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Jeong MA, Kang HW. [Early-onset Colorectal Cancer]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2019; 74:4-10. [PMID: 31344768 DOI: 10.4166/kjg.2019.74.1.4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/20/2019] [Accepted: 07/21/2019] [Indexed: 12/24/2022]
Abstract
The incidence of colorectal cancer (CRC) is increasing among young adults in several countries including the United States. Early-onset colorectal cancer (EO-CRC) is heterogenous group and appears to have a distinct clinical, pathologic, and molecular presentation compared to CRC diagnosed in older patients. EO-CRC patients tend to be diagnosed at later stage and with symptomatic disease. Tumors arise predominantly in the distal colon and rectum and have poorer histological features. Microsatellite and chromosome stable molecular pathway is frequently observed in EO-CRC. Survival data of EO-CRC is conflicting and younger patients tend to be treated more aggressively. It is important to identify high risk and have them screened appropriately to address increasing EO-CRC. Screening and treatment strategies for EO-CRC should be developed through further investigation of molecular mechanism and various environmental risk factors. In Korea, EO-CRC and late-onset CRC have both declined in recent several years, probably due to many screening colonoscopies in young population. Close observation and analysis of EO-CRC in Korea is necessary.
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Affiliation(s)
- Mo Ah Jeong
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Hyoun Woo Kang
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
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Colizzo J, Keshishian J, Kumar A, Vidyarthi G, Amodeo D. Colonic stasis and chronic constipation: Demystifying proposed risk factors for colon polyp formation in a spinal cord injury veteran population. J Spinal Cord Med 2018; 41:292-297. [PMID: 29072121 PMCID: PMC6055954 DOI: 10.1080/10790268.2017.1388602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND AND AIMS Patients with spinal cord injury (SCI) suffer significant morbidity from neurogenic bowel. Chronic constipation has long-been a proposed risk factor for polyp development. We performed a retrospective cohort study in veterans with SCI to assess polyp presence in the setting of colonic stasis. METHODS All consecutive patients at the James A. Haley Veterans Affairs Hospital with SCI and neurogenic bowel who completed screening colonoscopy between January 1, 2004 to June 30, 2013 were included. Colonoscopies were excluded if they were aborted, not completed to the cecum, of less than adequate preparation, or if polypectomy was precluded. Patient data included level, duration, and completeness of SCI. Polyp data included number, location, and histology. RESULTS 325 patients ultimately met inclusion criteria. Most were male (96%). The average age at screening colonoscopy was 62.8 years. The majority of patients had injury to the cervical spine (41.5%). Colon polyps were detected in 130 patients (40%). Adenomatous change was seen in 95 (73%) of these patients. The adenoma detection rate (ADR) across all patients was 29.2%. Polyp presence and ADR demonstrated no statistically significant correlation with level, degree, or duration of SCI. Only patient age at time of screening colonoscopy had a significant correlation with polyp and adenoma presence (P<0.05). CONCLUSIONS SCI had no statistically significant correlation with polyp or adenoma presence. The ADR in our veteran SCI population with chronic constipation is comparable with that reported in the general population.
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Affiliation(s)
- Jason Colizzo
- University of South Florida, Morsani College of Medicine, Department of Internal Medicine, Tampa, Florida, USA
| | - Jonathan Keshishian
- University of South Florida, Morsani College of Medicine, Department of Internal Medicine, Division of Digestive Diseases and Nutrition, Tampa, Florida, USA
| | - Ambuj Kumar
- University of South Florida, Morsani College of Medicine, Department of Internal Medicine, Division of Evidence Based Medicine, Tampa, Florida, USA
| | - Gitanjali Vidyarthi
- University of South Florida, Morsani College of Medicine, Department of Internal Medicine, Division of Digestive Diseases and Nutrition, James A. Haley Veterans Affairs Hospital, Tampa, Florida, USA
| | - Donald Amodeo
- University of South Florida, Morsani College of Medicine, Department of Internal Medicine, Division of Digestive Diseases and Nutrition, James A. Haley Veterans Affairs Hospital, Tampa, Florida, USA
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Brenner DR, Ruan Y, Shaw E, De P, Heitman SJ, Hilsden RJ. Increasing colorectal cancer incidence trends among younger adults in Canada. Prev Med 2017; 105:345-349. [PMID: 28987338 DOI: 10.1016/j.ypmed.2017.10.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/11/2017] [Accepted: 10/03/2017] [Indexed: 02/06/2023]
Abstract
