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Ng L, Wong SKM, Li HS, Sin RWY, Man JHW, Lo OSH, Pang RWC, Foo DCC, Law WL. A Four-Gene Panel in Rectal Swab Samples as a Biomarker for Colorectal Cancer Screening. Cells 2024; 13:930. [PMID: 38891062 PMCID: PMC11171518 DOI: 10.3390/cells13110930] [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: 04/26/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND The dysregulation of gene expression is one of the key molecular features of colorectal cancer (CRC) development. This study aimed to investigate whether such dysregulation is reflected in rectal swab specimens of CRC patients and to evaluate its potential as a non-invasive approach for screening. METHODS We compared the expression level of 14 CRC-associated genes in tumor and adjacent non-tumor tissue of CRC patients and examined the correlation of their levels in tissue with paired rectal swab specimens. The level of these 14 genes in rectal swab specimens was compared among patients with CRC or polyp and control subjects, and the diagnostic potential of each dysregulated gene and the gene panel were evaluated. RESULTS The expression of CXCR2, SAA, COX1, PPARδ, PPARγ, Groγ, IL8, p21, c-myc, CD44 and CSF1 was significantly higher in CRC, and there was a significant correlation in the levels of most of them between the CRC and rectal swab specimens. In the training study, we showed that CD44, IL8, CXCR2 and c-myc levels were significantly higher in the rectal swab specimens of the CRC patients. Such result was confirmed in the validation study. A panel of these four genes was developed, and ROC analysis showed that this four-gene panel could identify CRC patients with an AUC value of 0.83 and identify overall polyp and precancerous adenoma patients with AUC values of 0.6522 and 0.7322, respectively. Finally, the predictive study showed that the four-gene panel demonstrated sensitivities of 63.6%, 76.9% and 88.9% in identifying overall polyp, precancerous adenoma and CRC patients, respectively, whereas the specificity for normal subjects was 72.2%. CONCLUSION The expression of CRC-associated genes in rectal swab specimens reflects the dysregulation status in colorectal tissue, and the four-gene panel is a potential non-invasive biomarker for early precancerous adenoma and CRC screening.
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Affiliation(s)
- Lui Ng
- Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (S.K.-M.W.); (H.-S.L.); (R.W.-Y.S.); (J.H.-W.M.); (O.S.-H.L.); (R.W.-C.P.); (D.C.-C.F.)
| | | | | | | | | | | | | | | | - Wai-Lun Law
- Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (S.K.-M.W.); (H.-S.L.); (R.W.-Y.S.); (J.H.-W.M.); (O.S.-H.L.); (R.W.-C.P.); (D.C.-C.F.)
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Zhang J, Zhu S, Liu C, Xiao X, Xie H, Zhang Y, Hong Y. Colorectal cancer and its attributable risk factors in East Asia, 1990-2030. J Gastroenterol Hepatol 2024; 39:880-892. [PMID: 38221664 DOI: 10.1111/jgh.16467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND The disease burden of colorectal cancer in East Asia has been at a high level. However, the epidemiological characteristics of the disease burden in this region have not been systematically studied. METHOD Data were obtained from the Global Burden of Disease 2019 program. Joinpoint analysis was used to identify long-term trends in mortality of colorectal cancer. Independent effects of age, period, and cohort were detected by the age-period-cohort model. The Bayesian age-period-cohort model was performed to predict the burden of colorectal cancer across East Asia by 2030. RESULTS From 1990 to 2019, the average annual percentage change (AAPC) showed upward trends in mainland China (1.05 [95% confidence interval (CI)], 0.82, 1.28) as well as Taiwan Province of China (1.81 [95% CI], 1.51, 2.10) but downward in Japan (-0.60 [95% CI], -0.70, -0.49) (P < 0.05). Attributable risk factors for colorectal cancer in East Asia remained stable over 30 years, while the risk of metabolic factors is noteworthy in the future. In the next decade, the age-standardized death rate (ASDR) of colorectal cancer in China was predicted to surpass that of Japan and South Korea in expectation. CONCLUSION The mortality of colorectal cancer is escalating in developing countries, while it is gradually declining in high-income countries across East Asia. Nonetheless, the disease burden of colorectal cancer in high-income countries remains substantial level.
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Affiliation(s)
- Jian Zhang
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Neurosurgery, the Seventh Clinical College of China Medical University, Fushun, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Chunlong Liu
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang, China
| | - Xiong Xiao
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Haojie Xie
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yonghui Zhang
- Department of Neurosurgery, the Seventh Clinical College of China Medical University, Fushun, China
| | - Yang Hong
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
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Nash SH, Verhage E, Flanagan C, Haverkamp D, Roik E, Zimpelman G, Redwood D. Clinical Outcomes from the Alaska Native Tribal Health Consortium Colorectal Cancer Control Program: 2009-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:552. [PMID: 38791767 PMCID: PMC11120796 DOI: 10.3390/ijerph21050552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/14/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
The Alaska Native Tribal Health Consortium (ANTHC) participated in the United States Centers for Disease Control and Prevention Colorectal Cancer Control Program (CRCCP) from 2009 to 2015. We conducted a descriptive evaluation of ANTHC CRCCP demographics, quality measures, and clinical outcomes, including screening methods employed within the program and screening outcomes. There were 6981 program screenings completed, with the majority (81.3%) of people screened in the 50-75 year age group. Colonoscopy was the primary screening test used, accounting for 6704 (96.9%) of the screening tests. Quality of colonoscopy was high: adequate bowel preparation was reported in 98.2% of colonoscopies, cecal intubation rate was 98.9%, and the adenoma detection rate was 38.9%. A high proportion (58.9%) of colonoscopies had an initial finding of polyps or lesions suspicious for cancer; 41.2% of all colonoscopies had histological confirmation of either adenomatous polyps (40.6%) or cancer (0.5%). The ANTHC CRCCP successfully increased CRC screening among American Indian and Alaska Native peoples living in Alaska; this was achieved primarily through high-quality colonoscopy metrics. These data support a continued focus by the Alaska Native Tribal Health Consortium and its tribal health partners on increasing CRC screening and reducing cancer mortality among Alaska Native peoples.
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Affiliation(s)
- Sarah H. Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA 52242, USA
- State Health Registry of Iowa, College of Public Health, Iowa City, IA 52242, USA
| | - Elizabeth Verhage
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| | - Christie Flanagan
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA
| | - Donald Haverkamp
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Albuquerque, NM 87110, USA
| | - Elena Roik
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA
| | - Garrett Zimpelman
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA
| | - Diana Redwood
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA
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Leong W, Guo JQ, Ning C, Luo FF, Jiao R, Yang DY. Should we perform sigmoidoscopy for colorectal cancer screening in people under 45 years? World J Gastrointest Oncol 2024; 16:1248-1255. [PMID: 38660667 PMCID: PMC11037058 DOI: 10.4251/wjgo.v16.i4.1248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/19/2024] [Accepted: 02/28/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND The strategy for preventing colorectal cancer is screening by colonoscopy, which offers a direct way for detection and removal of adenomatous polyps (APs). American College of Gastroenterology guidelines recommend that people aged ≥ 45 years should undergo colonoscopy; however, how to deal with people aged ≤ 45 years is still unknown. AIM To compare the prevalence of APs and high-grade neoplasia between the left and right colon in patients ≤ 45 years. METHODS A retrospective observational study was conducted at a single tertiary III hospital in China. This study included patients aged 18-45 years with undergoing initial colonoscopy dissection and pathological diagnosis AP or high-grade neoplasia between February 2014 and January 2021. The number of APs in the entire colon while screening and post-polypectomy surveillance in following 1-3 years were evaluated. RESULTS A total of 3053 cases were included. The prevalence of APs in the left and right colon was 55.0% and 41.6%, respectively (OR 1.7, 95%CI 1.6-2.4; P < 0.05). For APs with high-grade neoplasia, the prevalence was 2.7% and 0.9%, respectively (OR 3.0, 95%CI 2.0-4.6; P < 0.05). Therefore, the prevalence of APs and high-grade neoplasia in the left colon was significantly higher than in the right colon in patients aged ≤ 45 years. There were 327 patients who voluntarily participated in post-polypectomy surveillance in following 1-3 years, and APs were found in 216 cases (66.1%); 170 cases had 1-3 polyps (52.0%) and 46 cases had > 3 polyps (14.1%; OR 0.3, 95%CI 0.1-0.6; P < 0.05). CONCLUSION This study suggests that flexible sigmoidoscopy would be an optimal approach for initial screening in people aged ≤ 45 years and would be a more cost-effective and safe strategy.
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Affiliation(s)
- Waiian Leong
- Division of Gastroenterology & Hepatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
- Department of Accident & Emergency, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
| | - Jia-Qi Guo
- Division of Gastroenterology & Hepatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
| | - Chun Ning
- Division of Gastroenterology & Hepatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
| | - Fei-Fei Luo
- Department of Anatomical Pathology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
| | - Rui Jiao
- Department of Anatomical Pathology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
| | - Dong-Ye Yang
- Division of Gastroenterology & Hepatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
- Endoscopy Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
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Troelsen FS, Farkas DK, Erichsen R, Strate LL, Baron JA, Sørensen HT. Risk of Cancer in Patients With Diverticular Disease: A Population-Based Cohort Study. Clin Gastroenterol Hepatol 2024:S1542-3565(24)00251-9. [PMID: 38490316 DOI: 10.1016/j.cgh.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND & AIMS Several studies have investigated the association between diverticular disease (DD) and colorectal cancer. However, whether there is an association between DD and malignancies other than those in the colorectum remains uncertain. METHODS For the 1978-2019 period, we conducted a nationwide, population-based cohort study using national Danish health care data. We followed patients with DD for up to 20 years, beginning 1 year after the date of DD diagnosis until the first occurrence of incident cancer, emigration, death, 20 years of follow-up, or December 31, 2019. We calculated cumulative incidence proportions of cancer and standardized incidence ratios (SIRs) comparing cancer incidence among patients with DD with that in the general population. RESULTS We identified 200,639 patients with DD, of whom 20,498 were diagnosed with cancer during the 1-20 years after their DD diagnosis. The SIRs were increased for most cancer sites except for those in the colorectum (SIR, 0.75; 95% confidence interval, 0.72-0.78). The highest SIRs were observed for cancers of the lung, bronchi, and trachea (SIR, 1.20; 95% confidence interval, 1.15-1.24) and kidney (SIR, 1.27; 95% confidence interval, 1.16-1.39). CONCLUSIONS Our findings show an increased long-term relative risk of cancer following a diagnosis of DD. These findings are likely caused by prevalence of numerous risk factors in patients with DD that confer an increased risk of cancer. The decreased relative risk of colorectal cancer might be explained by an increased likelihood of patients with DD undergoing colonoscopy with polypectomy.
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Affiliation(s)
| | - Dóra K Farkas
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Rune Erichsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Lisa L Strate
- Division of Gastroenterology, Department of Medicine, Harborview Medical Center, University of Washington School of Medicine, Seattle, Washington
| | - John A Baron
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; Division of Gastroenterology, Department of Medicine, Harborview Medical Center, University of Washington School of Medicine, Seattle, Washington
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Shelton J, Zotow E, Smith L, Johnson SA, Thomson CS, Ahmad A, Murdock L, Nagarwalla D, Forman D. 25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis. BMJ 2024; 384:e076962. [PMID: 38479774 PMCID: PMC10935512 DOI: 10.1136/bmj-2023-076962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To examine and interpret trends in UK cancer incidence and mortality for all cancers combined and for the most common cancer sites in adults aged 35-69 years. DESIGN Retrospective secondary data analysis. DATA SOURCES Cancer registration data, cancer mortality and national population data from the Office for National Statistics, Public Health Wales, Public Health Scotland, Northern Ireland Cancer Registry, NHS England, and the General Register Office for Northern Ireland. SETTING 23 cancer sites were included in the analysis in the UK. PARTICIPANTS Men and women aged 35-69 years diagnosed with or who died from cancer between 1993 to 2018. MAIN OUTCOME MEASURES Change in cancer incidence and mortality age standardised rates over time. RESULTS The number of cancer cases in this age range rose by 57% for men (from 55 014 cases registered in 1993 to 86 297 in 2018) and by 48% for women (60 187 to 88 970) with age standardised rates showing average annual increases of 0.8% in both sexes. The increase in incidence was predominantly driven by increases in prostate (male) and breast (female) cancers. Without these two sites, all cancer trends in age standardised incidence rates were relatively stable. Trends for a small number of less common cancers showed concerning increases in incidence rates, for example, in melanoma skin, liver, oral, and kidney cancers. The number of cancer deaths decreased over the 25 year period, by 20% in men (from 32 878 to 26 322) and 17% in women (28 516 to 23 719); age standardised mortality rates reduced for all cancers combined by 37% in men (-2.0% per year) and 33% in women (-1.6% per year). The largest decreases in mortality were noted for stomach, mesothelioma, and bladder cancers in men and stomach and cervical cancers and non-Hodgkin lymphoma in women. Most incidence and mortality changes were statistically significant even when the size of change was relatively small. CONCLUSIONS Cancer mortality had a substantial reduction during the past 25 years in both men and women aged 35-69 years. This decline is likely a reflection of the successes in cancer prevention (eg, smoking prevention policies and cessation programmes), earlier detection (eg, screening programmes) and improved diagnostic tests, and more effective treatment. By contrast, increased prevalence of non-smoking risk factors are the likely cause of the observed increased incidence for a small number of specific cancers. This analysis also provides a benchmark for the following decade, which will include the impact of covid-19 on cancer incidence and outcomes.
