33 WORLD GASTROENTEROLOGY NEWS MAY 2016 Editorial | Expert Point of View | Gastro 2016: EGHS-WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events WORLD GASTROENTEROLOGY ORGANISATION DISTINGUISHED GLOBAL LECTURE (AT THE ASIAN PACIFIC DIGESTIVE WEEK 2015, TAIPEI, TAIWAN) Emerging Gastrointestinal and Liver Diseases in the Asia Pacific - Implications to Health Care in the Region KL Goh, MBBS, FRCP (Glasgow, London), MD, FACG, FASGE Professor of Medicine University of Malaya Kuala Lumpur, Malaysia Immediate Past President, Asian Pacific Association of Gastroen-terology (APAGE) Vice President, World Gastroenterology Organisation (WGO) 2011- 2015 The Asian Pacific region represents the biggest landmass in the world with a huge and diverse population of over 3 billion. Several diseases are considered emerging diseases in this region and include colorectal cancer (CRC), gas-troesophageal reflux disease (GERD), inflammatory bowel disease (IBD), and non-alcoholic fatty liver disease (NAFLD). CRC is the fastest emerging gastro-intestinal cancer in the Asian Pacific region with age-standardized incidence rates (ASR) of 40-50 per 100,000 per year reported from Korea, Japan, and Singapore Chinese1,2. The exact rea-sons for this rapid rise is unclear, but may be related to the rising obesity in the region3. The pattern of disease mirrors that of the West. Awareness of screening for CRC is increasing in the region. However in most countries only opportunistic screening with fecal occult blood testing and colonoscopy is carried out. Formal CRC screening programs have been started in some countries in Asia, including in Japan, Singapore, Hong Kong, and Taiwan4. These programs impose a significant financial burden on governments and as such cannot as yet be implemented across the region. GERD, once thought to be non-existent in Asia, is now a common dis-ease in Asia. A prevalence of 15% for erosive esophagitis and of up to 20% for reflux symptoms has been reported 5. An overall GERD disease burden of 60 million in the Asian Pacific region is estimated. However the prevalence of Barrett’s esophagus and esophageal adenocarcinoma remains low. The us-age of potent acid suppressing agents, as a consequence, is similarly huge in the Asian Pacific region. The costs of medications are mitigated by the use of generic acid suppressing drugs available “over the counter.” As with other parts of the world, self managed care for heartburn and other upper GI symptoms have been increas-ingly practiced, as is well described in WGO’s guideline on “Coping with Common GI Symptoms in the Com-munity” 6. IBD, both ulcerative colitis (UC) and Crohn’s disease (CD), has also been reported to be on the increase7. Studies from Korea and India, for example, have shown a very high prevalence of these diseases7. A pan- Asian Pacific study showed variable Prof. Goh speaks at APDW.
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