Recent analyses in the United States have shown an overall decrease in the incidence of colorectal cancer despite contrasting increases in younger age groups. We examined whether these cohort trends are occurring in Canada. Age-specific trends in colon and rectal cancer incidence in Canada from the National Cancer Incidence Reporting System (1969-1992) and the Canadian Cancer Registry (1992-2012) were analyzed. We estimated annual percent changes (APC) with the Joinpoint Regression Program from the Surveillance Epidemiology, and End Results Program. Birth cohort effects were estimated using 5-year groups starting in 1888. Age-specific prevalence of class I, II and III obesity in Canada was examined from the National Population Health Survey (1994-2001) and the Canadian Community Health Survey (2001-2011). The reductions in CRC incidence among Canadians are limited to older populations. While reductions among younger age groups (20-29year olds (yo), 30-39yo and 40-50yo) were observed between 1969 and 1995, rates have returned to and surpassed historical levels (APCs 20-29yo colon cancer=6.24%, APCs 20-29yo rectal cancer=1.5%). Recent birth cohorts (1970-1990) have the highest incidence rate ratios ever recorded. Ecologic trends in obesity prevalence among these birth cohorts in Canada are suggestive of an impact on increasing incidence trends. Furthermore, obesity prevalence estimates suggest that these trends may continue to increase justifying further examination of the etiologic associations and biological impacts of excess adipose tissue among younger populations. While population-based screening of younger age groups deserves careful consideration, these concerning observed trends warrant public health action to address the growing obesity epidemic.
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Affiliation(s)
- Darren R Brenner
- Department of Oncology, Cumming School of Medicine, University of Calgary, Canada; Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Canada
| | - Eileen Shaw
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Canada
| | - Prithwish De
- Division of Surveillance, Cancer Care Ontario, Canada
| | - Steven J Heitman
- Department of Medicine, Cumming School of Medicine, University of Calgary, Canada
| | - Robert J Hilsden
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Canada
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Lacy BE, Spiegel B. No Results? No Problem! Why We Are Publishing Methods of a Landmark Study With Results Still Pending. Am J Gastroenterol 2017; 112:1747-1748. [PMID: 29109496 DOI: 10.1038/ajg.2017.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 08/28/2017] [Indexed: 12/11/2022]
Abstract
Colorectal cancer (CRC) is the third most commonly diagnosed cancer in both men and women in the United States, and screening for CRC is a national health-care priority. In this issue, investigators from the CONFIRM study group report on the aims and study design of a large, multicenter, randomized prospective study of whether screening colonoscopy is superior to an annual fecal immunochemical test (FIT). CONFRIM hopes to enroll 50,000 individuals, aged 50-75 years, from 46 Veterans Affairs Medical Centers and monitor them for 10 years. This article is unique in that no results are presented as the study is not yet complete. We have taken this unusual step as we believe the topic of CRC screening is critically important for our readers and that the results of this massive study have the potential to change clinical practice throughout all fields of medicine.
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Affiliation(s)
- Brian E Lacy
- Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Brennan Spiegel
- Health Services Research in Academic Affairs and Clinical Transformation, Cedars-Sinai Health Services Research, Professor of Medicine and Public Health, Los Angeles, California, USA
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Wang H, Jin S, Lu H, Mi S, Shao W, Zuo X, Yin H, Zeng S, Shimamoto F, Qi G. Expression of survivin, MUC2 and MUC5 in colorectal cancer and their association with clinicopathological characteristics. Oncol Lett 2017; 14:1011-1016. [PMID: 28693267 DOI: 10.3892/ol.2017.6218] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 03/17/2017] [Indexed: 12/16/2022] Open
Abstract
Survivin is a bifunctional protein that suppresses apoptosis and regulates cell division, and is highly expressed in various cancer types. Mucins are high-molecular-weight, heavily glycosylated proteins. In the present study, the association between survivin, mucin 2 (MUC2) and MUC5 expression, and the clinicopathological features of colorectal cancer (CRC) were investigated. The immunohistochemistry and western blotting results demonstrated that survivin was highly expressed in CRC tissues and rarely expressed in normal colon tissues. Moreover, the overexpression of survivin and MUC5 was strongly associated with lymph node metastasis, poor cellular differentiation, advanced tumor stage and a poor prognosis in CRC. By contrast, low expression of MUC2 was significantly associated with lymph node metastasis, poor cellular differentiation and an advanced tumor stage in CRC. The results of the present study suggest that survivin, MUC2 and MUC5 levels may be associated with tumor progression and could be used to aid the early diagnosis and clinical characterization of CRC.