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Affiliation(s)
| | - Ewa Zotow
- University College London, London, UK
| | - Lesley Smith
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | | | | | | | | | | | - David Forman
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
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Tsang HF, Pei XM, Wong YKE, Wong SCC. Plasma Circulating mRNA Profile for the Non-Invasive Diagnosis of Colorectal Cancer Using NanoString Technologies. Int J Mol Sci 2024; 25:3012. [PMID: 38474258 DOI: 10.3390/ijms25053012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/26/2024] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
Colorectal cancer (CRC) is one of the most prevalent cancers and the second leading cause of cancer deaths in developed countries. Early CRC may have no symptoms and symptoms usually appear with more advanced diseases. Regular screening can identify people who are at increased risk of CRC in order to offer earlier treatment. A cost-effective non-invasive platform for the screening and monitoring of CRC patients allows early detection and appropriate treatment of the disease, and the timely application of adjuvant therapy after surgical operation is needed. In this study, a cohort of 71 plasma samples that include 48 colonoscopy- and histopathology-confirmed CRC patients with TNM stages I to IV were recruited between 2017 and 2019. Plasma mRNA profiling was performed in CRC patients using NanoString nCounter. Normalized data were analyzed using a Mann-Whitney U test to determine statistically significant differences between samples from CRC patients and healthy subjects. A multiple-group comparison of clinical phenotypes was performed using the Kruskal-Wallis H test for statistically significant differences between multiple groups. Among the 27 selected circulating mRNA markers, all of them were found to be overexpressed (gene expression fold change > 2) in the plasma of patients from two or more CRC stages. In conclusion, NanoString-based targeted plasma CRC-associated mRNAs circulating the marker panel that can significantly distinguish CRC patients from a healthy population were developed for the non-invasive diagnosis of CRC using peripheral blood samples.
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Affiliation(s)
- Hin Fung Tsang
- Department of Clinical Laboratory and Pathology, Hong Kong Adventist Hospital, Hong Kong SAR, China
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Xiao Meng Pei
- Department of Applied Biology & Chemical Technology, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yin Kwan Evelyn Wong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Sze Chuen Cesar Wong
- Department of Applied Biology & Chemical Technology, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Gangrade S, Sharma PC, Sharma AK, Singh YP. Modified DeeplabV3+ with multi-level context attention mechanism for colonoscopy polyp segmentation. Comput Biol Med 2024; 170:108096. [PMID: 38320340 DOI: 10.1016/j.compbiomed.2024.108096] [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: 09/11/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/08/2024]
Abstract
The development of automated methods for analyzing medical images of colon cancer is one of the main research fields. A colonoscopy is a medical treatment that enables a doctor to look for any abnormalities like polyps, cancer, or inflammatory tissue inside the colon and rectum. It falls under the category of gastrointestinal illnesses, and it claims the lives of almost two million people worldwide. Video endoscopy is an advanced medical imaging approach to diagnose gastrointestinal disorders such as inflammatory bowel, ulcerative colitis, esophagitis, and polyps. Medical video endoscopy generates several images, which must be reviewed by specialists. The difficulty of manual diagnosis has sparked research towards computer-aided techniques that can quickly and reliably diagnose all generated images. The proposed methodology establishes a framework for diagnosing coloscopy diseases. Endoscopists can lower the risk of polyps turning into cancer during colonoscopies by using more accurate computer-assisted polyp detection and segmentation. With the aim of creating a model that can automatically distinguish polyps from images, we presented a modified DeeplabV3+ model in this study to carry out segmentation tasks successfully and efficiently. The framework's encoder uses a pre-trained dilated convolutional residual network for optimal feature map resolution. The robustness of the modified model is tested against state-of-the-art segmentation approaches. In this work, we employed two publicly available datasets, CVC-Clinic DB and Kvasir-SEG, and obtained Dice similarity coefficients of 0.97 and 0.95, respectively. The results show that the improved DeeplabV3+ model improves segmentation efficiency and effectiveness in both software and hardware with only minor changes.
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Affiliation(s)
- Shweta Gangrade
- School of Information Technology, Manipal University Jaipur, Jaipur, Rajasthan, India; School of Computer Science and Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
| | - Prakash Chandra Sharma
- School of Information Technology, Manipal University Jaipur, Jaipur, Rajasthan, India; School of Computer Science and Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
| | - Akhilesh Kumar Sharma
- School of Information Technology, Manipal University Jaipur, Jaipur, Rajasthan, India; School of Computer Science and Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India
| | - Yadvendra Pratap Singh
- School of Information Technology, Manipal University Jaipur, Jaipur, Rajasthan, India; School of Computer Science and Engineering, Manipal University Jaipur, Jaipur, Rajasthan, India.
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Nazarinejad N, Hajikhani B, Vaezi AA, Firoozeh F, Sameni F, Yaslianifard S, Goudarzi M, Dadashi M. Association between colorectal cancer, the frequency of Bacteroides fragilis, and the level of mismatch repair genes expression in the biopsy samples of Iranian patients. BMC Gastroenterol 2024; 24:82. [PMID: 38395750 PMCID: PMC10885486 DOI: 10.1186/s12876-024-03169-z] [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] [Received: 06/05/2023] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Deficient DNA mismatch repair (MMR) can cause microsatellite instability (MSI) and is more common in colorectal cancer (CRC) patients. Understanding the carcinogenic mechanism of bacteria and their impact on cancer cells is crucial. Bacteroides fragilis (B. fragilis) has been identified as a potential promoter of tumorigenesis through the alteration of signaling pathways. This study aims to assess the expression levels of msh2, msh6, mlh1, and the relative frequency of B. fragilis in biopsy samples from CRC patients. MATERIALS AND METHODS Based on the sequence of mlh1, msh2, and msh6 genes, B. fragilis specific 16srRNA and bacterial universal 16srRNA specific primers were selected, and the expression levels of the target genes were analyzed using the Real-Time PCR method. RESULTS Significant increases in the expression levels of mlh1, msh2, and msh6 genes were observed in the cancer group. Additionally, the expression of these MMR genes showed a significant elevation in samples positive for B. fragilis presence. The relative frequency of B. fragilis in the cancer group demonstrated a significant rise compared to the control group. CONCLUSION The findings suggest a potential correlation between the abundance of B. fragilis and alterations in the expression of MMR genes. Since these genes can play a role in modifying colon cancer, investigating microbial characteristics and gene expression changes in CRC could offer a viable solution for CRC diagnosis.
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Affiliation(s)
- Nooshin Nazarinejad
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Bahareh Hajikhani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Vaezi
- Department of Internal Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Farzaneh Firoozeh
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Sameni
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Somayeh Yaslianifard
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mehdi Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Dadashi
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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10
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Rezasoltani S, Azizmohammad Looha M, Asadzadeh Aghdaei H, Jasemi S, Sechi LA, Gazouli M, Sadeghi A, Torkashvand S, Baniali R, Schlüter H, Zali MR, Feizabadi MM. 16S rRNA sequencing analysis of the oral and fecal microbiota in colorectal cancer positives versus colorectal cancer negatives in Iranian population. Gut Pathog 2024; 16:9. [PMID: 38378690 PMCID: PMC10880352 DOI: 10.1186/s13099-024-00604-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/06/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) poses a significant healthcare challenge, accounting for nearly 6.1% of global cancer cases. Early detection, facilitated by population screening utilizing innovative biomarkers, is pivotal for mitigating CRC incidence. This study aims to scrutinize the fecal and salivary microbiomes of CRC-positive individuals (CPs) in comparison to CRC-negative counterparts (CNs) to enhance early CRC diagnosis through microbial biomarkers. MATERIAL AND METHODS A total of 80 oral and stool samples were collected from Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, encompassing both CPs and CNs undergoing screening. Microbial profiling was conducted using 16S rRNA sequencing assays, employing the Nextera XT Index Kit on an Illumina NovaSeq platform. RESULTS Distinct microbial profiles were observed in saliva and stool samples of CPs, diverging significantly from those of CNs at various taxonomic levels, including phylum, family, and species. Saliva samples from CPs exhibited abundance of Calothrix parietina, Granulicatella adiacens, Rothia dentocariosa, and Rothia mucilaginosa, absent in CNs. Additionally, Lachnospiraceae and Prevotellaceae were markedly higher in CPs' feces, while the Fusobacteria phylum was significantly elevated in CPs' saliva. Conversely, the non-pathogenic bacterium Akkermansia muciniphila exhibited a significant decrease in CPs' fecal samples compared to CNs. CONCLUSION Through meticulous selection of saliva and stool microbes based on Mean Decrease GINI values and employing logistic regression for saliva and support vector machine models for stool, we successfully developed a microbiota test with heightened sensitivity and specificity for early CRC detection.
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Grants
- RIGLD1065 Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- RIGLD1065 Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Regione Autonoma della Sardegna, legge regionale 12 dicembre 2022, n. 22 UNISS FAR fondi ricercar 2021, 2022 and Fondazione di Sardegna 2017
- Regione Autonoma della Sardegna, legge regionale 12 dicembre 2022, n. 22 UNISS FAR fondi ricercar 2021, 2022 and Fondazione di Sardegna 2017
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Affiliation(s)
- Sama Rezasoltani
- Section Mass Spectrometric Proteomics, Diagnostic Center, University Medical Center Hamburg-Eppendorf (UKE), 20246, Hamburg, Germany
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH University Hospital, 52057 Aachen, Germany
| | - Mehdi Azizmohammad Looha
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, 19835-178, Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, 19835-178, Iran
| | - Seyedesomayeh Jasemi
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43b, 07100, Sassari, Italy
| | - Leonardo Antonio Sechi
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43b, 07100, Sassari, Italy.
- Struttura Complessa Microbiologia e Virologia, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy.
| | - Maria Gazouli
- Department of Basic Medical Sciences, Laboratory of Biology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Amir Sadeghi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, 19835-178, Iran
| | - Shirin Torkashvand
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, 19835-178, Iran
| | - Reyhaneh Baniali
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, 19835-178, Iran
| | - Hartmut Schlüter
- Section Mass Spectrometric Proteomics, Diagnostic Center, University Medical Center Hamburg-Eppendorf (UKE), 20246, Hamburg, Germany
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, 19835-178, Iran
| | - Mohammad Mehdi Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, 19835-178, Iran.
- Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
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11
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Ciocan RA, Ciocan A, Mihăileanu FV, Ursu CP, Ursu Ș, Bodea C, Cordoș AA, Chiș BA, Al Hajjar N, Dîrzu N, Dîrzu DS. Metabolic Signatures: Pioneering the Frontier of Rectal Cancer Diagnosis and Response to Neoadjuvant Treatment with Biomarkers-A Systematic Review. Int J Mol Sci 2024; 25:2381. [PMID: 38397058 PMCID: PMC10889270 DOI: 10.3390/ijms25042381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Colorectal cancer (CRC) is one of the most aggressive, heterogenous, and fatal types of human cancer for which screening, and more effective therapeutic drugs are urgently needed. Early-stage detection and treatment greatly improve the 5-year survival rate. In the era of targeted therapies for all types of cancer, a complete metabolomic profile is mandatory before neoadjuvant therapy to assign the correct drugs and check the response to the treatment given. The aim of this study is to discover specific metabolic biomarkers or a sequence of metabolomic indicators that possess precise diagnostic capabilities in predicting the efficacy of neoadjuvant therapy. After searching the keywords, a total of 108 articles were identified during a timeframe of 10 years (2013-2023). Within this set, one article was excluded due to the use of non-English language. Six scientific papers were qualified for this investigation after eliminating all duplicates, publications not referring to the subject matter, open access restriction papers, and those not applicable to humans. Biomolecular analysis found a correlation between metabolomic analysis of colorectal cancer samples and poor progression-free survival rates. Biomarkers are instrumental in predicting a patient's response to specific treatments, guiding the selection of targeted therapies, and indicating resistance to certain drugs.
