Alarm features, not screening logic, should drive referral for suspected GI cancer

The edition in brief

A Mexican gastroenterology society position statement, developed by 20 specialists through structured consensus, issued 13 statements for primary care on alarm features, risk factors, diagnostic tests and urgent, priority or elective referral for suspected oesophageal, gastric and colorectal cancer. It stresses that a symptomatic patient needs diagnostic endoscopy or high-quality colonoscopy, not a screening test. A systematic review of 15 studies of crisis services for children and adolescents with severe depression, suicidal ideation or self-harm found brief structured, family-focused and linkage interventions associated with fewer suicidal thoughts, emergency visits and admissions, though the evidence is largely observational. A BJGP qualitative synthesis of eight studies and 375 participants identified five themes behind low uptake of annual physical health checks by people with severe mental illness, from unclear purpose to service design. The pearl covers asking young people directly about suicidal thoughts.