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Affiliation(s)
- Haipeng Wang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Guilin Medical College, Guilin, Guangxi 541199, P.R. China
| | - Shengjian Jin
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Guilin Medical College, Guilin, Guangxi 541199, P.R. China
| | - Huiling Lu
- Department of Pathology and Physiopathology, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
| | - Sisi Mi
- Department of Pathology and Physiopathology, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
| | - Wenhua Shao
- Department of Pathology and Physiopathology, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
| | - Xiaoxv Zuo
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Guilin Medical College, Guilin, Guangxi 541199, P.R. China
| | - Huangyi Yin
- Department of Pathology and Physiopathology, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
| | - Sien Zeng
- Department of Pathology and Physiopathology, Guilin Medical University, Guilin, Guangxi 541004, P.R. China
| | - Fumio Shimamoto
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima 734-8558, Japan.,Department of Pathology, Faculty of Humanities and Human Sciences, Hiroshima Shudo University, Hiroshima 731-3195, Japan
| | - Guangying Qi
- Department of Pathology and Physiopathology, Guilin Medical University, Guilin, Guangxi 541004, P.R. China.,Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima 734-8558, Japan
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Chen QZ, Li Y, Shao Y, Zeng YH, Ren WY, Liu RX, Zhou LY, Hu XL, Huang M, He F, Sun WJ, Wu K, He BC. TGF-β1/PTEN/PI3K signaling plays a critical role in the anti-proliferation effect of tetrandrine in human colon cancer cells. Int J Oncol 2017; 50:1011-1021. [PMID: 28197642 DOI: 10.3892/ijo.2017.3875] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/31/2017] [Indexed: 12/17/2022] Open
Abstract
The diagnosis and treatment for colon cancer have been greatly developed, but the prognosis remains unsatisfactory. There is still a great clinical need to explore new efficacious drugs for colon cancer treatment. Tetrandrine (Tet) is a bis-benzylisoquinoline alkaloid. It has been shown that Tet may be a potential candidate for cancer treatment, but the explicit mechanism underlying this activity remains unclear. In this study, we investigated the anticancer activity of Tet in human colon cancer cells and dissected the possible mechanism. With cell viability assay and flow cytometry analysis, we confirmed that Tet can effectively inhibit the proliferation and induce apoptosis in HCT116 cells. Mechanically, we found that Tet greatly increases the mRNA and protein level of TGF-β1 in HCT116 cells. Exogenous TGF-β1 enhances the anti-proliferation and apoptosis inducing effect of Tet in HCT116 cells, which has been partly reversed by TGF-β1 inhibitor. Tet decreases the phosphorylation of Akt1/2/3 in HCT116 cells. This effect can be enhanced by exogenous TGF-β1, but partly reversed by TGF-β1 inhibitor. Tet exhibits no effect on total level of PTEN, but decreases the phosphorylation of PTEN; exogenous TGF-β1 enhances the effect of Tet on decreasing the phosphorylation of PTEN, which was partly reversed by TGF-β1 inhibitor. Our findings suggested that Tet may be a promising candidate for colon cancer treatment, and the anticancer activity may be mediated by inactivating PI3K/Akt signaling through upregulating TGF-β1 to decrease the phosphorylation of PTEN.
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Affiliation(s)
- Qian-Zhao Chen
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Yang Li
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Ying Shao
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Yu-Hua Zeng
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Wen-Yan Ren
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Rong-Xing Liu
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Lin-Yun Zhou
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Xue-Lian Hu
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Ming Huang
- Chongqing Key Laboratory for Biochemistry and Molecular Pharmacology, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Fang He
- Chongqing Key Laboratory for Biochemistry and Molecular Pharmacology, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Wen-Juan Sun
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Ke Wu
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Bai-Cheng He
- Department of Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing 400016, P.R. China
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Cancer screening barriers and facilitators for under and never screened populations: A mixed methods study. Cancer Epidemiol 2016; 45:126-134. [PMID: 27810484 DOI: 10.1016/j.canep.2016.10.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 07/21/2016] [Accepted: 10/23/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cancer screening is below targets in Ontario, Canada. Our objective was to identify and quantify the barriers and facilitators for breast, cervical and colorectal cancer screening for under and never screened (UNS) residents living in Ontario between 2011 and 2013. METHODS We used a multi-phased mixed methods study design. Results from thematic analysis of focus group discussions with health care providers and UNS community members were used to develop an on-line, province-wide, cross-sectional survey to estimate the prevalence of barriers and facilitators for the provincial population. Adjusted prevalence odds ratios and 95% confidence intervals were estimated for UNS compared to regularly screened participants using logistic regression. RESULTS Four focus groups were held with health service providers and sixteen with UNS community members. Top barriers and facilitators themed around provider-patient communication, fear and embarrassment, history of physical or sexual abuse, social determinants of health (including low literacy, lack of awareness, and health insurance), symptoms appearing, and family and friends. 3075 participants completed the online survey. Compared to regularly screened participants, UNS had significantly higher odds of reporting: no regular health care provider; not feeling comfortable talking about screening; or the Doctor or Nurse Practitioner not suggesting screening. UNS also had significantly higher odds of reporting the facilitators: the test being less scary/painful or uncomfortable; friend/family insisting on getting screened; starting to have symptoms; or an easier test that could be done at home. CONCLUSIONS Interventions addressing fear through individual, interpersonal and structural facilitators may increase cancer screening.