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Affiliation(s)
- Răzvan Alexandru Ciocan
- Department of Surgery-Practical Abilities, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania;
| | - Andra Ciocan
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania; (F.V.M.); (C.-P.U.); (Ș.U.); (C.B.); (N.A.H.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania
| | - Florin Vasile Mihăileanu
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania; (F.V.M.); (C.-P.U.); (Ș.U.); (C.B.); (N.A.H.)
| | - Cristina-Paula Ursu
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania; (F.V.M.); (C.-P.U.); (Ș.U.); (C.B.); (N.A.H.)
| | - Ștefan Ursu
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania; (F.V.M.); (C.-P.U.); (Ș.U.); (C.B.); (N.A.H.)
| | - Cătălin Bodea
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania; (F.V.M.); (C.-P.U.); (Ș.U.); (C.B.); (N.A.H.)
| | | | - Bogdan Augustin Chiș
- Department of Internal Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania;
| | - Nadim Al Hajjar
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania; (F.V.M.); (C.-P.U.); (Ș.U.); (C.B.); (N.A.H.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania
| | - Noemi Dîrzu
- Clinical Laboratory Department, Transilvania Hospital, 400486 Cluj-Napoca, Romania
| | - Dan-Sebastian Dîrzu
- Emergency County Hospital Cluj, 400006 Cluj-Napoca, Romania;
- STAR—UBB Institute, Babeș Bolyai University, 400084 Cluj-Napoca, Romania
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12
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Zhang J, Sun H, Xiong F, Lei S, Zhou G, Xiao X, Liu L, Wang P. The absolute number of small and diminutive adenomas with high-grade dysplasia is substantially higher compared with large adenomas: a retrospective pooled study. Front Oncol 2024; 14:1294745. [PMID: 38410098 PMCID: PMC10896556 DOI: 10.3389/fonc.2024.1294745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/22/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction The risk that a large polyp (≥10 mm) evolves into high-grade dysplasia (HGD) is relatively high compared with that of a small/diminutive polyp (<10 mm). Recently, the detection of small and diminutive polyps has been substantially improved with the advancement of endoscopy. However, further research is needed on the role of the incidence of HGD caused by the co-occurrence of small and diminutive polyps in the progression of HGD. In this study, we aim to investigate whether and how the small and diminutive polyps correlate with the incidence of HGD in the population. Methods The pooled data were deeply analyzed from four published randomized controlled trials (RCTs) regarding colon polyp detection. All polyps detected were examined and confirmed by pathologists. The primary outcome was the composition ratio of the HGD polyps in each polyp size category. Results Among a total of 3,179 patients with 2,730 polyps identified, there were 83 HGD polyps confirmed, and 68 patients had at least one polyp with HGD. The risk of development of HGD was lower for a single small and diminutive polyp than for one large polyp (2.18% vs. 22.22%, P < 0.0001). On the contrary, the composition ratio for HGD from small and diminutive polyps was significantly higher than that from the large ones (68.67% vs. 31.33%, P < 0.0001). The combined number of HGD presented a trend negatively correlated to size. Conclusions Our data demonstrated that the absolute number of HGD significantly derives more from small and diminutive polyps than from the large ones, and the collective number of small and diminutive polyps per patient is indicative of his/her HGD exposure. These findings positively provide novel perspectives on the management of polyps and may further optimize the prevention of colorectal cancer. Systematic Review Registration http://www.chictr.org.cn, identifier ChiCTR1900025235, ChiCTR1800017675, ChiCTR1800018058, and ChiCTR1900023086.
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Affiliation(s)
- Jiancheng Zhang
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Huajun Sun
- Department of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Fei Xiong
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Shan Lei
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Guanyu Zhou
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xun Xiao
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Lin Liu
- Institute of Natural Sciences, MOE-LSC, School of Mathematical Sciences, CMA-Shanghai, and SJTU-Yale Joint Center for Biostatistics and Data Science, Shanghai Jiao Tong University, Shanghai, China and Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Pu Wang
- Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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13
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Galadima H, Anson-Dwamena R, Johnson A, Bello G, Adunlin G, Blando J. Machine Learning as a Tool for Early Detection: A Focus on Late-Stage Colorectal Cancer across Socioeconomic Spectrums. Cancers (Basel) 2024; 16:540. [PMID: 38339293 PMCID: PMC10854986 DOI: 10.3390/cancers16030540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
PURPOSE To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against the backdrop of socio-economic and regional healthcare disparities. METHODS An innovative theoretical framework was developed to integrate individual- and census tract-level social determinants of health (SDOH) with sociodemographic factors. A comparative analysis of the ML models was conducted using key performance metrics such as AUC-ROC to evaluate their predictive accuracy. Spatio-temporal analysis was used to identify disparities in late-stage CRC diagnosis probabilities. RESULTS Gradient boosting emerged as the superior model, with the top predictors for late-stage CRC diagnosis being anatomic site, year of diagnosis, age, proximity to superfund sites, and primary payer. Spatio-temporal clusters highlighted geographic areas with a statistically significant high probability of late-stage diagnoses, emphasizing the need for targeted healthcare interventions. CONCLUSIONS This research underlines the potential of ML in enhancing the prognostic predictions in oncology, particularly in CRC. The gradient boosting model, with its robust performance, holds promise for deployment in healthcare systems to aid early detection and formulate localized cancer prevention strategies. The study's methodology demonstrates a significant step toward utilizing AI in public health to mitigate disparities and improve cancer care outcomes.
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Affiliation(s)
- Hadiza Galadima
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (R.A.-D.); (A.J.); (J.B.)
| | - Rexford Anson-Dwamena
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (R.A.-D.); (A.J.); (J.B.)
| | - Ashley Johnson
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (R.A.-D.); (A.J.); (J.B.)
| | - Ghalib Bello
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Georges Adunlin
- Department of Pharmaceutical, Social and Administrative Sciences, Samford University, Birmingham, AL 35229, USA;
| | - James Blando
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (R.A.-D.); (A.J.); (J.B.)
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14
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Huang BL, Wei LF, Lin YW, Huang LS, Qu QQ, Li XH, Chu LY, Xu YW, Wang WD, Peng YH, Wu FC. Serum IGFBP-1 as a promising diagnostic and prognostic biomarker for colorectal cancer. Sci Rep 2024; 14:1839. [PMID: 38246959 PMCID: PMC10800337 DOI: 10.1038/s41598-024-52220-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
Our previous study showed that levels of circulating insulin-like growth factor binding protein-1 (IGFBP-1) has potential diagnostic value for early-stage upper gastrointestinal cancers. This study aimed to assess whether serum IGFBP-1 is a potential diagnostic and prognostic biomarker for CRC patients. IGFBP-1 mRNA expression profile data of peripheral blood in colorectal cancer (CRC) patients were downloaded and analyzed from Gene Expression Omnibus database. We detected serum IGFBP-1 in 138 CRC patients and 190 normal controls using enzyme-linked immunosorbent assay. Blood IGFBP-1 mRNA levels were higher in CRC patients than those in normal controls (P = 0.027). In addition, serum IGFBP-1 protein levels in the CRC group were significantly higher than those in normal control group (P < 0.0001). Serum IGFBP-1 demonstrated better diagnostic accuracy for all CRC and early-stage CRC, respectively, when compared with carcinoembryonic antigen (CEA), carbohydrate antigen19-9 (CA 19-9) or the combination of CEA and CA19-9. Furthermore, Cox multivariate analysis revealed that serum IGFBP-1 was an independent prognostic factor for OS (HR = 2.043, P = 0.045). Our study demonstrated that serum IGFBP-1 might be a potential biomarker for the diagnosis and prognosis of CRC. In addition, the nomogram might be helpful to predict the prognosis of CRC.
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Affiliation(s)
- Bin-Liang Huang
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, China
| | - Lai-Feng Wei
- Department of Clinical Laboratory Medicine, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, China
| | - Yi-Wei Lin
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, China
| | - Li-Sheng Huang
- Department of Radiation Oncology, The Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, 515041, China
| | - Qi-Qi Qu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, China
| | - Xin-Hao Li
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, China
| | - Ling-Yu Chu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, China
| | - Yi-Wei Xu
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, China
- Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - Wei-Dong Wang
- Department of Bone and Soft Tissue Oncology Surgery, The Cancer Hospital of Shantou University Medical College, Shantou, China.
| | - Yu-Hui Peng
- Department of Clinical Laboratory Medicine, The Cancer Hospital of Shantou University Medical College, Shantou, China.
- Precision Medicine Research Center, Shantou University Medical College, Shantou, China.
- Guangdong Esophageal Cancer Institute, Guangzhou, China.
| | - Fang-Cai Wu
- Department of Radiation Oncology, The Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou, 515041, China.
- Guangdong Esophageal Cancer Institute, Guangzhou, China.
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15
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Cui J, Ding R, Liu H, Ma M, Zuo R, Liu X. Trends in the incidence and survival of cancer in individuals aged 55 years and older in the United States, 1975-2019. BMC Public Health 2024; 24:72. [PMID: 38172749 PMCID: PMC10763484 DOI: 10.1186/s12889-023-17571-x] [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: 07/09/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND In ageing societies such as the United States, evaluating the incidence and survival rates of cancer in older adults is essential. This study aimed to analyse the incidence and survival rates of cancer in individuals aged 55 years or older in the United States. METHODS This retrospective study (1975-2019) was conducted using combined registry data from the Surveillance, Epidemiology, and End Results database. Data from the 9, 12, and 17 Registries (Nov 2021 Sub) datasets were used. RESULTS In 2019, the incidence of cancer in individuals older than 55 years and the overall population was 1322.8 and 382.1 per 100,000 population, respectively. From 2000 to 2019, the incidence of cancer in individuals older than 55 years showed a decreasing trend, whereas their five-year survival rates showed an increasing trend. The incidence of cancer in the 75-79 and 80-84 year age groups was the highest among all age groups. CONCLUSIONS The incidence of colon cancer declined significantly, whereas that of intrahepatic bile duct cancer increased considerably. These trends may be due to increased screening for cancers with high incidence rates and improved control of the risk factors for cancer. Rapid development of targeted therapy and immunotherapy combined with early tumour detection may be an important reason for the improved survival rates.
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Affiliation(s)
- Junpeng Cui
- Department of General Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Rongmei Ding
- Department of Oncology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Haifeng Liu
- Department of General Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Mingxiu Ma
- Department of General Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Ruixue Zuo
- Department of General Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Xun Liu
- Department of General Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China.
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16
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Akonde M, Mishio Bawa E, Dakurah OB, Das Gupta R. Impact of family history of cancer on colorectal cancer screening: a propensity score-matched analysis from the Health Information National Trends Survey (HINTS). J Egypt Natl Canc Inst 2023; 35:38. [PMID: 38072859 DOI: 10.1186/s43046-023-00201-3] [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: 09/16/2022] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Early detection of colon cancer leads to better survival outcomes. This can be achieved through colorectal cancer (CRC) screening. People with a family history of cancer (FHC) have increased risk of developing CRC. Increasing screening in this group will reduce CRC mortality. This study evaluated CRC screening in people with FHC. METHODS The study used data from the Health Information National Trends Survey (HINTS) 5, cycle 3. This is an annual cross-sectional survey with a nationally representative sample of American adults. The objective was to study the association between FHC and performing CRC screening. Propensity score matching was used to create a matched population with variables that constituted beliefs in cancer from the survey. Replication procedure, which is based on repeated sampling and allows for accurate computation of standard errors, was used for calculating statistical tests. Multivariable models were fitted in the matched population to assess the association between FHC and performing CRC screening. RESULTS People with FHC were 14% (OR = 1.14; 95% CI: 0.81-1.60) more likely to perform CRC screening than those without FHC, even though not statistically significant. Age in years (OR = 1.14; 95% CI: 1.12-5.27) had increased likelihood of performing CRC screening, while other races such as American Indians/Alaskan Natives (except African Americans) compared to Caucasians (OR = 0.49; 95% CI: 0.29-0.84) had significantly decreased likelihood of performing CRC screening. CONCLUSION FHC was not significantly associated with having a colorectal cancer screening test. Public health advocacy should be directed towards increasing awareness of CRC screening among people with FHC.
