Hot-button issues: Experts share opinions on shifts in clinical innovation, policy in 2024

Throughout 2024, experts in the fields of gastroenterology and hepatology weighed in on cutting edge research, emerging trends and policies, as well as clinical innovations shaping the future of patient care.

Hot topic interviews included the AGA’s opinion on UnitedHealthcare’s Gold Card program for GI endoscopy, concerns about rising rates of anal cancer and metastatic stomach cancer, and a new AI chatbot that aims to make colonoscopy prep “a little less painful” for patients.

In addition, following the FDA’s accelerated approval of Rezdiffra (resmetirom, Madrigal Pharmaceuticals) in March for the treatment of metabolic dysfunction-associated steatohepatitis with moderate to advanced fibrosis, Mazen Noureddin, MD, MHSc, helped Healio fill in the gaps on how to leverage noninvasive tests to assess treatment response.

In 2025, Healio will continue to feature the voices and expert opinions of health care providers. Meantime, check out some coverage on hot-button issues from 2024 in gastroenterology and hepatology below.

Q&A: ‘Concerning rise’ in anal cancer underscores need for effective screening programs

Despite being considered a fairly rare disease, the incidence of anal cancer has doubled over the last 30 years, with the American Cancer Society estimating approximately 10,540 new cases and 2,190 related deaths in 2024.

“It is the 25th most common cancer in U.S. and about 10,000 new cases are diagnosed each year,” Syed Husain, MD, MBBS, colorectal surgeon at The Ohio State University Comprehensive Cancer Center and Arthur G. James Cancer Hospital and Solove Research Institute, told Healio. “While being rare, anal cancer is on the rise and its incidence has doubled over last 30 years. This concerning rise in incidence underscores the need for effective screening programs for this cancer.” Read more.

Q&A: AGA snubs UHC’s choice to ‘forgo transparency’ in Gold Card program for GI endoscopy

As the launch of UnitedHealthcare’s Gold Card program approaches, the AGA continues to urge the insurer to reconsider implementation of a program that could affect various gastrointestinal procedures and “threaten patient health.”

According to UnitedHealthcare, its Gold Card program, which recognizes qualified practices that have “consistently demonstrated adherence to evidence-based guidelines,” will begin Oct. 1, 2024. Qualified practices will not have to submit prior authorization requests, but instead will be “required to complete a simple advance notification for Gold Card services, which will confirm member eligibility and coverage for the service(s) requested.” Read more.

Q&A: Endometriosis impact on GI function remains ‘vastly understudied, underrecognized’

Women with endometriosis had higher rates of health care utilization and were significantly more likely to experience upper gastrointestinal and dyspeptic symptoms, according to preliminary data in Clinical Gastroenterology and Hepatology.

“Females with endometriosis are at three to five times greater risk of developing irritable bowel syndrome than healthy women, with rates of IBS as high as 52%,” Madison Simons, PsyD, a gastrointestinal psychologist at the Cleveland Clinic Digestive Disease Institute, and colleagues wrote. “Patients with IBS and endometriosis experience lower pain thresholds and more painful menstrual cycles than those with either condition alone. This amplification of pain experiences can increase health care utilization and decrease quality of life.” Read more.

Q&A: What is driving ‘disturbing’ rise in metastatic stomach cancer in young adults?

In 2021, Jessica Sheth Bhutada, MD, MS, and colleagues uncovered a startling 2% annual uptick in metastatic stomach cancer in young adults, despite declining rates in older adults. Three years later, they are still trying to understand why.

“We found that the rates of advanced stage disease were similar to older adults, except for stomach cancer, where over half of young adults were presenting with advanced disease vs. only about one-third of older adults,” Bhutada, a pediatric oncologist at Children’s Hospital Los Angeles, told Healio. “We don’t have a clear reason for why this is happening; it’s a worldwide phenomenon.” Read more.

Q&A: Blue Lights Campaign spreads ‘urgency’ of message to screen for colorectal cancer

Over the past 10 years, the Blue Lights Campaign has illuminated in blue more than 30 iconic landmarks in Philadelphia and beyond to promote the importance of screening during Colorectal Cancer Awareness Month.

“I want people that walk through Philadelphia in early March to feel wrapped in blue,” Marianne T. Ritchie, MD, founder and director of the Blue Lights Campaign and clinical associate professor of medicine at Thomas Jefferson University, told Healio. “When they see so many buildings that are blue, they’re going to realize there’s an urgency to the message and ask, ‘What is all this blue for?’ Hopefully, it will get people to think about screening [for CRC], even if it’s just a stool test.” Read more.

Q&A: Surge in ‘sober curious’ movement could yield lasting health benefits

While the CDC estimated that excessive alcohol use contributed to approximately 178,000 U.S. deaths each year from 2020 to 2021, an emerging lifestyle trend may help counter those statistics in the years ahead.

A recent survey from NCSolutions showed that more than 40% of Americans — especially younger Americans — are trying to drink less alcohol as the “sober curious” movement gains popularity. Read more.

Q&A: MASH experts emphasize using noninvasive tests to assess response to Rezdiffra

With the FDA label for Rezdiffra excluding the need for liver biopsy, experts proposed recommendations to “fill the gap” on how to leverage noninvasive tests to assess treatment response in metabolic dysfunction-associated steatohepatitis.

This landmark subpart H FDA approval of Rezdiffra (resmetirom, Madrigal Pharmaceuticals) in March for the treatment of patients with MASH and stage 2 or 3 fibrosis was largely based on successful data from the ongoing phase 3 MAESTRO-NASH trial. Despite the huge win this approval represents, Mazen Noureddin, MD, MHSc, professor of medicine, hepatologist and director at Houston Methodist Hospital, told Healio it also presents prescribers with certain challenges and questions. Read more.

Q&A: AI chatbot helps make colonoscopy prep ‘a little less painful’ for patients

AI has already made its mark in gastroenterology as a tool for detecting gastrointestinal lesions, adenomas and inflammatory bowel disease. However, its next phase of evolution might seem the most unlikely: Aiding colonoscopy preparation.

A “conversational AI” chatbot created by Memora Health enables patients to receive text messages rather than taking home paperwork on preparations for colonoscopies or other gastrointestinal procedures. The Memora chatbot is equipped not only to help patients understand the procedure and provide step-by-step instructions for bowel preparation, but also to respond in real-time to patient questions regarding their care. Read more.