Miguel Areia is a member of the Research Group iGO, integrated into the Thematic Line 2 – Clinical & Translational Research, of the CINTESIS – Center for Health Technology and Services Research.

He was born in 1975 in Brussels. At the time, his father was there doing his doctorate in Anthropology. He was a few months old when he returned to Coimbra. He has always considered himself “a person of the sciences,” “very rational,” but also “with a taste for helping others.” He would not necessarily have to be a doctor, but medicine seemed to him “a rather obvious choice.”

He earned his degree in Medicine from the Faculty of Medicine of Coimbra in 1999 and completed the general internship at the Hospitals of the University of Coimbra, where he would apply for a gastroenterologist position. He finished the specialty in 2007. In 2008, he began working at the IPO of Coimbra as a specialist doctor and in 2009 he earned a Master’s degree in Medicine from FMUC and applied for a position at the PhD program in Clinical and Health Services Research chaired by Altamiro da Costa Pereira at the Faculty of Medicine of the University of Porto (FMUP); and worked under the supervision of Mário Dinis-Ribeiro.

He completed his doctorate in 2014 with a series of work in the field of gastric cancer, specifically in the detection and surveillance of premalignant lesions in the stomach, as part of prevention. “When I was an intern, I had a feeling that the endoscopy results depended more on the doctor I was working with than on the endoscopic findings. It was confusing and I thought it deserved to be studied. My conclusion is that it is only worth following patients between 50 and 75 years old, in cases of severe or extensive gastritis – and for that we have defined criteria – and perform an endoscopy only every 3 years”, argues the CINTESIS researcher.

Miguel Areia’s study was one of the basis for the European Society of Gastrointestinal Endoscopy (ESGE) to adapt its recommendations, and advised endoscopy every 3 years. And this is how the specialist carries out his clinical practice at the IPO of Coimbra. “People believe that in the IPO there are only cancer patients. Luckily, this is not the case.  As gastroenterologists we have many non-cancer patients with more or less extensive and severe gastritis and polyps that we have to remove to prevent cancer,” he continues.

Personally, he has no doubt that research has made him a better clinician. “I have always enjoyed the research work and trying to answer pending questions. I think I’m a better doctor today than I was 10 years ago because I’m a better researcher than I was 10 years ago,” he says.

Miguel Areia also has responsibilities as new president of the Portuguese Society for Digestive Endoscopy (SPED), a position he will hold until 2021, and as a member of the ESGE Quality Commission, being responsible for the quality of upper digestive endoscopy.

1-Year Ambition

There is an application in which gastroenterologists at European level can report quality criteria for digestive endoscopy. We are about to receive the first results of this report. More than guidelines, we want to know what is being done and evaluate.

10-Year Ambition

As a researcher, I intend to continue the study of premalignant stomach lesions in CINTESIS, together with my colleagues Mário Dinis-Ribeiro and Pedro Pimentel Nunes. We want to know if the recommended 3-year timeframe for endoscopy is applicable in practice. This is an international, multi-center project where we will see if we can always detect lesions before cancer. The project was recently presented and is in its early stages.

As a gastroenterologist, I have some goals that I would like to see accomplished in a 10-years period. They are really ambitious. One is to have, in Portugal, a national screening for colon and rectal cancer from the age of 50 on asymptomatic people (persons with no complaints) every 2 years through fecal occult blood test, followed by colonoscopy in case of positive results.

Colorectal cancer is currently the most killer cancer in Portugal. In theory, all these cancers would be preventable if polyps were removed in time. It is the ideal cancer to be screened. We have a big window of opportunity and it’s a shame we are not taking advantage of it. We currently have some regional projects, but there is no national screening yet. First, there is always the problem of money. It is always difficult to convince governing bodies to make these expenditures that do not produce immediate results. On the other hand, there has been a great deal of resistance from gastroenterologists who continue to advocate colonoscopy screening.  I agree that colonoscopy is the ideal exam for studying the colon, I do not agree that it is the ideal exam for screening, which should be simple, inexpensive and risk-free. Not all people without complaints agree to undergo a colonoscopy. It is an expensive exam and though rare it does involves some risks. There is yet another problem: there are colonoscopy waiting lists today. That is, if we tried to implement screening based on colonoscopy, it would be impossible. There is only one country that is performing screening using colonoscopy, which is Poland, and they can only reach 10% of the population.

Another project, within SPED, is to have a national database of endoscopies, something that only exists in the UK. This database, which would be centralized in the Ministry of Health and would instantaneously aggregate thousands of endoscopies performed by gastroenterologists; would allow access to data on quality, and would provide data for research.

Life Beyond Your Clinical Practice and Research

My three sons, 17, 14 and 9 years old, are my greatest antistress remedy. My hobbies are music and sports. I studied violin at the Conservatory. It was more of a classical type of education, but I have always been part of amateur bands. Right now, I have a band called  Quarentuna de Coimbra. The term comes from the forty years olds who have played in the various tunas of the University of Coimbra. We arrange music from Coimbra and perform shows.

Doing sports is essential for me. For those who don’t know, doing endoscopies from Monday to Friday can cause stiff necks and a lot of pain. I have been swimming for many years from a purely amateur point of view. As I have always wanted my children to go swimming, instead of staring at them in the pool, I swim too. So, when I take my kids to the pool, I swim too. I have been doing it for 17 years now. It makes me feel good.