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Affiliation(s)
- Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Eric Mishio Bawa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ottovon Bismark Dakurah
- Center for Bioinformatics and Computational Biology, Stellenbosch University, Stellenbosch, South Africa
| | - Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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17
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Wang C, Zhao S, Bai Y. Challenges to the Fecal Occult Blood Test: Where Is the Way Forward? Gastroenterology 2023; 165:1578-1579. [PMID: 37558141 DOI: 10.1053/j.gastro.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Chenglong Wang
- Department of Colorectal Surgery and GI Endoscopy Center, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China; Department of Gastroenterology and GI Endoscopy Center, Xiamen University Affiliated Chenggong Hospital (Chinese PLA 73rd Army Corps Hospital), Xiamen, Fujian, China
| | - Shengbing Zhao
- Department of Gastroenterology, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
| | - Yu Bai
- Department of Gastroenterology, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
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18
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Wong MCS, Leung EYM, Chun SCC, Deng Y, Lam T, Tang RSY, Huang J. Risk of recurrent advanced colorectal neoplasia in individuals with baseline non-advanced neoplasia followed up at 5 vs 7-10 years. J Gastroenterol Hepatol 2023; 38:2122-2129. [PMID: 37771047 DOI: 10.1111/jgh.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/10/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND AND AIM Colorectal cancer (CRC) is one of the commonest cancers, especially among the Asian populations. We compared the recurrence rate of advanced colorectal neoplasia (ACN) at 5 year vs 7-10 years among individuals with non-advanced adenoma (NAA) detected and polypectomized at baseline colonoscopy in a large Chinese population. METHODS We extracted data of a large Chinese population with NAA polypectomized who received surveillance colonoscopy after 5 or 7-10 years from a large database (2008-2018). The outcome variable included recurrence of ACN at surveillance colonoscopy. We examined the association between length of surveillance and the outcome variable, whilst controlling for risk factors of colorectal cancer. RESULTS We include 109 768 subjects who have received a baseline colonoscopy from our dataset. They were aged 67.35 (SD 9.84) years, and 60.9% of them were male subjects. The crude 5-year and 10-year recurrence rate of ACN was 1.50% and 2.42%, respectively (crude odds ratio = 1.629, 95% CI 1.362 to 1.949, P < 0.001). From the binary logistic regression model, individuals with surveillance colonoscopy performed at 10 years had a statistically higher recurrence rate of ACN than those followed-up at 5 year (adjusted odds ratio [aOR] = 1.544, 95% CI 1.266 to 1.877, P < 0.001), but the effect size of aOR is small. CONCLUSIONS There is a small difference in recurrence of ACN between individuals who received colonoscopy workup at 5 years vs 7-10 years. These findings support a 7-10 years surveillance period after baseline NAA was polypectomized.
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Affiliation(s)
- Martin C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
- The Chinese Academy of Medical Sciences and The Peking Union Medical College, Hong Kong, China
- The School of Public Health, The Peking University, Hong Kong, China
| | - Eman Yee-Man Leung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Sam C C Chun
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Yunyang Deng
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Thomas Lam
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
- S.H. Ho Centre for Digestive Health, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China
| | - Raymond S Y Tang
- S.H. Ho Centre for Digestive Health, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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19
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Kumarasamy G, Mohd Salim NH, Mohd Afandi NS, Hazlami Habib MA, Mat Amin ND, Ismail MN, Musa M. Glycoproteomics-based liquid biopsy: translational outlook for colorectal cancer clinical management in Southeast Asia. Future Oncol 2023; 19:2313-2332. [PMID: 37937446 DOI: 10.2217/fon-2023-0704] [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: 11/09/2023] Open
Abstract
Colorectal cancer (CRC) signifies a significant healthcare challenge in Southeast Asia. Despite advancements in screening approaches and treatment modalities, significant medical gaps remain, ranging from prevention and early diagnosis to determining targeted therapy and establishing personalized approaches to managing CRC. There is a need to expand more validated biomarkers in clinical practice. An advanced technique incorporating high-throughput mass spectrometry as a liquid biopsy to unravel a repertoire of glycoproteins and glycans would potentially drive the development of clinical tools for CRC screening, diagnosis and monitoring, and it can be further adapted to the existing standard-of-care procedure. Therefore this review offers a perspective on glycoproteomics-driven liquid biopsy and its potential integration into the clinical care of CRC in the southeast Asia region.
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Affiliation(s)
- Gaayathri Kumarasamy
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Pulau Pinang, 11800, Malaysia
| | - Nurul Hakimah Mohd Salim
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Nur Syafiqah Mohd Afandi
- Analytical Biochemistry Research Centre, Universiti Sains Malaysia, Bayan Lepas, Pulau Pinang, 11900, Malaysia
| | - Mohd Afiq Hazlami Habib
- Analytical Biochemistry Research Centre, Universiti Sains Malaysia, Bayan Lepas, Pulau Pinang, 11900, Malaysia
| | - Nor Datiakma Mat Amin
- Analytical Biochemistry Research Centre, Universiti Sains Malaysia, Bayan Lepas, Pulau Pinang, 11900, Malaysia
- Nature Products Division, Forest Research Institute Malaysia, Kepong, Selangor, 52109, Malaysia
| | - Mohd Nazri Ismail
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Pulau Pinang, 11800, Malaysia
- Analytical Biochemistry Research Centre, Universiti Sains Malaysia, Bayan Lepas, Pulau Pinang, 11900, Malaysia
| | - Marahaini Musa
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
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Duzkoylu Y, Kılavuz H, Demircioglu MK, Arıkan S, Sarı S. Colonoscopy following the positron emission tomography/computed tomography scan in patients with incidental colorectal uptake: what is the most effective management? REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230302. [PMID: 37729363 PMCID: PMC10508895 DOI: 10.1590/1806-9282.20230302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/01/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Colorectal cancer is one of the most common malignancies. Survival rates are directly related to the stage of cancer at the time of diagnosis, emphasizing the value of early diagnosis. Positron emission tomography with 18F-fluorodeoxyglucose is the gold standard imaging technique in staging, monitoring after treatment, and follow-up. We aimed to assess the importance of incidental 18F-fluorodeoxyglucose uptake by colon and rectum in positron emission tomography-computed tomography imaging to determine a significant cutoff value for further investigation using colonoscopy and histopathological assessment. METHODS We performed a retrospective analysis of patients with both 18F-fluorodeoxyglucose-positron emission tomography/computed tomography scan and colonoscopy during 1 year and included the cases who had undergone a colonoscopy within 3 months following the positron emission tomography/computed tomography scan due to an incidental positive finding. Patients with a diagnosed colorectal malignancy or with a history of previous colorectal operations were excluded. RESULTS A total of 81 patients were included in this study. Among 81 colonoscopic evaluations, histopathology revealed malignancy in 8 patients, and the prevalence of incidental colorectal cancer 18F-fluorodeoxyglucose uptake was found to be 9.87%. SUVmax was found to be significantly related to malignancy and other colonoscopic findings (p<0.001). SUVmax cutoff value to suggest colorectal cancer was found to be median [7.9 (4.1-12.7)] (p<0.001). CONCLUSION Regarding the studies determining a significant cutoff value, incidental colonic 18F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography should lead the clinician to further investigation with colonoscopic biopsy, although the cutoff values for SUVmax are not certain and different in almost every published study, and negative positron emission tomography.computed tomography findings should not completely rule out malignancy, especially in high-risk patients.
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Affiliation(s)
- Yigit Duzkoylu
- Cam and Sakura City Hospital, Department of Gastrointestinal Surgery – Istanbul, Turkey
| | - Huseyin Kılavuz
- Cam and Sakura City Hospital, Department of General Surgery – Istanbul, Turkey
| | | | - Soykan Arıkan
- Cam and Sakura City Hospital, Department of Surgical Oncology – Istanbul, Turkey
| | - Serkan Sarı
- Cam and Sakura City Hospital, Department of General Surgery – Istanbul, Turkey
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Zhang S, Wu J, Shi E, Yu S, Gao Y, Li LC, Kuo LR, Pomeroy MJ, Liang ZJ. MM-GLCM-CNN: A multi-scale and multi-level based GLCM-CNN for polyp classification. Comput Med Imaging Graph 2023; 108:102257. [PMID: 37301171 DOI: 10.1016/j.compmedimag.2023.102257] [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: 02/07/2023] [Revised: 05/04/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
Distinguishing malignant from benign lesions has significant clinical impacts on both early detection and optimal management of those early detections. Convolutional neural network (CNN) has shown great potential in medical imaging applications due to its powerful feature learning capability. However, it is very challenging to obtain pathological ground truth, addition to collected in vivo medical images, to construct objective training labels for feature learning, leading to the difficulty of performing lesion diagnosis. This is contrary to the requirement that CNN algorithms need a large number of datasets for the training. To explore the ability to learn features from small pathologically-proven datasets for differentiation of malignant from benign polyps, we propose a Multi-scale and Multi-level based Gray-level Co-occurrence Matrix CNN (MM-GLCM-CNN). Specifically, instead of inputting the lesions' medical images, the GLCM, which characterizes the lesion heterogeneity in terms of image texture characteristics, is fed into the MM-GLCN-CNN model for the training. This aims to improve feature extraction by introducing multi-scale and multi-level analysis into the construction of lesion texture characteristic descriptors (LTCDs). To learn and fuse multiple sets of LTCDs from small datasets for lesion diagnosis, we further propose an adaptive multi-input CNN learning framework. Furthermore, an Adaptive Weight Network is used to highlight important information and suppress redundant information after the fusion of the LTCDs. We evaluated the performance of MM-GLCM-CNN by the area under the receiver operating characteristic curve (AUC) merit on small private lesion datasets of colon polyps. The AUC score reaches 93.99% with a gain of 1.49% over current state-of-the-art lesion classification methods on the same dataset. This gain indicates the importance of incorporating lesion characteristic heterogeneity for the prediction of lesion malignancy using small pathologically-proven datasets.
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Affiliation(s)
- Shu Zhang
- Center for Brain and Brain-Inspired Computing Research, School of Computer Science, Northwestern Polytechnical University, Xi'an 710000, China.
| | - Jinru Wu
- Center for Brain and Brain-Inspired Computing Research, School of Computer Science, Northwestern Polytechnical University, Xi'an 710000, China
| | - Enze Shi
- Center for Brain and Brain-Inspired Computing Research, School of Computer Science, Northwestern Polytechnical University, Xi'an 710000, China
| | - Sigang Yu
- Center for Brain and Brain-Inspired Computing Research, School of Computer Science, Northwestern Polytechnical University, Xi'an 710000, China
| | - Yongfeng Gao
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Lihong Connie Li
- Department of Engineering & Environmental Science, City University of New York, Staten Island, NY 10314, USA
| | - Licheng Ryan Kuo
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA; Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Marc Jason Pomeroy
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA; Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Zhengrong Jerome Liang
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA; Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
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Tokuhara M, Shimatani M, Tominaga K, Nakahira H, Ohtsu T, Kouda K, Naganuma M. Evaluation of a new method, "non-injection resection using bipolar soft coagulation mode (NIRBS)", for colonic adenomatous lesions. Clin Endosc 2023; 56:623-632. [PMID: 37524565 PMCID: PMC10565442 DOI: 10.5946/ce.2022.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/21/2022] [Accepted: 12/16/2022] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND/AIMS Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called "non-injection resection using bipolar soft coagulation mode (NIRBS)" method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method. METHODS We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer. RESULTS A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1-35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation. CONCLUSIONS NIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.
