Sian Morrison-Rees

Review article: the prevalence of Helicobacter pylori and the incidence of gastric cancer across Europe.

There is little up‐to‐date review evidence on the prevalence of Helicobacter pylori across Europe.

Survey of digestive health across Europe: Final report. Part 1: The burden of gastrointestinal diseases and the organisation and delivery of gastroenterology services across Europe

United European Gastroenterology (UEG) which represents gastroenterology and hepatology and its sub-disciplines across Europe relies on accurate and up to date information on the burden of gastrointestinal diseases in Europe, the availability and quality of diagnostic and therapeutic services and the economic impact of these diseases across the member countries of the European Union to inform its strategy in advising relevant agencies on future clinical services and research priorities. Determining the trajectory of the morbidity and mortality of digestive diseases is vital in planning health services for the future and in making the case for investment in research where there are clear gaps in knowledge. In addition there are marked economic differences across the member nations in Europe and this is reflected in the funding available to support health services, making it highly likely that there are important disparities in the accessibility to high-quality healthcare. In September 2012 the UEG Council accepted a proposal from the UEG Future Trends Committee to commission a detailed survey of digestive health across Europe. The Future Trends Committee developed an outline framework for the study, following which there was an open, competitive process across Europe to identify a competent research group to undertake the project. The contract was awarded to an experienced group within the College of Medicine, Swansea University, United Kingdom, and the project was formally initiated in April 2013. The research group at Swansea has worked closely with the Committee, including an interim update meeting with the Committee in October 2013. The Committee also had the opportunity to make specific comments on a draft final report submitted in May 2014; a final report, Survey of Digestive Health Across Europe was received in August 2014. The final report is organised into two parts: Part 1, The burden of gastrointestinal diseases and the organisation and delivery of gastroenterology services across Europe and Part 2, The economic impact and burden of digestive disorders. We present here the executive summaries of the two parts of the survey, but the full report can be found on the UEG journal website. It is anticipated that several shorter publications will follow, focusing on some specific topics of particular importance and interest. Michael Farthing President United European Gastroenterology

Colectomy rates in patients with ulcerative colitis following treatment with infliximab or ciclosporin: a systematic literature review.

This review aimed to compile all available published data on colectomy rates following treatment using infliximab or ciclosporin in adult ulcerative colitis patients and to analyse colectomy rates, timing to colectomy and postcolectomy mortality for each treatment. We systematically reviewed the literature after 1990 reporting colectomy rates in ulcerative colitis patients treated with infliximab or ciclosporin, excluding articles on paediatric patients, patients with indeterminate colitis or Crohn’s disease and bowel surgery not related to ulcerative colitis. We presented weighted mean colectomy rates and mortality rates. Cox’s regression was used to assess time to colectomy adjusting for colitis severity, patient age and sex. We tabulated 78 studies reporting on ciclosporin and/or infliximab and colectomy rates or postcolectomy mortality rates. Not all studies reported data in a standardized manner. Infliximab had a significantly lower colectomy rate than ciclosporin at 36 months when analysing all studies, studies directly comparing infliximab and ciclosporin and studies using severe colitis patients, but not at 3, 12 or 24 months. Severity and age were key indicators in the likelihood of undergoing colectomy after treatment. Postcolectomy mortality rates were less than 1.5% for both drugs. This review indicates that long-term colectomy rates following infliximab are significantly lower than ciclosporin in the longer term, and that postcolectomy mortality following infliximab and ciclosporin is very low. However, many key data items were missing from research articles, reducing our ability to establish with more confidence the actual impact of these two drugs on colectomy rates and postcolectomy mortality rates.