About

Dr. Andrew Gawron is a gastroenterologist at University of Utah Health. His expertise includes the diagnosis and management of gastrointestinal conditions, with a focus on colorectal health. In the context of recent research, he discusses the increasing incidence of colorectal cancer among younger adults, emphasizing that while the disease remains rare in this population, there has been a notable rise in new cases, particularly in individuals under 50. Dr. Gawron highlights the importance of awareness of symptoms such as changes in bowel habits, bleeding, unexplained weight loss, and other warning signs, advocating for proactive patient advocacy and timely medical evaluation. He underscores the significance of understanding family history and personal risk factors, noting that most colorectal cancers in young people are sporadic and not linked to family history. Dr. Gawron emphasizes lifestyle choices, including diet, exercise, and avoiding smoking and processed meats, as crucial for prevention. His approach advocates for early detection through symptom awareness and lifestyle modifications, aiming to improve outcomes and reduce the burden of colorectal cancer in younger populations.

Research topics

• Medicine
• Internal medicine
• Surgery
• Demography
• Anesthesia
• Oncology
• Radiology
• Emergency medicine

Selected publications

• Overall Quality Indicators in Colonoscopy

  2026-03-17

  otherSenior author

  Although colonoscopy has been demonstrated to reduce colorectal cancer (CRC) incidence and mortality, variability in the quality of colonoscopy has been linked to adverse patient outcomes, including post-colonoscopy CRC. High-quality colonoscopy includes adequate bowel cleansing, safe insertion of the colonoscope to the cecum, a detailed examination of the mucosa with identification and resection of neoplasia, appropriate follow-up recommendations, and accurate and complete procedural documentation. Colonoscopists may master the performance of some aspects of colonoscopy but may be inadequate in others. Thus, deficiencies in performance can have severe consequences, highlighting the importance of quality measurement and interventions to address any identified performance gaps. In this chapter, we provide an overview of colonoscopy quality indicators that have been recommended by the American Society for Gastrointestinal Endoscopy American College of Gastroenterology Quality Task Force and the European Society of Gastrointestinal Endoscopy and United European Gastroenterology.

  PublisherDOI

• Training Future Endoscopists: Gastroenterology Fellows’ Perspectives and Hands-on Exposure to Artificial Intelligence for Polyp Detection in the United States

  iGIE · 2026-02-01

  articleOpen access
  PublisherDOI

• Impact of Guideline-Concordant Post-Polypectomy Colonoscopy Surveillance on Colorectal Cancer Incidence and Mortality

  Clinical Gastroenterology and Hepatology · 2025-11-25

  articleOpen access

  BACKGROUND & AIMS: Impact of exposure to guideline-concordant post-polypectomy surveillance colonoscopy on colorectal cancer (CRC) risk is uncertain. We aimed to determine whether follow-up concordant with post-polypectomy surveillance guidelines is associated with reduced CRC incidence and mortality. METHODS: We conducted a retrospective case-cohort study among United States Veterans who underwent colonoscopy with polyp removal between 1999 and 2016 across 128 health care systems. The primary predictor was concordance status with surveillance colonoscopy guidelines, assessed as a binary time-varying variable. Time to incident and fatal CRC was investigated using multivariable weighted Cox regression adjusting for key baseline characteristics, with risk summarized using adjusted hazard ratios (HRs). RESULTS: From a cohort of 516,058 individuals with baseline polypectomy, we included 685 individuals with incident CRC, 233 individuals with fatal CRC, and a random subsample of 1530 individuals. At baseline, median age was 63 years (interquartile range, 58-68 years); 97.3% were male; and 32.6% had an advanced polyp. Exposure to guideline concordant follow-up was associated with a 78% relative reduction for incident CRC risk over 9730 person-years follow-up (HR, 0.22; 95% confidence interval, 0.16-0.31). Guideline concordant follow-up was not associated with reduced fatal CRC risk over 8224 person-years follow-up (HR, 0.96; 95% confidence interval, 0.49-1.87). A large proportion of incident (55.2%) and fatal (39.5%) CRC events occurred within 4 years of baseline colonoscopy. CONCLUSIONS: Follow-up concordant with post-polypectomy surveillance guidelines is associated with reduced risk of incident CRC, but impact on risk of fatal CRC requires further study. Many post-polypectomy CRC events occur early in the surveillance window, underscoring importance of baseline colonoscopy quality in influencing post-polypectomy CRC risk.