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Affiliation(s)
- Mitsuo Tokuhara
- Department of Gastroenterology, Japan Community Healthcare Organization Hoshigaoka Medical Center, Osaka, Japan
- Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University Hirakata Hospital, Osaka, Japan
| | - Masaaki Shimatani
- Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University Hirakata Hospital, Osaka, Japan
| | - Kazunari Tominaga
- Department of Gastroenterology, Japan Community Healthcare Organization Hoshigaoka Medical Center, Osaka, Japan
| | - Hiroko Nakahira
- Department of Gastroenterology, Japan Community Healthcare Organization Hoshigaoka Medical Center, Osaka, Japan
| | - Takuya Ohtsu
- Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University Hirakata Hospital, Osaka, Japan
| | - Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University Hirakata Hospital, Osaka, Japan
| | - Makoto Naganuma
- Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University Hirakata Hospital, Osaka, Japan
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He Y, Xu T, Fang J, Tong L, Gao W, Zhang Y, Wang Y, Xu Y, Shi S, Liu S, Jin L. Trends in colorectal cancer screening in the United States, 2012 to 2020. J Med Screen 2023; 30:125-133. [PMID: 37157812 DOI: 10.1177/09691413231174163] [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: 05/10/2023]
Abstract
OBJECTIVES Despite recommendations to increase the uptake of colorectal cancer (CRC) screening, trends in CRC screening vary with sociodemographic status. We aimed to evaluate trends in CRC screening in the US population and subpopulations. METHODS A total of 1,082,924 participants aged 50 to 75 from five cycles (2012, 2014, 2016, 2018, and 2020) of the Behavioral Risk Factor Surveillance System were involved. Multivariable logistic regression models were performed to evaluate linear trends in CRC screening utilization from 2012 to 2018. Rao-Scott chi-square tests were used to assess the differences in CRC screening utilization between 2018 and 2020. RESULTS The estimated percentage reporting up-to-date with CRC screening increased significantly (P for trend <0.001), from 62.8% (95% CI, 62.4%-63.2%) in 2012 to 66.7% (95% CI, 66.3%-67.2%) in 2018 and 70.4% (95% CI, 69.8%-71.0%) in 2020, in accordance with 2008 US Preventive Services Task Force recommendations. Trends followed similar patterns in most subgroups, although with different magnitudes in several subgroups, primarily those underweight showed a stable percentage over time (P for trend = 0.170). In 2020, 72.4% of participants reported they were up to date with CRC screening, including the utilization of stool DNA tests and virtual colonoscopy. Colonoscopy was the most commonly used test in 2020 (64.5%), followed by FOBT (12.6%), stool DNA test (5.8%), sigmoidoscopy (3.8%), and virtual colonoscopy (2.7%). CONCLUSIONS In this nationally representative survey of the US population from 2012 through 2020, the percentage reporting up to date with CRC screening has increased, but not equally among all subgroups.
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Affiliation(s)
- Yue He
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Tong Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Li Tong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Wenhui Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yanfang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Shunyao Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Siyu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
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Imran M, Baig M, Alshuaibi RO, Almohammadi TA, Albeladi SA, Zaafarani FTM. Knowledge and awareness about colorectal cancer and barriers to its screening among a sample of general public in Saudi Arabia. PLoS One 2023; 18:e0290269. [PMID: 37611015 PMCID: PMC10446202 DOI: 10.1371/journal.pone.0290269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/04/2023] [Indexed: 08/25/2023] Open
Abstract
INTRODUCTION The present study investigated knowledge, awareness, and barriers to colorectal cancer (CRC) screening from a sample of the general population in Saudi Arabia. METHODS This cross-sectional study was conducted between August 2022 and January 2023 among a sample of the general population in Jeddah, Saudi Arabia. The questionnaire consisted of demographics, knowledge and awareness, and questions about CRC screening barriers. RESULTS A total of 1105 adults belonged to the general public [505 females (45.7%) and 600 males (54.3%)] recruited in this survey. The mean age of the respondents was 39.79±12.49. The internet was the primary source of CC information for most participants, 661(59.8%). Gender-wise comparison of general public responses regarding CRC knowledge and awareness and barriers to screening showed a mixed response. Analysis of participants' knowledge regarding CRC and its risk factors and warning signs showed that 356(32.2%) people believed that the best age for the CRC test is 41-50 years, and 285(25.8%) responded they don't know. Almost half of the participants, 539(48.8%), were not interested in attending awareness seminars about CRC, while 371(33.6%) were interested in attending awareness seminars about CRC. Only one-third of the respondents, 368(33.3%), knew of any tests or examinations used to detect CRC. Participants' perceptions about colonoscopy-related and FOBT-related barriers to CRC screening disclosed that these are time-consuming, expensive, painful, embarrassing, etc. CONCLUSION Insufficient information, poor awareness, and several assumed barriers to CRC screening were found among study participants. There is a need to close knowledge gaps and offer them comprehensive information regarding CRC, as well as the availability and benefits of screening. In this aspect, social media can be extremely beneficial.
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Affiliation(s)
- Muhammad Imran
- Department of Surgery, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | - Samah Abdulsalam Albeladi
- 6 Year Medical Student, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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Kusnik A, Renjithlal SLM, Chodos A, Shanmukhappa SC, Eid MM, Renjith KM, Alweis R. Trends in Colorectal Cancer Mortality in the United States, 1999 - 2020. Gastroenterology Res 2023; 16:217-225. [PMID: 37691750 PMCID: PMC10482602 DOI: 10.14740/gr1631] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/14/2023] [Indexed: 09/12/2023] Open
Abstract
Background The United States faces a significant public health issue with colorectal cancer (CRC), which remains the third leading cause of cancer-related fatalities despite early diagnosis and treatment progress. Methods This investigation utilized death certificate data from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) database to investigate trends in CRC mortality and location of death from 1999 to 2020. Additionally, the study utilized the annual percent change (APC) to estimate the average annual rate of change over the specific time period for the given health outcome. Incorporating the location of death in this study served the purpose of identifying patterns related to CRC and offering valuable insights into the specific locations where deaths occurred. Results Between 1999 and 2020, there were 1,166,158 CRC-related deaths. The age-adjusted mortality rates (AAMRs) for CRC consistently declined from 20.7 in 1999 to 12.5 in 2020. Men had higher AAMR (18.8) than women (13.4) throughout the study. Black or African American patients had the highest AAMR (21.1), followed by White (15.4), Hispanic/Latino (11.8), American Indian or Alaska native (11.4), and Asian or Pacific Islanders (10.2). The location of death varied, with 41.99% at home, 28.16% in medical facilities, 16.6% in nursing homes/long-term care facilities, 7.43% in hospices, and 5.80% at other/unknown places. Conclusion There has been an overall improvement in AAMR among most ethnic groups, but an increase in AAMR has been observed among white individuals below the age of 55. Notably, over one-quarter of CRC-related deaths occur in medical facilities.
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Affiliation(s)
- Alexander Kusnik
- Department of Internal Medicine, Unity Hospital, Rochester, NY, USA
| | | | - Ari Chodos
- Department of Internal Medicine, Unity Hospital, Rochester, NY, USA
| | | | | | | | - Richard Alweis
- Department of Internal Medicine, Unity Hospital, Rochester, NY, USA
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Yoon SL, Grundmann O. Relevance of Dietary Supplement Use in Gastrointestinal-Cancer-Associated Cachexia. Nutrients 2023; 15:3391. [PMID: 37571328 PMCID: PMC10421404 DOI: 10.3390/nu15153391] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Cancer cachexia is a multi-organ syndrome with unintentional weight loss, sarcopenia, and systemic inflammation. Gastrointestinal (GI) cancer patients are more susceptible to cachexia development due to impaired nutrient absorption and digestion. Given the widespread availability and relatively low cost of dietary supplements, we examined the evidence and effects of fish oil (omega-3 fatty acids), melatonin, probiotics, and green tea for managing symptoms of GI cancer cachexia. A literature review of four specific supplements was conducted using PubMed, Google Scholar, and CINAHL without a date restriction. Of 4621 available literature references, 26 articles were eligible for review. Fish oil decreased C-reactive protein and maintained CD4+ cell count, while melatonin indicated inconsistent findings on managing cachexia, but was well-tolerated. Probiotics decreased serum pro-inflammatory biomarkers and increased the tolerability of chemotherapy by reducing side effects. Green tea preparations and extracts showed a decreased risk of developing various cancers and did not impact tumor growth, survival, or adverse effects. Among these four supplements, probiotics are most promising for further research in preventing systemic inflammation and maintaining adequate absorption of nutrients to prevent the progression of cancer cachexia. Supplements may benefit treatment outcomes in cancer cachexia without side effects while supporting nutritional and therapeutic needs.
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Affiliation(s)
- Saunjoo L. Yoon
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32610, USA;
| | - Oliver Grundmann
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32610, USA;
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA
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Cronin O, Bourke MJ. Endoscopic Management of Large Non-Pedunculated Colorectal Polyps. Cancers (Basel) 2023; 15:3805. [PMID: 37568621 PMCID: PMC10417738 DOI: 10.3390/cancers15153805] [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: 06/13/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
Large non-pedunculated colorectal polyps ≥20 mm (LNPCPs) comprise approximately 1% of all colorectal polyps. LNPCPs more commonly contain high-grade dysplasia, covert and overt cancer. These lesions can be resected using several means, including conventional endoscopic mucosal resection (EMR), cold-snare EMR (C-EMR) and endoscopic submucosal dissection (ESD). This review aimed to provide a comprehensive, critical and objective analysis of ER techniques. Evidence-based, selective resection algorithms should be used when choosing the most appropriate technique to ensure the safe and effective removal of LNPCPs. Due to its enhanced safety and comparable efficacy, there has been a paradigm shift towards cold-snare polypectomy (CSP) for the removal of small polyps (<10 mm). This technique is now being applied to the management of LNPCPs; however, further research is required to define the optimal LNPCP subtypes to target and the viable upper size limit. Adjuvant techniques, such as thermal ablation of the resection margin, significantly reduce recurrence risk. Bleeding risk can be mitigated using through-the-scope clips to close defects in the right colon. Endoscopic surveillance is important to detect recurrence and synchronous lesions. Recurrence can be readily managed using an endoscopic approach.
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Affiliation(s)
- Oliver Cronin
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Clinical School, University of Sydney, Sydney, NSW 2145, Australia
| | - Michael J. Bourke
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Clinical School, University of Sydney, Sydney, NSW 2145, Australia
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Jain A, Bhattacharya S. Recent advances in nanomedicine preparative methods and their therapeutic potential for colorectal cancer: a critical review. Front Oncol 2023; 13:1211603. [PMID: 37427139 PMCID: PMC10325729 DOI: 10.3389/fonc.2023.1211603] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Colorectal cancer (CRC) is a prevalent malignancy that affects a large percentage of the global population. The conventional treatments for CRC have a number of limitations. Nanoparticles have emerged as a promising cancer treatment method due to their ability to directly target cancer cells and regulate drug release, thereby enhancing therapeutic efficacy and minimizing side effects. This compilation examines the use of nanoparticles as drug delivery systems for CRC treatment. Different nanomaterials can be used to administer anticancer drugs, including polymeric nanoparticles, gold nanoparticles, liposomes, and solid lipid nanoparticles. In addition, we discuss recent developments in nanoparticle preparation techniques, such as solvent evaporation, salting-out, ion gelation, and nanoprecipitation. These methods have demonstrated high efficacy in penetrating epithelial cells, a prerequisite for effective drug delivery. This article focuses on the various targeting mechanisms utilized by CRC-targeted nanoparticles and their recent advancements in this field. In addition, the review offers descriptive information regarding numerous nano-preparative procedures for colorectal cancer treatments. We also discuss the outlook for innovative therapeutic techniques in the management of CRC, including the potential application of nanoparticles for targeted drug delivery. The review concludes with a discussion of current nanotechnology patents and clinical studies used to target and diagnose CRC. The results of this investigation suggest that nanoparticles have great potential as a method of drug delivery for the treatment of colorectal cancer.
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Joo HJ, Seok JU, Kim BC, Lee DE, Kim B, Han KS, Hong CW, Sohn DK, Lee DW, Park SC, Chang HJ, Oh JH. Effects of prior endoscopic resection on recurrence in patients with T1 colorectal cancer who underwent radical surgery. Int J Colorectal Dis 2023; 38:167. [PMID: 37300565 DOI: 10.1007/s00384-023-04448-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Endoscopic resection (ER) is a reliable treatment for early colorectal cancer without lymph node metastasis. We aimed to examine the effects of ER performed prior to T1 colorectal cancer (T1 CRC) surgery by comparing long-term survival after radical surgery with prior ER to that after radical surgery alone. METHODS This retrospective study included patients who underwent surgical resection of T1 CRC at the National Cancer Center, Korea, between 2003 and 2017. All eligible patients (n = 543) were divided into primary and secondary surgery groups. To ensure similar characteristics between the groups, 1:1 propensity score matching was used. Baseline characteristics, gross and histological features, along with postoperative recurrence-free survival (RFS) between the two groups were compared. Cox proportional hazard model was used to identify the risk factors affecting recurrence after surgery. Cost analysis was performed to examine the cost-effectiveness of ER and radical surgeries. RESULTS No significant differences were observed in 5-year RFS between the two groups in matched data (96.9% vs. 95.5%, p = 0.596) and in the unadjusted model (97.2% vs. 96.8%, p = 0.930). This difference was also similar in subgroup analyses based on node status and high-risk histologic features. ER before surgery did not increase the medical costs of radical surgery. CONCLUSION ER prior to radical surgery did not affect the long-term oncologic outcomes of T1 CRC or significantly increased the medical costs. Attempting ER first for suspected T1 CRC would be a good strategy to avoid unnecessary surgery without concerns of worsening cancer-related prognosis.
