Rene Gomez-Esquivel, MD: Screening for Pediatric Colon Cancer

As previously covered in discussions with HCPLive, pediatric colon cancer is a rare occurrence compared to adult rates. Fewer than 3% of all cases occur in children; as a result, advances to alternative screening strategies and guidelines are generally lagging behind for pediatric specialists; what they have works for what they see.¹

That doesn’t mean, however, there are some key messaging and strategies for screening and diagnosing colon cancer in pediatric patients.

In the second segment of an interview with HCPLive during the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) 2023 Annual Meeting in San Diego, Rene D. Gomez-Esquivel, MD, assistant professor in the division of digestive diseases and nutrition at University of South Florida, discussed his session on conducting colon cancer screening in pediatric IBD.²

“I think what I want to highlight from my session is that colonoscopy in pediatrics tends to present with more advanced disease compared to adults,” Gomez-Esquivel said. “And that's very important, because the risk factors for colon cancer are varied conditions, like inflammatory bowel disease. And if we know those predisposing factors, and we perform a colonoscopy, we can prevent cancer.”

Gomez-Esquivel said prior literature supports the opportunity to not only prevent—but resect lesions and cure cancer in patients who are timely screened and treated.

“So that's why it's very important to highlight the importance of doing this surveillance and treat these lesions to prevent cancer, and also spare these children from a colectomy,” he explained. “If you find a lesion, then you can resect it. And by doing that, you can prevent cancer.”

Gomez-Esquivel additionally highlighted the shift in guidance for pediatric colon cancer - IBD screening, from when he and his peers were expected to conduct ≥33 biopsies.

“But those guidelines were designed when the colonoscopies were not high definition,” he said. “Now, I will say most of the units in the United States, Canada and the developed countries have high definition, and the new guidelines have changed, and they just recommend to do colonoscopy with high definition.”

References

1. ^{Kunzmann K. Rene Esquivel Gomez, MD: Pediatric Endoscopy and Colonoscopy Strategies. HCPLive. Published October 8, 2023. https://www.hcplive.com/view/pediatric-endoscopy-colonoscopy-strategies}
2. ^{NASPGHAN. Colorectal cancer screening in pediatric IBD: It’s a thing. 2023 NASPGHAN Annual Meeting Agenda. Accessed October 16, 2023. https://members.naspghan.org/Annualmeeting/2023_Annual_Meeting/2023_Annual_Meeting_Program/Annual_Meeting_Program_2023.aspx?WebsiteKey=71021121-8c45-432a-93e2-363355476a3f&hkey=1f4101cf-45c0-4a9a-b805-02d1c11e00fd&New_ContentCollectionOrganizerCommon=2#New_ContentCollectionOrganizerCommon}