Wentworth-Douglass Hospital announced that it successfully performed its first Transoral Incisionless Fundoplication (TIF) procedure on July 14, marking a significant milestone in the hospital’s commitment to providing advanced, minimally invasive treatments to the Seacoast community.

The TIF procedure is a cutting-edge technique that offers a revolutionary approach to the treatment of heartburn (acid reflux) and other chronic symptoms associated with GERD (chronic gastroesophageal reflux disease). Unlike traditional surgeries, which often require large incisions and extensive recovery periods, the TIF procedure is performed entirely through the mouth, eliminating the need for external incisions. This groundbreaking technique not only reduces the risk of complications, but also offers patients a faster recovery time and a quicker return to their daily activities.

The goal of anti-reflux surgery is to restore the normal functions of the junction between the esophagus and the stomach by creating a new anti-reflux valve. This is carried out by wrapping the upper portion of the stomach (the fundus) around the esophagus, either partially or totally.

“The introduction of this procedure at Wentworth-Douglass represents a major breakthrough for us locally in the management of GERD. By offering a less invasive alternative, we hope to empower patients to take control of their condition and improve their quality of life,” said Dr. Hany Takla, medical director for surgical services at Wentworth-Douglass. “It really has the potential to transform the treatment landscape for our current GERD patients and hopefully encourages those who need it to seek treatment as well.”

The TIF procedure exemplifies Wentworth-Douglass Hospital’s dedication to adopting innovative medical technologies that enhance patient care and improve outcomes.

“This is a game-changer for many of our patients who have chronic acid reflux,” said Khushboo Munot, MD, Gastroenterologist and TIF Specialist at Atlantic Digestive Specialists and Wentworth Douglass Hospital. “The procedure is non-invasive, and patients often can go home the same day. It can be a great treatment option for people who have been dealing with this issue for many years and can provide them with a better quality of life.”

The Centers for Medicare & Medicaid Services (CMS) made important changes to colorectal cancer (CRC) screening guidelines this year by lowering the minimum age from 50 to 45 and by allowing a follow-up colonoscopy after a positive stool-based test to be covered under Medicare Part B.

These policy changes require Medicare and most commercial plans to now cover, as part of preventive care and CRC screenings, a follow-up colonoscopy after a non-invasive stool-based test, like Cologuard, returns a positive or abnormal result for patients 45 years of age and older.

This is a significant coverage change because, until this year, CMS has maintained that a colonoscopy after a positive non-invasive stool-based CRC screening test is diagnostic. This meant that Medicare beneficiaries who thought they were going to have a free screening colonoscopy could be billed for a diagnostic colonoscopy if polyps were found and removed at an additional cost they did not anticipate. Now both tests will be 100 percent covered.

Colorectal cancer is the third most common cancer diagnosed in the United States and the third leading cause of cancer-related deaths in men and women.

With a focus on cancer rates and saving lives, the federal government made the change partly to encourage more people to take charge of their colorectal health. There is a greater understanding today that the non-invasive, stool-based test and the follow-up colonoscopy are part of a complete CRC screening.

Marking the seventh year in a row, New Hampshire physicians have chosen Atlantic Digestive Specialists as among the best gastroenterologists in the state in an annual poll conducted by New Hampshire Magazine.

When licensed New Hampshire physicians were asked which digestive specialists they would send their loved ones to, they chose Dr. Aristotle Damianos, Dr. Roger Epstein, Dr. Marylyn Grondin, Dr. Brian Hyett, Dr. Jennifer Lewis, Dr. Sean Lynch, Dr. William Maher, and Dr. Robert Ruben.

The board-certified physicians at Atlantic Digestive Specialists are the leading digestive specialists in the Seacoast, treating diseases associated with the esophagus, stomach, intestines, liver, and other digestive organs. With offices in Somersworth and Portsmouth, Atlantic Digestive Specialists is dedicated to providing the most comprehensive services related to the digestive system and are the trusted colonoscopy and endoscopy providers in the region.