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Affiliation(s)
- Hyun Jin Joo
- Division of Gastroenterology, Department of Internal Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Korea
- Division of Gastroenterology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Jee Ung Seok
- Division of Gastroenterology, Department of Internal Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Byung Chang Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea.
| | - Dong-Eun Lee
- Biostatistics Collaboration Team, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Bun Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Kyung Su Han
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Chang Won Hong
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Dae Kyung Sohn
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Dong Woon Lee
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Sung Chan Park
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Hee Jin Chang
- Department of Pathology, Research Institute, National Cancer Center, Goyang, Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
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Chang S, Gao Y, Pomeroy MJ, Bai T, Zhang H, Lu S, Pickhardt PJ, Gupta A, Reiter MJ, Gould ES, Liang Z. Exploring Dual-Energy CT Spectral Information for Machine Learning-Driven Lesion Diagnosis in Pre-Log Domain. IEEE TRANSACTIONS ON MEDICAL IMAGING 2023; 42:1835-1845. [PMID: 37022248 PMCID: PMC10238622 DOI: 10.1109/tmi.2023.3240847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this study, we proposed a computer-aided diagnosis (CADx) framework under dual-energy spectral CT (DECT), which operates directly on the transmission data in the pre-log domain, called CADxDE, to explore the spectral information for lesion diagnosis. The CADxDE includes material identification and machine learning (ML) based CADx. Benefits from DECT's capability of performing virtual monoenergetic imaging with the identified materials, the responses of different tissue types (e.g., muscle, water, and fat) in lesions at each energy can be explored by ML for CADx. Without losing essential factors in the DECT scan, a pre-log domain model-based iterative reconstruction is adopted to obtain decomposed material images, which are then used to generate the virtual monoenergetic images (VMIs) at selected n energies. While these VMIs have the same anatomy, their contrast distribution patterns contain rich information along with the n energies for tissue characterization. Thus, a corresponding ML-based CADx is developed to exploit the energy-enhanced tissue features for differentiating malignant from benign lesions. Specifically, an original image-driven multi-channel three-dimensional convolutional neural network (CNN) and extracted lesion feature-based ML CADx methods are developed to show the feasibility of CADxDE. Results from three pathologically proven clinical datasets showed 4.01% to 14.25% higher AUC (area under the receiver operating characteristic curve) scores than the scores of both the conventional DECT data (high and low energy spectrum separately) and the conventional CT data. The mean gain >9.13% in AUC scores indicated that the energy spectral-enhanced tissue features from CADxDE have great potential to improve lesion diagnosis performance.
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Affiliation(s)
- Shaojie Chang
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Yongfeng Gao
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Marc J. Pomeroy
- Departments of Radiology and Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Ti Bai
- Department of Radiation Oncology, University of Texas Southwestern Medical Centre, Dallas, TX 75390, USA
| | - Hao Zhang
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, NY 10065, USA
| | - Siming Lu
- Departments of Radiology and Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Perry J. Pickhardt
- Department of Radiology, School of Medicine, University of Wisconsin, Madison, WI 53792, USA
| | - Amit Gupta
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Michael J. Reiter
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Elaine S. Gould
- Department of Radiology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Zhengrong Liang
- Departments of Radiology and Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
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Alaimo L, Moazzam Z, Woldesenbet S, Lima HA, Endo Y, Munir MM, Azap L, Ruzzenente A, Guglielmi A, Pawlik TM. Artificial intelligence to investigate predictors and prognostic impact of time to surgery in colon cancer. J Surg Oncol 2023; 127:966-974. [PMID: 36840925 DOI: 10.1002/jso.27224] [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: 02/02/2023] [Accepted: 02/18/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND AND OBJECTIVES The role of time to surgery (TTS) for long-term outcomes in colon cancer (CC) remains ill-defined. We sought to utilize artificial intelligence (AI) to characterize the drivers of TTS and its prognostic impact. METHODS The National Cancer Database was utilized to identify patients diagnosed with non-metastatic CC between 2004 and 2018. AI models were employed to rank the importance of several sociodemographic, facility, and tumor characteristics in determining TTS, and postoperative survival. RESULTS Among 518 983 patients, 137 902 (26.6%) received intraoperative diagnosis of CC (TTS = 0), while 381 081 (74.4%) underwent elective surgery (TTS > 0) with median TTS of 19.0 days (interquartile range [IQR]: 7.0-33.0). An AI model, identified tumor stage, receipt of adequate lymphadenectomy, histologic grade, lymphovascular invasion, and insurance status as the most important variables associated with TTS = 0. Conversely, the type and location of treating facility and receipt of adjuvant therapy were among the most important variables for TTS > 0. Notably, TTS was among the most important variables associated with survival, and TTS > 3 weeks was associated with an incremental increase in mortality risk. CONCLUSIONS The identification of factors associated with TTS can help stratify patients most likely to suffer poor outcomes due to prolonged TTS, as well as guide quality improvement initiatives related to timely surgical care.
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Affiliation(s)
- Laura Alaimo
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
- Department of Surgery, University of Verona, Verona, Italy
| | - Zorays Moazzam
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Selamawit Woldesenbet
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Henrique A Lima
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Yutaka Endo
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Muhammad M Munir
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Lovette Azap
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| | | | | | - Timothy M Pawlik
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
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Voils CI, Coffman CJ, Wu RR, Grubber JM, Fisher DA, Strawbridge EM, Sperber N, Wang V, Scheuner MT, Provenzale D, Nelson RE, Hauser E, Orlando LA, Goldstein KM. A Cluster Randomized Trial of a Family Health History Platform to Identify and Manage Patients at Increased Risk for Colorectal Cancer. J Gen Intern Med 2023; 38:1375-1383. [PMID: 36307642 PMCID: PMC10160317 DOI: 10.1007/s11606-022-07787-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/06/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Obtaining comprehensive family health history (FHH) to inform colorectal cancer (CRC) risk management in primary care settings is challenging. OBJECTIVE To examine the effectiveness of a patient-facing FHH platform to identify and manage patients at increased CRC risk. DESIGN Two-site, two-arm, cluster-randomized, implementation-effectiveness trial with primary care providers (PCPs) randomized to immediate intervention versus wait-list control. PARTICIPANTS PCPs treating patients at least one half-day per week; patients aged 40-64 with no medical conditions that increased CRC risk. INTERVENTIONS Immediate-arm patients entered their FHH into a web-based platform that provided risk assessment and guideline-driven decision support; wait-list control patients did so 12 months later. MAIN MEASURES McNemar's test examined differences between the platform and electronic medical record (EMR) in rates of increased risk documentation. General estimating equations using logistic regression models compared arms in risk-concordant provider actions and patient screening test completion. Referral for genetic consultation was analyzed descriptively. KEY RESULTS Seventeen PCPs were randomized to each arm. Patients (n = 252 immediate, n = 253 control) averaged 51.4 (SD = 7.2) years, with 83% assigned male at birth, 58% White persons, and 33% Black persons. The percentage of patients identified as increased risk for CRC was greater with the platform (9.9%) versus EMR (5.2%), difference = 4.8% (95% CI: 2.6%, 6.9%), p < .0001. There was no difference in PCP risk-concordant action [odds ratio (OR) = 0.7, 95% CI (0.4, 1.2; p = 0.16)]. Among 177 patients with a risk-concordant screening test ordered, there was no difference in test completion, OR = 0.8 [0.5,1.3]; p = 0.36. Of 50 patients identified by the platform as increased risk, 78.6% immediate and 68.2% control patients received a recommendation for genetic consultation, of which only one in each arm had a referral placed. CONCLUSIONS FHH tools could accurately assess and document the clinical needs of patients at increased risk for CRC. Barriers to acting on those recommendations warrant further exploration. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT02247336 https://clinicaltrials.gov/ct2/show/NCT02247336.
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Affiliation(s)
- Corrine I Voils
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA.
| | - Cynthia J Coffman
- Durham Veterans Affairs Health Care System, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - R Ryanne Wu
- Durham Veterans Affairs Health Care System, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Deborah A Fisher
- Durham Veterans Affairs Health Care System, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Nina Sperber
- Durham Veterans Affairs Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Virginia Wang
- Durham Veterans Affairs Health Care System, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Maren T Scheuner
- San Francisco VA Health Care System, San Francisco, VA, USA
- Departments of Medicine and Pediatrics, University of California at San Francisco, San Francisco, CA, USA
| | - Dawn Provenzale
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Cooperative Studies Program Epidemiology Center, Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Richard E Nelson
- Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth Hauser
- Durham Veterans Affairs Health Care System, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Lori A Orlando
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Karen M Goldstein
- Durham Veterans Affairs Health Care System, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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Moon JY, Kye BH, Ko SH, Yoo RN. Sulfur Metabolism of the Gut Microbiome and Colorectal Cancer: The Threat to the Younger Generation. Nutrients 2023; 15:nu15081966. [PMID: 37111185 PMCID: PMC10146533 DOI: 10.3390/nu15081966] [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: 03/21/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Colorectal cancer diagnosed in individuals under 50 years old is called early-onset colorectal cancer (EOCRC), and its incidence has been rising worldwide. Simultaneously occurring with increasing obesity, this worrisome trend is partly explained by the strong influence of dietary elements, particularly fatty, meaty, and sugary food. An animal-based diet, the so-called Western diet, causes a shift in dominant microbiota and their metabolic activity, which may disrupt the homeostasis of hydrogen sulfide concentration. Bacterial sulfur metabolism is recognized as a critical mechanism of EOCRC pathogenesis. This review evaluates the pathophysiology of how a diet-associated shift in gut microbiota, so-called the microbial sulfur diet, provokes injuries and inflammation to the colonic mucosa and contributes to the development of CRC.
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Affiliation(s)
- Ji-Yeon Moon
- Division of Colorectal Surgery, Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon 442-723, Republic of Korea
| | - Bong-Hyeon Kye
- Division of Colorectal Surgery, Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon 442-723, Republic of Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon 442-723, Republic of Korea
| | - Ri Na Yoo
- Division of Colorectal Surgery, Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon 442-723, Republic of Korea
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Meine GC, Sander GB. PREVALENCE OF SERRATED POLYPS AND THEIR ASSOCIATION WITH SYNCHRONOUS COLORECTAL ADVANCED ADENOMAS. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:224-229. [PMID: 37556749 DOI: 10.1590/s0004-2803.20230223-020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/18/2023] [Indexed: 08/11/2023]
Abstract
•This study revealed a similar prevalence of clinically significant serrated polyps and advanced adenomas among patients who underwent colonoscopy. •Multivariate analysis demonstrated an association between clinically significant serrated polyps and synchronous advanced adenomas, though the strength of this association was stronger for proximal advanced adenomas. •Large serrated polyps and sessile serrated adenomas were associated with proximal advanced adenomas. Background - Serrated lesions are the precursors of up to one-third of colorectal cancer (CRC) cases and share molecular and epidemiological features with interval CRC. Previous studies have reported wide variation in serrated polyp prevalence and diverse magnitude of its relationship with synchronous advanced adenomas.Objective - Describe the prevalence of serrated polyps and evaluate their association with synchronous advanced adenomas. Methods - The study is a retrospective analysis of 1208 colonoscopies performed in patients aged 45 to 75, predominantly for CRC screening. Data on the prevalence of serrated polyps subsets and advanced adenomas were collected, and multivariate analysis were performed to identify the association between serrated polyps and synchronous advanced adenomas. Results - The prevalence of clinically significant serrated polyps (CSSP), large serrated polyps (LSP), and sessile serrated adenomas (SSA) were 11.3%, 6%, and 3.7%. CSSP were associated with synchronous advanced adenomas (OR 2.121, 95%CI 1.321-3.406), regardless of proximal (OR 2.966, 95%CI 1.701-5.170) or distal (OR 1.945, 95%CI 1.081-3.499) location, while LSP (OR 2.872, 95%CI 1.425-5.787) and SSA (OR 5.032, 95%CI 2.395-10.576) were associated with proximal advanced adenomas. Conclusion - The prevalence of CSSP and advanced adenomas were alike. CSSP is a risk factor for advanced adenomas, and the strength of this association is stronger for proximal advanced adenomas. LSP and SSA are associated with proximal advanced adenomas.