  PublisherDOI

• Why VA GI?

  Digestive Diseases and Sciences · 2025-04-28

  article
  PublisherDOI

• Elective colectomy for treatment of benign colon polyps: National surgical trends, outcomes, and cost analysis

  Endoscopy International Open · 2025-08-25

  articleOpen accessSenior author

  Background and study aims: Although endoscopic resection is recommended for management of complex benign colon polyps, patients are routinely referred for surgical resection. Little is known about the effects of these elective colectomies on patient outcomes. We sought to determine trends, surgical outcomes, and costs of elective colectomy for benign colon polyps. Patients and methods: We performed a retrospective cohort analysis of veterans nationwide using the National Veterans Affairs Surgical Quality Improvement Program (VASQIP) database linked to the national VA Corporate Data Warehouse database. We included all veterans (N = 7,102) undergoing elective colectomy for benign polyps from 2000 to 2015. Outcomes of interest were rates of colectomy, surgical pathology findings, morbidity, mortality, and costs. Results: Colectomy for benign polyps increased significantly from 6% of all colectomies in 2000 to 18% in 2014, and the percent of colectomies for colon cancer decreased from 40% to 31%. The 30-day mortality rate was 1.2% and the complication rate was 19.7%. Based on pathology, 80% of patients (n = 514) underwent right hemicolectomy, mean polyp size was 2.7 cm (± 1.7 cm), and 60.1% of resected polyps were adenomas. Median cost of colectomy was $22,712 for open and $20,697 for laparoscopic colectomy. Costs increased if a complication occurred. Conclusions: Rates of colectomy for benign adenomas significantly increased from 2000 to 2014. Colectomy was associated with significant mortality, morbidity, and cost. Development of strategies to improve endoscopic management of benign large colon neoplasms is urgently needed.

  PublisherOA PDFDOI

• THE VA ENDOSCOPY QUALITY IMPROVEMENT PROGRAM (VA-EQUIP): RESULTS OF A LARGE PRAGMATIC RANDOMIZED CONTROLLED TRIAL IN A NATIONAL US HEALTHCARE SYSTEM

  Gastrointestinal Endoscopy · 2025-05-01

  articleSenior author
  PublisherDOI

• Sa1441: CLINICAL CHARACTERIZATION AND OPIOID USE IN VETERANS WITH CHRONIC PANCREATITIS: RESULTS FROM A SINGLE-CENTER VETERANS HEALTH ADMINISTRATION STUDY

  Gastroenterology · 2025-05-01

  articleSenior author
  PublisherDOI

• Leveraging Natural Language Processing to Accurately Identify Histologically Confirmed Esophageal and Gastric Premalignant and Malignant Conditions Using a Large-Scale Health-Record Linked Genomic Biobank

