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Maida M, Dahiya DS, Shah YR, Tiwari A, Gopakumar H, Vohra I, Khan A, Jaber F, Ramai D, Facciorusso A. Screening and Surveillance of Colorectal Cancer: A Review of the Literature. Cancers (Basel) 2024; 16:2746. [PMID: 39123473 PMCID: PMC11312202 DOI: 10.3390/cancers16152746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
Colorectal cancer (CRC) has the highest mortality rate among men and is the second highest among women under fifty, with incidence and mortality rates rising in younger populations. Studies indicate that up to one-third of patients diagnosed before fifty have a family history or genetic factors, highlighting the need for earlier screening. Contrariwise, diagnosis in healthy subjects through screening strategies enables early-stage detection of the tumor and better clinical outcomes. In recent years, mortality rates of CRC in Western countries have been on a steady decline, which is largely attributed to widespread screening programs and advancements in treatment modalities. Indeed, early detection through screening significantly improves prognosis, with stark differences in survival rates between localized and metastatic disease. This article aims to provide a comprehensive review of the existing literature, delving into the performance and efficacy of various CRC screening strategies. It navigates through available screening tools, evaluating their efficacy and cost-effectiveness. The discussion extends to delineating target populations for screening, emphasizing the importance of tailored approaches for individuals at heightened risk.
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Affiliation(s)
- Marcello Maida
- Department of Medicine and Surgery, University of Enna ‘Kore’, 94100 Enna, Italy;
| | - Dushyant Singh Dahiya
- Division of Gastroenterology, Hepatology and Motility, The University of Kansas School of Medicine, Kansas City, KS 66160, USA
| | - Yash R. Shah
- Department of Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, MI 48341, USA
| | - Angad Tiwari
- Department of Internal Medicine, Maharani Laxmi Bai Medical College, Jhansi 284001, India;
| | - Harishankar Gopakumar
- Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL 61605, USA; (H.G.); (I.V.)
| | - Ishaan Vohra
- Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL 61605, USA; (H.G.); (I.V.)
| | - Aqsa Khan
- Department of Internal Medicine, Parkview Health, Fort Wayne, IN 46805, USA;
| | - Fouad Jaber
- Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, KS 64110, USA;
| | - Daryl Ramai
- Division of Gastroenterology and Hepatology, The University of Utah School of Medicine, Salt Lake City, UT 84132, USA;
| | - Antonio Facciorusso
- Gastroenterology Unit, Department of Biomedical Science, Foggia University Hospital, 71122 Foggia, Italy
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Zholmurzayeva R, Ospanova D, Dzhumabekov A, Noso Y, Talkimbayeva N, Aytmanbetova A, Ussebayeva N, Zhorayev T, Fakhradiyev I. Evaluating the Effectiveness of a Modified Colorectal Cancer Screening Program in Almaty, Kazakhstan. Asian Pac J Cancer Prev 2023; 24:3605-3611. [PMID: 37898869 PMCID: PMC10770665 DOI: 10.31557/apjcp.2023.24.10.3605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/14/2023] [Indexed: 10/30/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of a modified colorectal cancer (CRC) screening program, incorporating culturally tailored strategies to increase screening uptake and compliance, in Almaty, Kazakhstan. METHODS A cross-sectional study was conducted in Almaty between 2019-2022, involving 5370 participants aged 50-70 from diverse settings. Participants were assigned to the main (modified method) and comparison (standard method) groups based on the parity of their ID number digits. Variables of interest included demographics, somatic comorbidities, disability degree, and CRC screening results. The modified screening emphasized healthcare prioritization, optimized nursing resources, enhanced accessibility, and preparedness for the second screening stage. RESULTS In the study 2702 patients in the main group (modified method), and 2668 patients in the comparison group (standard method). Comorbidity data showed that the majority of participants in both groups had between 1-10 comorbidities, with an average of 8.2 in the main group and 8.1 in the comparison group. Screening response rates at stage I were higher in the main group, with 82.6% of subjects undergoing screening, compared to 78.9% in the comparison group (χ2=12.12, p=0.001). The response rates were higher among females in both groups, and no significant differences were found across age groups. At stage II, the response rate was again higher in the main group (56.2%) than in the comparison group (47.2%) (χ2=4.217, p=0.040), with no significant differences noted in relation to sex or age. However, the main group showed a higher response rate at stage I among respondents with 6-10 comorbidities (87.1% vs 82.5%, χ2 =7.820, p=0.009). CONCLUSION The study demonstrates that the modified program significantly outperformed the traditional one, achieving higher response rates at both the initial and subsequent stages of screening. These findings emphasize the value of revisiting and refining current CRC screening methods to maximize early detection rates.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ildar Fakhradiyev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