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Affiliation(s)
- Gilmara Coelho Meine
- Universidade Federal do Rio Grande do Sul, Escola de Medicina, Programa de Pós-graduação: Ciências em Gastroenterologia e Hepatologia, Porto Alegre, RS, Brasil
- Universidade Feevale, Faculdade de Medicina, Hospital Regina, Novo Hamburgo, RS, Brasil
| | - Guilherme Becker Sander
- Universidade Federal do Rio Grande do Sul, Escola de Medicina, Programa de Pós-graduação: Ciências em Gastroenterologia e Hepatologia, Porto Alegre, RS, Brasil
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Experience of a District General Hospital With a Diverse Community in Operated Colorectal Cancers According to Ethnic Background. Cureus 2023; 15:e36917. [PMID: 37009365 PMCID: PMC10063173 DOI: 10.7759/cureus.36917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Background This study aimed to investigate disparities in colorectal cancer (CRC) patients’ demographics according to the five major ethnicities of patients living in the catchment area of North Middlesex Hospital. Methodology This retrospective study included CRC patients operated on between January 1, 2010, and December 31, 2014. Records dating to the end of the five-year follow-up were extracted anonymously from a database of CRC outcomes at the North Middlesex University Hospital NHS Trust. Comparisons were made according to ethnicity, patient demographics, type of presentation, cancer location, stage at diagnosis, recurrence, and mortality. Results A total of 176 adult patients were operated on for CRC between January 1, 2010, and December 31, 2014. The majority of the patients were referred as two-week wait target referrals. Emergency presentation of CRC was the highest in White non-UK patients. The White British Irish patients had their tumors mostly in the cecum, followed by the sigmoid colon, while the rectum followed by the sigmoid colon were the most common sites in the Black population. All study populations mainly presented with stage I disease, and the next highest incidence of cancers according to stage and ethnicity was stage IIIb in the Black population. Conclusions Differences in the ethnic background are important factors, especially in a diverse community, which can impact the age and mode of presentation of the disease, as well as the stage it starts to present. The location of the primary tumor, metastases, and recurrence sites are all affected by the ethnic background, which, subsequently, affect the survival of the patient.
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Abbes S, Baldi S, Sellami H, Amedei A, Keskes L. Molecular methods for colorectal cancer screening: Progress with next-generation sequencing evolution. World J Gastrointest Oncol 2023; 15:425-442. [PMID: 37009313 PMCID: PMC10052664 DOI: 10.4251/wjgo.v15.i3.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/02/2023] [Accepted: 02/15/2023] [Indexed: 03/14/2023] Open
Abstract
Currently, colorectal cancer (CRC) represents the third most common malignancy and the second most deadly cancer worldwide, with a higher incidence in developed countries. Like other solid tumors, CRC is a heterogeneous genomic disease in which various alterations, such as point mutations, genomic rearrangements, gene fusions or chromosomal copy number alterations, can contribute to the disease development. However, because of its orderly natural history, easily accessible onset location and high lifetime incidence, CRC is ideally suited for preventive intervention, but the many screening efforts of the last decades have been compromised by performance limitations and low penetrance of the standard screening tools. The advent of next-generation sequencing (NGS) has both facilitated the identification of previously unrecognized CRC features such as its relationship with gut microbial pathogens and revolutionized the speed and throughput of cataloguing CRC-related genomic alterations. Hence, in this review, we summarized the several diagnostic tools used for CRC screening in the past and the present, focusing on recent NGS approaches and their revolutionary role in the identification of novel genomic CRC characteristics, the advancement of understanding the CRC carcinogenesis and the screening of clinically actionable targets for personalized medicine.
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Affiliation(s)
- Salma Abbes
- Laboratory of Parasitic and Fungal Molecular Biology, University of Sfax, Sfax 3029, Tunisia
| | - Simone Baldi
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Hayet Sellami
- Drosophila Research Unit-Parasitology and Mycologie Laboratory, University of Sfax, Sfax 3029, Tunisia
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
- SOD of Interdisciplinary Internal Medicine, Careggi University Hospital, Florence 50134, Italy
| | - Leila Keskes
- Laboratory of Human Molecular Genetic, University of Sfax, Sfax 3029, Tunisia
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Computer-aided detection, mucosal exposure device, their combination, and standard colonoscopy for adenoma detection: a randomized controlled trial. Gastrointest Endosc 2023; 97:507-516. [PMID: 36220382 DOI: 10.1016/j.gie.2022.09.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/16/2022] [Accepted: 09/23/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS Computer-aided detection (CADe) and a mucosal exposure device can improve adenoma detection rate (ADR). Potential benefits of combining the 2 modalities have never been studied. This study aimed to compare ADR differences among CADe alone, endocuff-assisted colonoscopy (EAC) alone, and the combination of CADe and EAC (CADe+EAC) with standard colonoscopy. METHODS This prospective randomized controlled study included 1245 participants who underwent screening colonoscopy. Participants were randomized to CADe, EAC, CADe+EAC, and standard colonoscopy as a control. The primary outcome was ADR. Secondary outcomes were proximal ADR (pADR), advanced ADR (AADR), and the number of adenomas per colonoscopy (APCs). RESULTS ADRs from the control, CADe, EAC, and CADe+EAC groups were 41.9%, 52.2%, 54.0%, and 58.8%, respectively; pADRs were 25.2%, 33.3%, 34.9%, and 37.0%, respectively; AADRs were 7.7%, 8.3%, 8.3%, and 13.6%, respectively; and APCs were .76, 1.11, 1.18, and 1.31, respectively. Significant increases in ADR and pADR were observed between the intervention and control groups (P < .05 in all comparisons). The AADR was significantly higher only in the CADe+EAC group than in the control group (P = .02). The adjusted incidence rate ratios of APCs were significantly higher in the intervention groups versus the control group (P < .01 in all comparisons). CONCLUSIONS CADe+EAC significantly improve ADR and AADR over standard colonoscopy. However, although CADe or EAC alone can substantially increase the detection of adenomas, they do not lead to increased detection of advanced adenomas unless used in combination. (Clinical trial registration number: TCTR20200929003.).
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Witt D, Faust U, Strobl-Wildemann G, Sturm M, Buchert R, Zuleger T, Admard J, Casadei N, Ossowski S, Haack TB, Rieß O, Schroeder C. Genome sequencing identifies complex structural MLH1 variant in unsolved Lynch syndrome. Mol Genet Genomic Med 2023:e2151. [PMID: 36760167 DOI: 10.1002/mgg3.2151] [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: 08/30/2022] [Revised: 12/15/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Lynch syndrome is one of the most common cancer predisposition syndromes. It is caused by inherited changes in the mismatch repair pathway. With current diagnostic approaches, a causative genetic variant can be found in less than 50% of cases. A correct diagnosis is important for ensuring that an appropriate surveillance program is used and that additional high-risk family members are identified. METHODS We used clinical genome sequencing on DNA from blood and subsequent transcriptome sequencing for confirmation. Data were analyzed using the megSAP pipeline and classified according to basic criteria in diagnostic laboratories. Segregation analyses in family members were conducted via breakpoint PCR. RESULTS We present a family with the clinical diagnosis of Lynch syndrome in which standard diagnostic tests, such as panel or exome sequencing, were unable to detect the underlying genetic variant. Genome sequencing in the index patient confirmed the previous diagnostic results and identified an additional complex rearrangement with intronic breakpoints involving MLH1 and its neighboring gene LRRFIP2. The previously undetected structural variant was classified as medically relevant. Segregation analysis in the family identified additional at-risk individuals which were offered intensified cancer screening. DISCUSSION AND CONCLUSIONS This case illustrates the advantages of clinical genome sequencing in detecting structural variants compared with current diagnostic approaches. Although structural variants are rare in Lynch syndrome families, they seem to be underreported, in part because of technical challenges. Clinical genome sequencing offers a comprehensive genetic characterization detecting a wide range of genetic variants.
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Affiliation(s)
- Dennis Witt
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Ulrike Faust
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | | | - Marc Sturm
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Rebecca Buchert
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Theresia Zuleger
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Jakob Admard
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Nicolas Casadei
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany.,NGS Competence Center Tübingen, Tübingen, Germany
| | - Stephan Ossowski
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Olaf Rieß
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
| | - Christopher Schroeder
- Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany
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Alkhiari R, Alfadda T, Alashgar M, Alrawaf F, Alquraishi A, Alkhiari K, Alrashedi O, Almutairi N, Albarrak A, alsahafi M. Characteristics of adenomatous colorectal polyps among a Saudi population. J Taibah Univ Med Sci 2023; 18:855-859. [PMID: 36852232 PMCID: PMC9957803 DOI: 10.1016/j.jtumed.2022.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/29/2022] [Accepted: 12/24/2022] [Indexed: 01/05/2023] Open
Abstract
Objectives Colorectal cancer is a common cause of cancer-related mortality in KSA with a rising incidence. Although adenomatous polyps are well-recognized as precursors of colorectal cancer, local data are scarce. Therefore, in this study, we aimed to evaluate the characteristics of adenomatous colon polyps in the Saudi population. Methods We retrospectively reviewed the electronic databases of all patients who underwent colonoscopy for any indication between January 2015 and December 2019 at a tertiary care hospital. This study included adult patients who were found to have colorectal polyps with identified histopathology reports. We collected clinical and pathological data, including patient age, sex, and histopathological polyp characteristics. A p-value <0.05 was considered significant for descriptive and analytical statistics. Results A total of 184 patients with colorectal polyps with identified histopathology reports were included in the analysis. Of these, 130 (70.6%) patients were aged 50 years or older, and 135 (73.3%) were male. Among all polyps, 127 (69%) were adenomatous, 31 (16.8%) were hyperplastic, and 24 (13%) were inflammatory. For adenomatous polyps, 31 (24.4%) were observed in patients younger than 50 years, and high-grade dysplasia was observed in 23 (18%) polyps. Among patients with adenomatous polyps, the anatomical location was as follows: 27 (23%) in the cecum/ascending colon, 12 (9%) in the transverse colon, 45 (35%) in the descending/sigmoid colon, 25 (19%) in the rectum, and 18 (14%) at multiple sites. Age >50 years was significantly associated with adenomatous polyps (P = 0.03). Conclusion Approximately one-third of adenomatous polyps were detected proximal to the splenic flexure. Although adenomatous polyps were significantly associated with increasing age, 24% were observed in patients younger than 50 years of age. This finding supports the current recommendation to start screening at the age of 45.
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Affiliation(s)
- Resheed Alkhiari
- Department of Medicine, College of Medicine, Qassim University, Qassim, KSA,Corresponding address: Department of Medicine, College of Medicine, Qassim University, Qassim, KSA.
| | | | | | | | | | - Khaled Alkhiari
- College of Medicine, Suliman Alrajhi University, Qassim, KSA
| | | | - Nawaf Almutairi
- Department of Medicine, King Fahad Specialist Hospital, Buraidah, Qassim, KSA
| | | | - Majid alsahafi
- Department of Medicine, College of Medicine, King Abdul-Aziz University, Jeddah, KSA
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Hashemi M, Mirdamadi MSA, Talebi Y, Khaniabad N, Banaei G, Daneii P, Gholami S, Ghorbani A, Tavakolpournegari A, Farsani ZM, Zarrabi A, Nabavi N, Zandieh MA, Rashidi M, Taheriazam A, Entezari M, Khan H. Pre-clinical and clinical importance of miR-21 in human cancers: Tumorigenesis, therapy response, delivery approaches and targeting agents. Pharmacol Res 2023; 187:106568. [PMID: 36423787 DOI: 10.1016/j.phrs.2022.106568] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022]
Abstract
The field of non-coding RNA (ncRNA) has made significant progress in understanding the pathogenesis of diseases and has broadened our knowledge towards their targeting, especially in cancer therapy. ncRNAs are a large family of RNAs with microRNAs (miRNAs) being one kind of endogenous RNA which lack encoded proteins. By now, miRNAs have been well-coined in pathogenesis and development of cancer. The current review focuses on the role of miR-21 in cancers and its association with tumor progression. miR-21 has both oncogenic and onco-suppressor functions and most of the experiments are in agreement with the tumor-promoting function of this miRNA. miR-21 primarily decreases PTEN expression to induce PI3K/Akt signaling in cancer progression. Overexpression of miR-21 inhibits apoptosis and is vital for inducing pro-survival autophagy. miR-21 is vital for metabolic reprogramming and can induce glycolysis to enhance tumor progression. miR-21 stimulates EMT mechanisms and increases expression of MMP-2 and MMP-9 thereby elevating tumor metastasis. miR-21 is a target of anti-cancer agents such as curcumin and curcumol and its down-regulation impairs tumor progression. Upregulation of miR-21 results in cancer resistance to chemotherapy and radiotherapy. Increasing evidence has revealed the role of miR-21 as a biomarker as it is present in both the serum and exosomes making them beneficial biomarkers for non-invasive diagnosis of cancer.
