To evaluate global, physical, and psychological symptom burden in patients with hematologic malignancies and its influencing factors.

This study employed convenience sampling. Sociodemographic data and standardized scales (Memorial Symptom Assessment Scale, Cancer Coping Modes Questionnaire, and Social Support Rate Scale) were collected. Statistical analyses included Kruskal-Wallis H test, Mann-Whitney U test, Spearman correlation, and generalized linear modeling.

A total of 501 questionnaires were distributed, and 405 valid questionnaires were finally recovered. Results showed an Memorial Symptom Assessment Scale total score of 0.36 (0.16, 0.67), with physical symptom dimension score 0.44 (0.17, 0.86) significantly exceeding psychological symptom dimension score 0.28 (0, 0.67). Lack of energy was the most prevalent (58.52%) and burdensome symptom. Generalized linear regression identified female gender (β = 0.096, p = 0.008), fewer treatment sessions (β =  - 0.003, p = 0.028), resignation coping (β = 0.042, p < 0.000), and fantasy coping (β = 0.029, p < 0.001) as significant predictors of higher overall burden. Compared to other malignancy types, leukemia(β = -0.244, p = 0.001), lymphoma (β =  - 0.282, p < 0.000), myelodysplastic syndrome (β =  - 0.189, p = 0.034), and multiple myeloma (β =  - 0.32; p < 0.000) demonstrated protective effects against symptom burden.

Patients experience a significant burden of physical symptoms during hospitalization, and the burden of psychological symptoms in patients may be underestimated. Therefore, it is crucial to construct and apply a more accurate assessment system of psychological symptom burden. Additionally, establishing a standardized symptom burden screening mechanism is recommended to effectively identify high-risk patients and enable immediate interventions for high-burden symptoms.

The resect-and-discard strategy for colorectal cancer prevention involves real-time optical diagnosis during colonoscopy to eliminate the need for histopathological analysis of diminutive colorectal polyps (1-5 mm). Although endorsed by international gastroenterology societies and supported by extensive evidence of diagnostic accuracy, implementation remains limited due to barriers including clinician confidence, medico-legal concerns, and procedural complexities. The emergence of artificial intelligence (AI)-based diagnostic systems has renewed interest in this strategy by potentially improving accuracy and clinician acceptance. While early real-world data indicate high patient approval and significant cost and environmental benefits, critical questions remain unanswered, including optimal techniques for accurate polyp size estimation and AI-based differentiation of specific histological features. Additionally, uncertainties regarding medico-legal liability and standardization of quality assurance processes require further clarification. This review highlights current evidence, identifies major implementation barriers, and proposes areas of future research necessary to facilitate widespread adoption of the resect-and-discard strategy.

Dobrow's 12 consolidated principles were applied to evaluate the extent to which colorectal cancer (CRC) screening programmes align with these established screening principles. The principles within the first domain - disease and conditions - are fully met. CRC represents a significant global public health burden with a well-understood natural history, including a long preclinical phase. These features make CRC suitable for population-based screening. Current guidelines recommend screening average-risk individuals, with starting ages as early as 45 years and stopping ages up to 85 years in some programs, although most programs target those aged 50-75 years. For Dobrow's second domain - test or intervention - we found that established CRC screening methods (faecal immunochemical testing (FIT), colonoscopy, and flexible sigmoidoscopy) have known and acceptable sensitivity and specificity. These tests have clear thresholds for interpretation and follow-up and are associated with reductions in both CRC incidence and mortality, confirming their clinical effectiveness in organised programmes. Dobrow's third domain - programme or system - addresses how screening programmes should be structured, implemented, and integrated into health systems. Unlike the other domains, this is fully achieved in only a small minority of programmes. While implementation may vary from country to country, the principles provide benchmarks for well-organised programmes. CRC screening is generally cost-effective and widely accepted by patients, providers, and society. Successful programmes require dedicated teams, infrastructure, and systems for coordination and quality assurance. Before implementation, a CRC screening initiative must meet, or have a clear plan to meet 12 principles. In summary, robust infrastructure and governance are essential for organised CRC screening programmes to align with the Dobrow principles and achieve long-term success.

Colorectal cancer (CRC) screening has proven to decrease CRC incidence and mortality, with many countries providing faecal immunochemical tests (FIT) in screening programs. Effectiveness, however, is limited in the setting of low participation rates, which has prompted growing research into blood-based screening. While blood testing is anticipated to improve participation due to greater population acceptability, its readiness for widespread implementation remains unclear, and comparative accuracy data against FIT is needed. This article provides a systematic review and meta-analysis on blood-based CRC screening tests that have been directly compared to FIT, and summarises the evidence for broader program considerations, including analytical quality, consumer preferences, participation rates and cost effectiveness. The findings show that blood tests currently lack the sensitivity and cost-effectiveness to replace FIT in screening programs, and that their use should be limited to individuals unable or unwilling to complete FIT.