  Gastro Hep Advances · 2025-08-26

  articleOpen access

  Background and Aims: Our understanding of the epidemiology and natural history of gastroesophageal precancerous conditions is limited by a lack of robust analyses using large-scale individual-level data. We aimed to develop and validate a natural language processing (NLP) algorithm to identify and phenotype esophageal and gastric precancerous conditions and cancer and apply this to the Million Veteran Program (MVP), a uniquely powerful nationwide genomic biobank linked to individual-level electronic health record data. Methods: We identified 121,808 individuals in MVP who underwent upper endoscopy with biopsies. From these, 426 pathology notes from 426 individuals were used to develop and manually validate an NLP rule-based algorithm identifying intestinal metaplasia, dysplasia, and tumors of the stomach or esophagus. Anatomic subsite and "qualifier" terms were also evaluated (eg, dysplasia grade). Performance metrics were calculated. Results: The algorithm identified all prespecified conditions with excellent accuracy, ranging from 97.6% to 100% (Bonferroni-corrected 95% lower bound 94.5%-98.5%). For gastric intestinal metaplasia, the algorithm achieved 91.7% precision, or positive predictive value and 86.8% recall, or sensitivity (F1 score 89.2%), with 99.0% specificity and 98.3% negative predictive value; while for Barrett's esophagus, it achieved 98.9% precision and recall, or sensitivity (F1 score 98.9%), with 99.6% specificity and 99.6% negative predictive value. When applied to the full MVP cohort (N = 121,808), 13.2% had gastric intestinal metaplasia (mean age 65 years) and 14.5% had Barrett's esophagus (mean age 64 years). Conclusion: This study confirms the ability to use NLP on large-scale unstructured data linked to robust genetic and clinical data for future gastroesophageal precancer analyses and to inform targeted prevention and/or early detection interventions (eg, endoscopic surveillance).

  PublisherDOI

• Comparing the effectiveness of implementation strategies to improve liver and colon cancer screening for Veterans: protocol for a large cluster-randomized implementation study

  Implementation Science · 2025-08-09

  articleOpen accessSenior author

  BACKGROUND: Screening for gastrointestinal (GI) cancers, specifically colorectal cancer (CRC) and hepatocellular carcinoma (HCC), is often inadequately and inequitably implemented, leading to preventable morbidity and mortality. This protocol paper describes a study designed to compare the effectiveness of external facilitation with patient navigation across hospitals in the Veterans Health Administration (VA). METHODS: Two hybrid type 3, cluster-randomized trials will compare the effectiveness of patient navigation versus external facilitation for supporting HCC and CRC screening completion. Twenty-four sites will be included in the HCC trial and 32 in the CRC trial, cluster-randomizing Veterans by their site of primary care. The primary outcome of reach of cancer screening completion will be measured after intervention and during sustainment. Multi-level implementation determinants (i.e., barriers and facilitators), preconditions, and moderators will be evaluated pre- and post-intervention, using Consolidated Framework for Implementation Research (CFIR)-mapped surveys and interviews of Veteran participants and provider participants. DISCUSSION: Comparing findings in the two trials will allow researchers to understand how implementation barriers and strategies operate differently for a one-time screening in a relatively healthy population (CRC) vs. repeated screening in a more medically complex population (HCC). TRIAL REGISTRATION: This project was registered at ClinicalTrials.Gov (NCT06458998) on 6/13/24.

  PublisherOA PDFDOI

• SIGNIFICANT VARIABILITY IN SESSILE SERRATED LESION DETECTION RATES IN A LARGE NATIONAL HEALTHCARE SYSTEM: URGENT NEED TO STANDARDIZE ENDOSCOPIC DETECTION AND PATHOLOGY DIAGNOSIS TO MEET NEW BENCHMARKS

  Gastrointestinal Endoscopy · 2025-05-01

  article1st authorCorresponding
  PublisherDOI

Frequent coauthors

• Tonya Kaltenbach

  174 shared

• Samir Gupta

  Moores Cancer Center

  115 shared

• Ranier Bustamante

  VA San Diego Healthcare System

  89 shared

• Ashley Earles

  88 shared

• Marı́a Elena Martı́nez

  85 shared

• Jason A. Dominitz

  United States Department of Veterans Affairs

  82 shared

• Karen Messer

  Concordia University

  75 shared

• Deborah A. Fisher

  Eli Lilly (United States)

  74 shared

Labs

• University of Utah Health - Andrew J. Gawron LabPI

Education

• M.D.

  Northwestern University

• Other

  Northwestern University

• Other

  Northwestern University