer (CRC) is the second most common cancer in Germany. Screening colonoscopies are considered an effective tool for early detection and prevention of CRC and are recommended in Germany for citizens over the age of 55. To increase the participation rate for screening colonoscopies, an invitation procedure was initiated in parts of Germany for patients between the ages of 55 and 75 who had never undergone a screening colonoscopy before.Methods: We examined the number of participating patients before, during, and after the invitation procedure and compared the number of the participating patients who received a cover letter with the participating patients from the control group. Additionally, we classified the findings of the colonoscopies including CRC, advanced adenomas, and polyps.Results: During the invitation period, the participation rate of the invitation group increased from 220 patients to 531 patients compared to 1256 to 1693 in the control group. The increase was significantly greater in patients with cover letters (+141% vs.+35%, p < 0.0001). Also, significantly more polyps and adenomas were found in patients from the invitation letter group (254 (+102%) vs. 679 (–9%), p < 0.0001).Conclusions: Our study clearly indicates that personal invitation letters are an effective measure to increase overall participation rates in screening colonoscopies.

Die vorliegende Übersichtsarbeit gibt einen Überblick über die aktuelle Studienlage zu geschlechtsspezifischen Unterschieden in der Behandlungsrealität von Patienten mit chronisch-entzündlichen Darmerkrankungen (CED). Dabei wird auf den Krankheitsverlauf, die medikamentöse und chirurgische Therapie ebenso wie auf die psychosozialen Unterschiede zwischen Frauen und Männern mit CED eingegangen. This review focuses on the gender and sex dimorphic disease profile and treatment reality of patients suffering from inflammatory bowel diseases (IBD). It provides an overview of gender-specific differences in the disease course, medical and surgical therapy as well as psychosocial aspects of IBD.

Background: Inflammatory bowel disease (IBD) remains an incurable illness. Patients with IBD show gender-specific differences in various aspects of the disease. There is still uncertainty about the causality of the differences. Methods: The aim of this study was to determine the most relevant psychophysiological gender-specific differences in IBD. For this purpose, a questionnaire survey was conducted on disease activity and psychological concomitant diseases in patients with IBD (n = 300). Among the 218 patients with IBD who provided gender information, both genders were equally distributed. Results: Females with IBD are significantly more affected by IBD-related symptoms than men. Disease activity Scores Harvey-Bradshaw Index (HBI), Partial Mayo Score (pMAYO) showed no significant differences between the sexes in the subgroups with CD (HBI, m: 3 (IQR 1–6), w: 4 (IQR 2–8), p = 0.0677) and UC (pMAYO, m: 1 (IQR 0–4), w: 3 (IQR 0–5), p = 0.2118). IBD Questionnaire (IBDQ)shows significant differences in the gender-specific analysis. The mean value of the IBDQ total score of the female participants was 4.4 (SD 1.1) and that of men was 5.0 (SD 1.0) (p = 0.0002). Conclusions: There is a great need to investigate the causality of gender-specific differences in greater depth.

Background: With the COVID-19 pandemic, a rapid adoption of telemedicine became necessary. Data regarding its implementation in specialized hepatology/IBD care remain limited. This study evaluated telemedicine’s effectiveness and safety during the pandemic at a German tertiary center and explored its integration into future hybrid care models. Methods: In a retrospective study, we analyzed 3147 patient encounters at the outpatient clinic of the Department for Gastroenterology and Hepatology at the University Hospital Frankfurt between March and June 2020. We assessed patient characteristics, appointment adherence, and outcomes across the three specialized clinics: hepatology (n = 1963), liver transplant (n = 594), and IBD (n = 590). Multivariate regression analysis identified predictors of successful telemedicine utilization. Results: Out of all appointments, 1112 (35.3%) were conducted via telemedicine, with significantly different adoption rates across clinics (hepatology, 40.4%; liver transplant, 32.8%; IBD, 21.0%, p < 0.01). Adherence rates were comparable between telemedicine (91.3%) and in-person visits (90.5%). Multivariate analysis identified age (OR 1.009, 95%CI 1.004–1.014, p < 0.001), metabolic-associated steatotic liver disease (OR 1.737, 95%CI 1.400–2.155, p < 0.001), and post-liver transplant status (OR 1.281, 95%CI 1.001–1.641, p = 0.049) as independent predictors of successful telemedicine utilization. HBV/HDV coinfection (OR 0.370, 95%CI 0.192–0.711, p = 0.003) and required endoscopy (OR 0.464, 95%CI 0.342–0.630, p < 0.001) were associated with in-person care. Hospitalization rates were low and comparable across modalities, confirming telemedicine’s safety. Conclusions: This study demonstrates that telemedicine can be successfully implemented in specialized gastroenterology and hepatology care, with high compliance rates comparable to in-person visits. Patient characteristics and disease-specific factors influence the suitability for telemedicine, supporting a stratified approach to hybrid care models, which can optimize resource utilization while maintaining quality of care. Particularly stable MASLD patients, well-controlled post-transplant recipients beyond one year, and IBD patients in sustained remission can be properly managed through telemedicine with annual in-person assessments.