Using a standardized data template, this study retrospectively collected data about colorectal cancer (CRC) screening activity in 2020 and 2021 to estimate the impact of the COVID-19 pandemic compared to the pre-pandemic period (2018 or 2019). Data were collected from 17 programs in 14 countries of which 15 were population-based programs. Invitation coverage was decreased by up to 53.7 % in 2020. Participation among those invited was similar in both periods for all programs. The maximum backlog in invitations was less than 7.4 months in 2020 and 3.3 months for 2021. Nine out of 15 programs observed a decrease in the number of detected CRCs in 2020. Four programs showed a positive percentage change in CRCs detected in 2021 relative to the pre-pandemic period. Half of the countries observed a worse stage-distribution in 2020/2021. Overall, organized CRC screening programs operated at lower screening activity, but screening outcomes were similar compared to the pre-pandemic period.

Colonoscopy is essential for colorectal cancer (CRC) screening, but its effectiveness depends on adequate bowel preparation (BP), which remains suboptimal in up to 44 % of cases. Poor BP reduces lesion detection, particularly in the proximal colon, and increases procedure time, repeat exams, and healthcare costs. This narrative review summarizes evidence-based strategies to improve BP, highlighting high- and low-volume polyethylene glycol (PEG) regimens, including newer very-low-volume options with better patient tolerance. Adjunctive agents like simethicone and 5-HT4 agonists benefit select groups, especially those with constipation. Split-dose and same-day regimens, particularly with a <5-h interval before the procedure, enhance cleansing and adenoma detection. A 1-day low-fiber diet is now preferred for better compliance. Risk factors for poor BP include age, comorbidities, and socioeconomic barriers. Emerging tools, such as predictive models and AI-enabled apps, support personalized care. A patient-centered, risk-adapted approach is vital to optimize colonoscopy quality and reduce CRC incidence.

Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the United States, with colonoscopy serving as the gold standard for both diagnosis and early intervention. While diminutive polyps (<5 mm) constitute most findings, only a small fraction exhibit advanced histological features. Optical diagnosis, which enables real-time classification of polyp histology through new technologies and the support of new strategies to leave low risk polyps in place (diagnose-and-leave) or resect without sending for formal pathology (resect-and-discard) have been studied as a cost-saving and effective strategy for diminutive polyps. There have been advances in imaging, such as narrow band imaging (NBI), but widespread adoption has yet to occur. The integration of artificial intelligence (AI), particularly computer-aided diagnosis (CADx) systems, has emerged as a promising tool to standardize optical diagnosis, reduce interobserver variability, and improve adherence to surveillance guidelines. However, barriers to widespread implementation persist, including concerns about medicolegal liability, financial disincentives, and skepticism of CADx accuracy. The goal of article is to review the current evidence surrounding optical diagnosis, review diagnostic accuracy, and evaluate the challenges of widespread clinical adoption.

The heterogeneous implementation of colorectal cancer screening programs across Europe makes performance comparison challenging. This study computed and analyzed seven key indicators of screening performance for eighteen European programs between 2011 and 2022. Trends in colorectal cancer incidence and mortality were also examined in relation to when each screening program was introduced. Coverage indicators showed considerable variation across programs but generally increased until the onset of the COVID pandemic. Yield indicators remained stable overall, whereas jumps were associated to protocol changes. In most countries, a decline in incidence followed the introduction of the screening program, whereas the connection of screening with mortality was less evident. The analysis of comparable screening performance indicators over time allows for cross-country and longitudinal monitoring of the programs. The observed decline in incidence following the implementation of fully rolled-out programs highlights the importance and effectiveness of well-organized screening in reducing the burden of the disease.

This review provides an overview of optical biopsy for colorectal lesions, focusing on the Eastern perspective-particularly recent advancements in Japan. Optical biopsy aims to predict the histopathology of colorectal lesions in real time during colonoscopy, distinguishing neoplastic from non-neoplastic lesions and assessing invasion depth. This paper examines various image-enhanced endoscopy techniques: narrow-band imaging (NBI) with the Japan NBI Expert Team classification, pit pattern analysis, and endocytoscopy using NBI and methylene blue staining. Additionally, it explores the evolving role of optical diagnosis in guiding expanded endoscopic treatment strategies for T1 and even selected T2 colorectal cancers, outlining future prospects for optical biopsy.

Colonoscopy is a cornerstone of colorectal cancer (CRC) prevention, with adenoma detection rate (ADR) serving as a critical quality metric. However, substantial variability in ADR persists across operators, and a significant proportion of colorectal neoplasia-particularly flat, serrated, and right-sided lesions-continues to be missed. These limitations are often attributable to suboptimal mucosal exposure, especially in anatomical regions hidden behind haustral folds and flexures. To address this, a variety of mechanical auxiliary devices-collectively termed behind-folds visualizing techniques and technologies (BFTs)-have been developed to enhance mucosal exposure during withdrawal. These include both add-on devices (e.g., caps, Endocuff, EndoRings) and integrated technologies (e.g., G-EYE, FUSE, Third Eye), each with varying levels of evidence and practicality. This review critically appraises current data on BFTs, highlighting their efficacy in improving ADR, particularly among endoscopists with lower baseline performance. Meta-analyses suggest that simple, low-cost devices such as Endocuff and caps offer the most favorable balance of effectiveness, accessibility, and ease of use. Furthermore, emerging data indicate that combining mechanical exposure devices with artificial intelligence-based systems may yield additive benefits. BFTs represent pragmatic tools to optimize colonoscopy quality and reduce post-colonoscopy CRC. Their selective implementation-especially in low-performing settings-should be considered a key component of modern endoscopic practice.