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Gesink D, Leach J, McBride K, Bergin-Payette K. Health Priorities and Health-Seeking Behaviors of Old Order Anabaptists in Southern Ontario With Emphasis on Cancer Screening. J Transcult Nurs 2016; 28:566-572. [PMID: 27589947 DOI: 10.1177/1043659616666325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cancer-screening rates are low among Old Order Anabaptists; the burden of cancer is unknown. PURPOSE To investigate cancer and health in the Old Order Anabaptist context. Specifically, to describe health priorities and health-seeking behaviors, crudely estimate cancer burden, and identify predictors of cancer screening. METHOD A cross-sectional survey was distributed to households around Perth County, Ontario, in January 2014. RESULTS Response rate was 45%. Cancer burden was low. Cancer was a lower priority than general and mental health. After adjustment, family/friends motivated cancer screening for regular screeners ( OR: 6.38, 95% CI [1.93, 21.07]) and symptoms was reported to motivate those underscreened/never screened ( OR: 0.48, 95% CI [0.24, 0.96]). CONCLUSION Cancer-screening participation may be low because the burden of cancer is low and there are other high-priority health concerns. IMPLICATIONS Integrated cancer screening and holistic care may improve participation.
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Affiliation(s)
| | - Jane Leach
- 2 Perth District Health Unit, Stratford, Ontario, Canada
| | - Kate McBride
- 3 Alberta Health Services, Calgary, Alberta, Canada
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Patterns and outcomes of colorectal cancer in adolescents and young adults. J Surg Res 2016; 205:19-27. [DOI: 10.1016/j.jss.2016.05.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/03/2016] [Accepted: 05/18/2016] [Indexed: 12/12/2022]
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Piątkiewicz P, Bernat-Karpińska M, Miłek T, Rabijewski M, Rosiak E. NK cell count and glucotransporter 4 (GLUT4) expression in subjects with type 2 diabetes and colon cancer. Diabetol Metab Syndr 2016; 8:38. [PMID: 27303448 PMCID: PMC4906701 DOI: 10.1186/s13098-016-0152-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 05/26/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) and colon cancer (CC) are numbered among the most common diseases in the world. The decreased activity of natural killer (NK) cells previously revealed in both mentioned pathological states may be correlated with impaired expression of GLUT4 as the major insulin-dependent glucose transporter in these cells. METHODS The aim of this study was to evaluate GLUT4 expression and NK cells number in subjects with T2D and/or CC in comparison with control group. We evaluated 78 individuals divided into four groups: (1) patients with CC and T2DM, (2) patients with CC, (3) patients with T2DM (4) healthy control. GLUT4 expression on the surface of NK cells was measured using flow cytometry and phenotyping of NK cell was performed by immunofluorescent method. RESULTS Subjects with diabetes had the highest GLUT4 expression (21.35 ± 7.2 %) in comparison with other groups (P < 0.01). The mean values of GLUT4 expression in group with CC and in patients with both T2D and CC were similar (1.4 ± 0.4 % vs 1.5 ± 1.0 %; respectively). These values were significantly lower than in control group (12.6 ± 2.9 %; P < 0.01). In patients with T2D and CC the number of NK cells (20.15 ± 6.6 %) was significantly higher than in other groups, i.e. in group with T2D (14.08 ± 5.7 %), in group with CC (9.21 ± 3.6 %) and in control group (9.48 ± 4.7 %), respectively (P < 0.01). CONCLUSIONS It seems that there is a need to pay more attention to the high incidence of colon cancer among patients with type 2 diabetes. Decreased GLUT4 expression observed on NK cells in patients with colon cancer may be responsible for dysfunction of these cells and the higher carcinogenic risk in type 2 diabetic subjects.