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Vyas AP, Ananthaneni A, Abdehou S, Pandit S. Esophageal squamous cell carcinoma at the site of tracheo-esophageal fistula repair in a patient with cystic fibrosis. BMJ Case Rep 2023; 16:e253542. [PMID: 37643818 PMCID: PMC10465901 DOI: 10.1136/bcr-2022-253542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
With increasing survival in patients with cystic fibrosis (CF), complications such as gastrointestinal (GI) malignancies are becoming more apparent, especially in transplanted patients. In patients with CF, these malignancies are most commonly found in the small bowel, colon, biliary tract and pancreas. We describe a patient with esophageal squamous cell cancer at the site of trachea-esophageal fistula repair in the setting of long-standing CF. Many factors such as low expression of CF transmembrane conductance regulator gene, inflammation and resulting metaplasia, bacterial dysbiosis, dysregulation of Wnt/β-catenin signalling, immune cell infiltration, disruption of intestinal stem cell homeostasis and intestinal barrier integrity have all been implicated in the causation of GI malignancy in patients with CF. Based on shared decision-making in high-risk transplanted individuals, esophagogastroduodenoscopy can be considered alongside colon cancer screening which is currently recommended starting at age 30-35 years.
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Affiliation(s)
- Aditya Pradeep Vyas
- Division of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Anil Ananthaneni
- Division of Hematology and Medical Oncology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Sam Abdehou
- Division of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Sudha Pandit
- Division of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
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Kang KW, Song JE, Lee BH, Jeon MJ, Yu ES, Kim DS, Lee SR, Sung HJ, Choi CW, Park Y, Kim BS. A nationwide study of patients with monoclonal gammopathy of undetermined significance with a 10-year follow-up in South Korea. Sci Rep 2021; 11:18449. [PMID: 34531426 PMCID: PMC8445957 DOI: 10.1038/s41598-021-97664-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/27/2021] [Indexed: 11/08/2022] Open
Abstract
In clinical practice, most patients with monoclonal gammopathy of undetermined significance (MGUS) undergo long-term follow-up without disease progression. There is insufficient real-world data about how closely and whether anything other than disease progression should be monitored. Herein, we performed a nationwide study of 470 patients with MGUS with a 10-year follow-up to determine the patterns of disease progression and other comorbidities. During the follow-up period, 158 of 470 patients with MGUS (33.62%) progressed to symptomatic monoclonal gammopathies. Most of these were multiple myeloma (134/470 patients, 28.51%), and those diagnosed within 2 years after diagnosis of MGUS was high. Approximately 30-50% of patients with MGUS had hypertension, diabetes, hyperlipidemia, and osteoarthritis at the time of diagnosis, and these comorbidities were newly developed during the follow-up period in approximately 50% of the remaining patients with MGUS. Approximately 20-40% of patients with MGUS have acute or chronic kidney failure, thyroid disorders, disc disorders, peripheral neuropathy, myocardial infarction, stroke, and heart failure during the follow-up period. Altogether, when MGUS is diagnosed, close follow-up of the possibility of progression to multiple myeloma is required, especially within 2 years after diagnosis; simultaneously, various comorbidities should be considered and monitored during the follow-up of patients with MGUS. Continuous research is needed to establish appropriate follow-up guidelines.
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Affiliation(s)
- Ka-Won Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Ji Eun Song
- Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea
| | - Byung-Hyun Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Min Ji Jeon
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Eun Sang Yu
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Dae Sik Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Se Ryeon Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Hwa Jung Sung
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Chul Won Choi
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Yong Park
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Byung Soo Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
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