Dr. Hassan R. Hashmi

A timely review from JAMA highlights a critical reality: obesity is not just a metabolic condition, it is a major oncologic risk factor.

With approximately 10% of new cancer diagnoses annually in the U.S. linked to obesity, and even higher proportions in cancers such as endometrial and hepatobiliary, this calls for a broader focus on prevention.

What stands out is the biology. Chronic inflammation, hormonal dysregulation, immune suppression, and microbiome alterations all converge to promote tumorigenesis.

This is particularly relevant in colore**al cancer too, where rising obesity rates parallel increasing incidence, including in younger patients.

Encouragingly, sustained weight loss of more than 10% may help reduce cancer risk.

As surgeons and clinicians, this reinforces that cancer prevention starts long before the endoscopy suite.

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American College of Surgeons American Cancer Society Cancer Action Network - ACS CAN OncoDaily The American Society of Colon and Re**al Surgeons - ASCRS American Society of Clinical Oncology American College of Gastroenterology Colore**al Cancer Alliance

On Earth Day 2026, a moment to reflect!

Standing in Grand Teton National Park last fall, I was reminded how interconnected everything truly is.

The health of our environment directly shapes the health of our communities. Clean air, clean water, and preserved ecosystems are the foundation of human well-being.

It’s worth reflecting on how each of us can contribute in small but meaningful ways to protecting what sustains us.



The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily American College of Surgeons World Health Organization (WHO) Grand Teton National Park National Park Service

Honored to be appointed to the International Committee at the American Society of Colon and Re**al Surgeons (ASCRS).

Thankful to Dr. Kirsten Wilkins for the opportunity to serve. I look forward to working with Dr. Leandro Feo and colleagues to support international engagement and advance colore**al surgery in underserved regions.

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The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily American College of Gastroenterology

Early detection of anastomotic leak saves lives.

A recent study published in JAMA Surgery highlights a critical reality in colore**al surgery. Delayed diagnosis of anastomotic leak significantly increases failure to rescue (FTR), meaning mortality after a complication.

The key message is clear. It is not just the complication, but also the timing of recognition that determines outcomes.

Patients with delayed diagnosis, especially after the onset of sepsis, had:

-Higher complication burden
-Increased reoperation rates
-Longer hospital stays
-Significantly higher mortality

As surgeons, this reinforces a fundamental responsibility. Vigilance in the postoperative period, early suspicion, and decisive intervention truly impact survival.

Improving systems for early detection of anastomotic leak and escalation of care are powerful quality improvement strategies which could improve mortality associated with colon resection.

**alSurgery

The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily American College of Surgeons American College of Gastroenterology

A major step forward in biomarker-driven adjuvant therapy for colon cancer.

In the phase 3 ATOMIC trial published in nejm the addition of atezolizumab to mFOLFOX6 significantly improved 3-year disease-free survival in resected stage III dMMR colon cancer (86.3% vs 76.2%; HR 0.50).

This is one of the strongest signals yet supporting immunotherapy in the adjuvant setting for dMMR disease, a population already known to have distinct tumor biology and immune responsiveness.

The tradeoff is a higher rate of grade 3–4 toxicities, highlighting the importance of careful patient selection and counseling.

Key implications:

Reinforces the importance of MMR testing

Opens the door for integrating immunotherapy in the treatment paradigm

Raises important questions about optimal duration, cost, and long-term survival benefit

Practice-changing data worth watching closely.

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American College of Surgeons The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily fightcrc Colore**al Cancer Alliance American Society of Clinical Oncology

A strong signal from high-level evidence in colore**al surgery.

A recent meta-analysis of randomized trials (n=4754) published in The Lancet Gastroenterology & Hepatology demonstrates that indocyanine green fluorescence angiography (ICGFA) significantly reduces anastomotic leak rates (RR 0.66, NNT 24).

The benefit is particularly compelling in:

• Left-sided resections
• Re**al resections
• Low anterior resections (NNT as low as 13)

Notably, the protective effect increases with higher BMI, suggesting a meaningful role for selective use in higher-risk patients. No significant benefit was observed in right-sided resections.