Rate doubled in under-50 age group since 1995, concerning trend toward more advanced disease.

Diagnosis of colorectal cancer (CRC) in younger people has almost doubled since 1995, a steeper increase than previously recognized, according to a study from the American Cancer Society (ACS).

The proportion of new diagnoses in patients younger than 55 increased from 11% to 20%. New cases of CRC rose by 2% annually among individuals younger than 50 and those 50-54. The incidence declined among people 65 or older, a trend that started in 2011.

The overall rate of decline in CRC incidence and mortality has slowed substantially since 2000, and the number of newly diagnosed advanced cancers has increased, reported Rebecca Siegel, MPH, senior scientific director of surveillance research at the ACS, and coauthors, in CA: A Cancer Journal for Clinicians.

“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” Siegel said in a statement. “The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened.”

Explanations for the concerning trends remain elusive.

“We have to address why the rates in young adults continue to trend in the wrong direction,” said Ahmedin Jemal, DVM, PhD, senior vice president of surveillance and health equity. “We need to invest more in research to uncover the cause of the rising trends and to discover new treatment for advanced-stage disease to reduce the morbidity and mortality associated with this disease in this young population, who are raising families and supporting other family members.”

The ACS data back up what colon cancer specialists have observed in clinical practice, said Michael Shusterman, MD, of the NYU Langone’s Perlmutter Cancer Center in New York City.

“We have seen an increase in patients in their 30s and 40s with rectal and left-sided colon cancers, consistent with the ACS report on epidemiological trends,” Shusterman told MedPage Today via email. “This population has unique needs including concerns regarding fertility, sexual health, and long-term cancer survivorship. Particularly for rectal cancer, our team has worked in a multidisciplinary patient-centered fashion to bring modern total neoadjuvant therapy protocols, where applicable, to allow for organ preservation in appropriate patients.”

The ACS data “underpin recent guideline changes from the USPSTF [U.S. Preventive Services Task Force] and the ACS for adults 45 to 75 years of age to be offered screening for colorectal cancer with one of several modalities,” Shusterman added. “Awareness of this change and sensitivity among primary care providers is critical to ensure that screening is provided to all newly eligible individuals.”

Siegel and coauthors gleaned the findings from an analysis of the NCI Surveillance, Epidemiology, and End Results program and the CDC’s National Program of Cancer Registries for the years 1995 through 2019. National mortality trends through 2020 came from the National Center for Health Statistics.

From the data, investigators estimated that 153,020 new cases of CRC will be diagnosed during 2023, and 52,550 people will die of the disease. The totals included 19,550 new cases and 3,750 deaths among individuals younger than 50.

Key findings from the analysis included:

• Rates of decline in CRC incidence and mortality slowed from 3-4% annually during the early 2000s to 1% for incidence and 2% for mortality in the past decade
• Men had a 33% higher incidence during 2015-2019 (41.5 vs 31.2 per 100,000)
• Incidence continued to decline among people 65 or older, stabilized in the 50-64 age group and increased by 2% annually in people younger than 50 and those 50-54
• CRC mortality increased by 1% annually among people younger than 50 and by 0.6% a year in the 50-54 group
• Advanced-stage disease (locally advanced and metastatic) now accounts for 60% of all newly diagnosed CRC, as compared with 52% in the mid-2000s
• CRC incidence is highest among Alaska Natives (88.5/100,000), American Indians (46/100,000) and Black individuals (41.7/100,000), and lowest among whites (35.7/100,000), with similar trends for CRC mortality

“These highly concerning data illustrate the urgent need to invest in targeted cancer research studies dedicated to understanding and preventing early-onset colorectal cancer,” said ACS CEO Karen E. Knudsen, MBA, PhD. “The shift to diagnosis of more advanced disease also underscores the importance of screening and early detection, which saves lives.”

~ credit MedPage Today, Charles Bankhead