Aim: Gastrointestinal malignant melanoma is a rare mucosal melanoma (MM). Other MM include the respiratory and the genitourinary tract. All mucosal melanomas have a poor prognosis when compared to cutaneous melanomas. Ano-rectal melanomas are by far the most common and most studied gastrointestinal MM. Large-scale clinical data is lacking due to the rarity of the disease. We aim to analyze epidemiology and survival of the Gastrointestinal (G.I.) MM over 45 years using a national database.Methods: The Surveillance, Epidemiology and End Results (SEER) database was queried to identify patients with biopsy-proven G.I. Melanomas. We selected tumor site, intervention, and survival information for oncology codes as per the international classification of diseases. Survival analysis was performed using the SPSS v 27 ® IBM software.Results: Of the 1105 biopsy-proven confirmed cases of primary G.I. melanoma's, 191 (17.3%) received chemotherapy (C.T.), 202 (18.3%) received radiotherapy (R.T.), 63 (5.7%) received both C.T and R.T., while 684 (61.9%) of the population received surgery alone or combined with C.T. and/or R.T. Statistically significant improvement in survival was noted in all treatment strategies that utilized surgery and also when site-specific MM cohorts underwent a surgical approach with or without C.T and/or R.T.Conclusion: This is the most extensive study reporting epidemiological and survival data of treatment strategy outcomes of primary G.I. mucosal melanoma elucidating best overall survival with a management strategy involving surgical intervention.

Adenoma detection rate (ADR) is challenging to measure, given its dependency on pathology reporting. Polyp detection rate (PDR) (percentage of screening colonoscopies detecting a polyp) is a proposed alternative to overcome this issue. Overall PDR from all colonoscopies is a relatively novel concept, with no large-scale studies comparing overall PDR with screening-only PDR. The aim of the study was to compare PDR from screening, surveillance, and diagnostic indications with overall PDR and evaluate any correlation between individual endoscopist PDR by indication to determine if overall PDR can be a valuable surrogate for screening PDR. Our study analyzed a prospectively collected national endoscopy database maintained by the National Institute of Health from 2009 to 2014. Out of 354,505 colonoscopies performed between 2009–2014, 298,920 (n = 110,794 average-risk screening, n = 83,556 average-risk surveillance, n = 104,770 diagnostic) met inclusion criteria. The median screening PDR was 25.45 (IQR 13.15–39.60), comparable with the median overall PDR of 24.01 (IQR 11.46–35.86, p = 0.21). Median surveillance PDR was higher at 33.73 (IQR 16.92–47.01), and median diagnostic PDR was lower at 19.35 (IQR 9.66–29.17), compared with median overall PDR 24.01 (IQR 11.46–35.86; p < 0.01). The overall PDR showed excellent concordance with screening, surveillance, and diagnostic PDR (r > 0.85, p < 0.01, 2-tailed). The overall PDR is a reliable and pragmatic surrogate for screening PDR and can be measured in real time, irrespective of colonoscopy indication.

Objectives: Pancreatitis is the third leading cause of gastrointestinal disease-related hospitalization. Pancreatitis burden has continued to increase since 1990, with trends driven by changing exposures to risk factors, population growth, and population aging. We report the national- and state-level estimates of pancreatitis burden. Methods: Global Burden of Disease (GBD) is a multinational collaborative research study that quantified the burden of 375 diseases. We reported the most recent incidence, prevalence, mortality, and the age-standardized rates per 100,000 population and the significant change from 1990 to 2023 in the US. Permission was obtained to report state-level estimates. Results: In 2023, there were an estimated 235,610 (217,889–251,545) new cases, 403,446 (298,429–514,224) prevalent cases and 5717 (5034–6443) deaths. Pancreatitis contributed 168,062 (147,357–191,446) years of disability-adjusted life years (DALYs). The age-standardized incidence rate (ASIR) was 51.11 (47.33–54.37) and age-standardized mortality rate (ASMR) was 1.05 (0.93–1.19). More burden is noted in men and in the ≥75 age group. High alcohol use contributed to 16.18% (6.14–26.95%) deaths and to 19% (7.16–31.56%) DALYs. Pancreatitis contributed 0.18% (0.16–0.21%) deaths and 0.14% (0.12–0.16) DALYs. From 1990 to 2023, ASIR decreased in all states, ASMR increased in 10 states, and decreased in DC. Conclusions: From 1990 to 2023, driven by demographic shifts, the number of cases and deaths have increased. However, when adjusted for age, the overall disease burden remained stable or slightly declined, suggesting that the risk per individual has not worsened. The future burden can be mitigated by specific prevention efforts and by addressing the risk factors.