Trial sequential analysis indicates that sufficient evidence has likely been reached. The question is no longer “does it work?” but:

How do we implement it effectively?
Which patients would benefit the most?

As we continue refining anastomotic safety, this reinforces a broader principle of objective perfusion assessment.

Are you using ICGFA routinely, or selectively?

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The American Society of Colon and Re**al Surgeons - ASCRS amcollsurgeons

Today is Lynch Syndrome Awareness Day.

Lynch syndrome is the most common hereditary colore**al cancer syndrome, yet it remains underdiagnosed.

Up to 1 in 300 individuals may carry a mismatch repair gene mutation, but many are identified only after developing cancer.

As surgeons and clinicians, this has real implications:

• Early-onset colore**al cancer
• Synchronous/metachronous malignancies
• Risk beyond the colon: endometrial, ovarian, gastric

Universal tumor testing for the mismatch repair deficiency is no longer optional. It’s essential.

Identifying Lynch syndrome doesn’t just change one patient’s care; it impacts an entire family.

Are we doing enough to recognize it early?

**alCancer

The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily Las Vegas Review-Journal Colore**al Cancer Alliance Colon Cancer Coalition American Cancer Society American College of Surgeons Colon Cancer Alliance for Research & Education for Lynch Syndrome - CCARE

Image courtesy: Lynsight

Important RCT data from the ORCHESTRA trial published in highlights a critical point in metastatic colore**al cancer care.

Even when >80% tumor debulking is feasible in multiorgan metastatic colore**al cancer, adding local debulking to chemotherapy does not translate into a survival benefit and is associated with higher serious adverse events.

It highlights that biology often outweighs technical feasibility.

Thought-provoking implications for how we approach cytoreduction in advanced disease.

**alCancer

Honored to see my recent post on colore**al cancer screening highlighted by OncoDaily.

Colore**al cancer remains one of the most preventable cancers when detected early. Increasing awareness and encouraging timely screening can truly save lives.

Glad to contribute to the conversation during Colore**al Cancer Awareness Month and help educate patients about the importance of screening.

If you are 45 or older, or experiencing concerning symptoms, please talk to your physician about screening.

Early detection makes a huge difference.

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The American Society of Colon and Re**al Surgeons - ASCRS Las Vegas Review-Journal Colore**al Cancer Alliance Colon Cancer Coalition American College of Surgeons American Cancer Society

March is Colore**al Cancer Awareness Month.

Colore**al cancer is one of the most preventable and treatable cancers when detected early.

Yet many patients delay screening because they feel well or are hesitant to discuss symptoms.

Here’s what you should know:

-For average-risk individuals, screening begins at age 45

-Those with a family history, inflammatory bowel disease, or genetic syndromes may need screening earlier

-Colore**al cancer is increasingly being diagnosed in younger adults

-Most colore**al cancers begin as polyps that can be removed before they turn cancerous

-Early-stage colore**al cancer is highly curable

If you are 45 or older, or if you have symptoms such as re**al bleeding, unexplained weight loss, or persistent changes in bowel habits, do not ignore them.

Screening saves lives.

As a colore**al surgeon, I see firsthand the difference early detection makes.

**alCancerAwarenessMonth **alCancerAwareness **alCancer **alCancerScreening

The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily Colore**al Cancer Alliance Las Vegas Review-Journal Colon Cancer Coalition

Important 10-year follow-up data from the LIR!C trial published in The Lancet Gastroenterology & Hepatology.

In patients with uncomplicated ileal Crohn’s disease:

• Ileocaecal resection achieved significantly higher 10-year therapy-free remission compared with infliximab

• Overall long-term clinical remission rates were similar

• Younger patients appeared to derive greater durable benefit from early surgery

In carefully selected patients with localized, non-stricturing ileocecal disease early in the disease course, laparoscopic resection may represent a strategic treatment option rather than a failure of medical therapy.

Multidisciplinary IBD care remains essential.

**alSurgery

The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily Crohn's & Colitis Foundation

Headed out to Pahrump clinic this morning and caught a striking view of snow over Red Rock Canyon National Conservation Area.

A rare contrast in the desert.

Nevada never fails to surprise.