With the dog days of summer in the rear view, gastroenterology has had a specialty-changing year severely affected by the COVID-19 pandemic, but the specialty is gradually recovering and moving forward. Here are seven trends that will shape the specialty going forward:
COVID-19's fallout
From the elective surgery shutdown to the recovery period, GI practices have had to weather the storm and continue to do so. As a result of the pandemic-related shutdowns, it's projected that the missed screening tests could result in a boom of colorectal cancer cases. Colonoscopy remains difficult to perform because of the potential to spread COVID-19. Colonoscopy alternatives continue to vie to fill the hole left by the pause in screening colonoscopy.
CRC guideline updates
To lower the screening age or not to lower the screening age continues to be the question. The U.S. Multi-Society Task Force on Colorectal Cancer updated its 2012 recommendations for post-colonoscopy follow-up with or without polypectomy. The society recommended physicians:
- Make more detailed follow-up recommendations to patients after removing serrated polyps
- Follow updated polyp surveillance recommendations that are based on CRC outcomes risk
- Conduct comprehensive high-quality baseline examinations
Compensation
Gastroenterologists reported average annual compensation of $419,000, the sixth highest amount of specialty physicians, according to Medscape's "Physician Debt & Net Worth Report 2020." Unfortunately, compensation has remained flat for gastroenterology between 2019 and 2020, one of only four other specialties that didn't report an increase.
A hard line on probiotics in gastroenterology
The American Gastroenterological Association issued a guideline on probiotics use in gastroenterology, recommending against the use of such treatments in June. The guideline, published in Gastroenterology, found only three clinical scenarios where probiotics were beneficial to patients; in general, there was not enough evidence to support the use of probiotics for most conditions.
The rise of AI
Artificial intelligence tools continue to attempt to make a mark on the specialty. Most tools are based around increasing polyp detection rates. Fujifilm Europe notably launched a real-time colonic policy detection tool in Europe after receiving a CE Mark in February. It's expected the device will come to the U.S. if initial results continue to be encouraging.
Pharmaceutical consolidation
AbbVie acquired Allergan in May for $63 billion, one of several consolidations in the specialty this year. Among the other moves was Bausch Health announcing it would spin off its core eye business to focus on its other tenants like gastroenterology, and also RDD Pharma, Innovate Biopharmaceuticals and Naia Rare Diseases merging to form new GI-focused company 9 Meters Biopharma.
Private equity continues to make its mark
COVID-19 seriously affected investment activity through the first half of the 2020 (only four deals closed), but analysts expect activity to pick up as the year comes to a close.