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Affiliation(s)
- Paweł Piątkiewicz
- />Department of Internal Diseases, Diabetology and Endocrinology, Warsaw Medical University, Ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Małgorzata Bernat-Karpińska
- />Department of Internal Diseases, Diabetology and Endocrinology, Warsaw Medical University, Ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Tomasz Miłek
- />Department of General and Vascular Surgery, Warsaw Medical University, Warsaw, Poland
| | - Michał Rabijewski
- />Department of Internal Diseases, Diabetology and Endocrinology, Warsaw Medical University, Ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Elżbieta Rosiak
- />Department of Nuclear Medicine, Warsaw Medical University, Warsaw, Poland
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Nurse Participation in Colonoscopy Observation versus the Colonoscopist Alone for Polyp and Adenoma Detection: A Meta-Analysis of Randomized, Controlled Trials. Gastroenterol Res Pract 2015; 2016:7631981. [PMID: 26839543 PMCID: PMC4709663 DOI: 10.1155/2016/7631981] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 10/08/2015] [Indexed: 12/22/2022] Open
Abstract
The role of nurse participation (NP) in colonoscopy observation for polyp and adenoma detection is unclear. This study aimed to evaluate whether nurse participation can improve polyp and adenoma detection. Patients and Methods. The PUBMED, EMBASE, and Cochrane Library databases were searched for randomized controlled trials (RCTs) published in English. The outcome measurements included (1) the polyp and adenoma detection rate (PDR and ADR); (2) the advanced lesions detection rate; and (3) the mean polyp and adenoma detection rate per colonoscopy. Results. Three RCTs with a total of 1676 patients were included. The pooled data showed a significantly higher ADR in the NP group than colonoscopist alone (CA) (45.7% versus 39.3%; RR 1.16; 95% CI, 1.04–1.30). And it showed no significant difference in the PDR and advanced lesions detection rate between the two groups (RR: 1.14, 95% CI: 0.95–1.37; RR: 1.35, 95% CI: 0.91–2.00; resp.). Conclusions. Nurse participation during a colonoscopy can improve the ADR, whereas no benefit for the PDR and advanced lesions detection rate was observed. All RCTs included in the meta-analysis had high risk of bias. Thus, there is a need for new research that uses sound methodology to definitively address the research question under study.
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Dhaliwal A, Vlachostergios PJ, Oikonomou KG, Moshenyat Y. Fecal DNA testing for colorectal cancer screening: Molecular targets and perspectives. World J Gastrointest Oncol 2015; 7:178-183. [PMID: 26483873 PMCID: PMC4606173 DOI: 10.4251/wjgo.v7.i10.178] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/17/2015] [Accepted: 08/28/2015] [Indexed: 02/05/2023] Open
Abstract
The early detection of colorectal cancer with effective screening is essential for reduction of cancer-specific mortality. The addition of fecal DNA testing in the armamentarium of screening methods already in clinical use launches a new era in the noninvasive part of colorectal cancer screening and emanates from a large number of previous and ongoing clinical investigations and technological advancements. In this review, we discuss the molecular rational and most important genetic alterations hallmarking the early colorectal carcinogenesis process. Also, representative DNA targets-markers and key aspects of their testing at the clinical level in comparison or/and association with other screening methods are described. Finally, a critical view of the strengths and limitations of fecal DNA tests is provided, along with anticipated barriers and suggestions for further exploitation of their use.
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Abstract
Lung cancer is the leading cause of cancer death worldwide with an average rate of 40-100/100,000 depending on the level of deprivation, and the rates are higher in smokers. The National Lung Screening Trial using three consecutive annual low-dose computed tomography scans is the first and largest screening study to show clear evidence of a significant reduction in lung cancer mortality in selected high-risk subjects. The many on-going European screening studies will generate information on the groups of subjects that may or may not benefit from screening (demographics, pack-years smoked, length of smoking, number of years from quitting etc.) and the required frequency and duration of the intervention. Smoking cessation remains the most important tool for general improvement in health outcomes and in particular lung cancer prevention. Early intervention for investigations of symptoms that are considered mild or common could also change the outcome. Doctors and patients must become increasingly aware that these common symptoms are also potentially symptoms of lung cancer and are not ‘normal’ even in smokers.
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Affiliation(s)
- Mary Er O'Brien
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
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