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Affiliation(s)
- Mehrdad Hashemi
- Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran
| | - Motahare Sadat Ayat Mirdamadi
- Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran; Department of Biology, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Yasmin Talebi
- Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran; Department of Biology, Islamic Azad University Central Tehran Branch, Tehran, Iran
| | - Nasrin Khaniabad
- Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran
| | - Gooya Banaei
- Group of Mutagenesis, Department of Genetics and Microbiology, Faculty of Biosciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193 Barcelona, Spain
| | - Pouria Daneii
- Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran
| | - Sadaf Gholami
- Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran
| | - Amin Ghorbani
- Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran; Department of Cellular and Molecular Biology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Alireza Tavakolpournegari
- Group of Mutagenesis, Department of Genetics and Microbiology, Faculty of Biosciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193 Barcelona, Spain
| | - Zoheir Mohammadian Farsani
- Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran; Department of Industrial and Environmental Biotechnology, National Institute for Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran
| | - Ali Zarrabi
- Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul 34396, Turkey
| | - Noushin Nabavi
- Department of Urological Sciences and Vancouver Prostate Centre, University of British Columbia, Vancouver, BC V6H3Z6, Canada
| | - Mohammad Arad Zandieh
- Department of Food Hygiene and Quality Control, Division of epidemiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Mohsen Rashidi
- Department Pharmacology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; The Health of Plant and Livestock Products Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Afshin Taheriazam
- Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran; Department of Orthopedics, Faculty of medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Maliheh Entezari
- Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Farhikhtegan Medical Convergence sciences Research Center, Farhikhtegan Hospital Tehran Medical sciences, Islamic Azad University, Tehran, Iran.
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan, 23200, Pakistan.
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Tharwat M, Sakr NA, El-Sappagh S, Soliman H, Kwak KS, Elmogy M. Colon Cancer Diagnosis Based on Machine Learning and Deep Learning: Modalities and Analysis Techniques. SENSORS (BASEL, SWITZERLAND) 2022; 22:9250. [PMID: 36501951 PMCID: PMC9739266 DOI: 10.3390/s22239250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
The treatment and diagnosis of colon cancer are considered to be social and economic challenges due to the high mortality rates. Every year, around the world, almost half a million people contract cancer, including colon cancer. Determining the grade of colon cancer mainly depends on analyzing the gland's structure by tissue region, which has led to the existence of various tests for screening that can be utilized to investigate polyp images and colorectal cancer. This article presents a comprehensive survey on the diagnosis of colon cancer. This covers many aspects related to colon cancer, such as its symptoms and grades as well as the available imaging modalities (particularly, histopathology images used for analysis) in addition to common diagnosis systems. Furthermore, the most widely used datasets and performance evaluation metrics are discussed. We provide a comprehensive review of the current studies on colon cancer, classified into deep-learning (DL) and machine-learning (ML) techniques, and we identify their main strengths and limitations. These techniques provide extensive support for identifying the early stages of cancer that lead to early treatment of the disease and produce a lower mortality rate compared with the rate produced after symptoms develop. In addition, these methods can help to prevent colorectal cancer from progressing through the removal of pre-malignant polyps, which can be achieved using screening tests to make the disease easier to diagnose. Finally, the existing challenges and future research directions that open the way for future work in this field are presented.
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Affiliation(s)
- Mai Tharwat
- Information Technology Department, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt
| | - Nehal A. Sakr
- Information Technology Department, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt
| | - Shaker El-Sappagh
- Information Systems Department, Faculty of Computers and Artificial Intelligence, Benha University, Benha 13512, Egypt
- Faculty of Computer Science and Engineering, Galala University, Suez 435611, Egypt
| | - Hassan Soliman
- Information Technology Department, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt
| | - Kyung-Sup Kwak
- Department of Information and Communication Engineering, Inha University, Incheon 22212, Republic of Korea
| | - Mohammed Elmogy
- Information Technology Department, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt
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Owens CA, Rigaud B, Ludmir EB, Gupta AC, Shrestha S, Paulino AC, Smith SA, Peterson CB, Kry SF, Lee C, Henderson TO, Armstrong GT, Brock KK, Howell RM. Development and validation of a population-based anatomical colorectal model for radiation dosimetry in late effects studies of survivors of childhood cancer. Radiother Oncol 2022; 176:118-126. [PMID: 36063983 PMCID: PMC9845018 DOI: 10.1016/j.radonc.2022.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/10/2022] [Accepted: 08/24/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE The purposes of this study were to develop and integrate a colorectal model that incorporates anatomical variations of pediatric patients into the age-scalable MD Anderson Late Effects (MDA-LE) computational phantom, and validate the model for pediatric radiation therapy (RT) dose reconstructions. METHODS Colorectal contours were manually derived from whole-body non-contrast computed tomography (CT) scans of 114 pediatric patients (age range: 2.1-21.6 years, 74 males, 40 females). One contour was used for an anatomical template, 103 for training and 10 for testing. Training contours were used to create a colorectal principal component analysis (PCA)-based statistical shape model (SSM) to extract the population's dominant deformations. The SSM was integrated into the MDA-LE phantom. Geometric accuracy was assessed between patient-specific and SSM contours using several overlap metrics. Two alternative colorectal shapes were generated using the first 17 dominant modes of the PCA-based SSM. Dosimetric accuracy was assessed by comparing colorectal doses from test patients' CT-based RT plans (ground truth) with reconstructed doses for the mean and two alternative models in age-matched MDA-LE phantoms. RESULTS When using all 103 PCA modes, the mean (min-max) Dice similarity coefficient, distance-to-agreement and Hausdorff distance between the patient-specific and reconstructed contours for the test patients were 0.89 (0.85-0.91), 2.1 mm (1.7-3.0), and 8.6 mm (5.7-14.3), respectively. The average percent difference between reconstructed and ground truth mean and maximum colorectal doses for the mean (alternative 1, 2) model were 6.3% (8.1%, 6.1%) and 4.4% (4.3%, 4.7%), respectively. CONCLUSIONS We developed, validated and integrated a colorectal PCA-based SSM into the MDA-LE phantom and demonstrated its dosimetric performance for accurate pediatric RT dose reconstruction.
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Affiliation(s)
- Constance A Owens
- The University of Texas MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX, USA; MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Graduate Program in Medical Physics, Houston, TX, USA.
| | - Bastien Rigaud
- The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Houston, TX, USA
| | - Ethan B Ludmir
- The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX, USA; The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX, USA
| | - Aashish C Gupta
- The University of Texas MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX, USA; MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Graduate Program in Medical Physics, Houston, TX, USA
| | - Suman Shrestha
- The University of Texas MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX, USA; MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Graduate Program in Medical Physics, Houston, TX, USA
| | - Arnold C Paulino
- The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX, USA
| | - Susan A Smith
- The University of Texas MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX, USA
| | - Christine B Peterson
- The University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX, USA
| | - Stephen F Kry
- The University of Texas MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX, USA; MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Graduate Program in Medical Physics, Houston, TX, USA
| | - Choonsik Lee
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Tara O Henderson
- The University of Chicago, Department of Pediatrics, Chicago, IL, USA
| | - Gregory T Armstrong
- St. Jude Children's Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN, USA
| | - Kristy K Brock
- The University of Texas MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX, USA; The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Houston, TX, USA
| | - Rebecca M Howell
- The University of Texas MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX, USA; MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Graduate Program in Medical Physics, Houston, TX, USA.
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Awareness, Knowledge, Perceptions, and Attitudes towards Familial and Inherited Cancer. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101400. [PMID: 36295561 PMCID: PMC9611391 DOI: 10.3390/medicina58101400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: In 2020, the World Health Organization (WHO) reported 9.9 million deaths from cancer, with a mortality rate of 10.65%. Early detection of cancer can decrease mortality and increase the chance of cure. In Saudi Arabia, multiple studies were performed for awareness and attitudes toward cancer, but few studies evaluated the awareness of familial and inherited cancers. Materials and Methods: This is a cross-sectional observational survey of the awareness, knowledge, and attitudes of Saudi women toward familial and inherited cancers. The estimated sample size was 385. Questionnaires were distributed through social media platforms from 1 January 2021 to 22 January 2021. Results: Of the 385 participants, the majority have a bachelor’s degree. More than half (68.9%) know that family history is related to cancer, and approximately 57.2% are aware of genetic testing. The most common indication of genetic testing is premarital testing (18.5%). An inverse relationship is noted between the awareness of familial and inherited cancers and age (p = 0.003, CI = 0.723−0.938). However, awareness of inherited and familial cancer is positively associated with awareness of the association of genetic mutation to cancer (p = 0.013, CI = 1.080−1.921) and knowledge about genetic testing (p > 0.000, CI = 2.487−8.426). Conclusions: Our results reveal that Saudi women, especially older adults, have suboptimal knowledge about inherited and familial cancers, and poor attitudes toward genetic screening. We recommend increasing public awareness regarding risk factors and screening for inherited and familial cancers.
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Bayrak T, Çetin Z, Saygılı Eİ, Ogul H. Identifying the tumor location-associated candidate genes in development of new drugs for colorectal cancer using machine-learning-based approach. Med Biol Eng Comput 2022; 60:2877-2897. [DOI: 10.1007/s11517-022-02641-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/28/2022] [Indexed: 02/07/2023]
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Redd DF, Shao Y, Zeng-Treitler Q, Myers LJ, Barker BC, Nelson SJ, Imperiale TF. Identification of colorectal cancer using structured and free text clinical data. Health Informatics J 2022; 28:14604582221134406. [DOI: 10.1177/14604582221134406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Colorectal cancer incidence has continually fallen among those 50 years old and over. However, the incidence has increased in those under 50. Even with the recent screening guidelines recommending that screening begins at age 45, nearly half of all early-onset colorectal cancer will be missed. Methods are needed to identify high-risk individuals in this age group for targeted screening. Colorectal cancer studies, as with other clinical studies, have required labor intensive chart review for the identification of those affected and risk factors. Natural language processing and machine learning can be used to automate the process and enable the screening of large numbers of patients. This study developed and compared four machine learning and statistical models: logistic regression, support vector machine, random forest, and deep neural network, in their performance in classifying colorectal cancer patients. Excellent classification performance is achieved with AUCs over 97%.
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Affiliation(s)
- Douglas F Redd
- Washington DC VA Medical Center, Washington, DC, USA Biomedical Informatics Center, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Yijun Shao
- Washington DC VA Medical Center, Washington, DC, USA Biomedical Informatics Center, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Qing Zeng-Treitler
- Washington DC VA Medical Center, Washington, DC, USA Biomedical Informatics Center, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Laura J Myers
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USAIndiana University School of Medicine, Indianapolis, IN, USA Regenstrief Institute Inc, Indianapolis, IN, USA
| | - Barry C Barker
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Stuart J Nelson
- Biomedical Informatics Center, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Thomas F Imperiale
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USA Indiana University School of Medicine, Indianapolis, IN, USA Regenstrief Institute Inc, Indianapolis, IN, USA
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García-Rodríguez A, Tudela Y, Córdova H, Carballal S, Ordás I, Moreira L, Vaquero E, Ortiz O, Rivero L, Sánchez FJ, Cuatrecasas M, Pellisé M, Bernal J, Fernández-Esparrach G. In vivo computer-aided diagnosis of colorectal polyps using white light endoscopy. Endosc Int Open 2022; 10:E1201-E1207. [PMID: 36118638 PMCID: PMC9473851 DOI: 10.1055/a-1881-3178] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 06/10/2022] [Indexed: 12/24/2022] Open
Abstract
Background and study aims Artificial intelligence is currently able to accurately predict the histology of colorectal polyps. However, systems developed to date use complex optical technologies and have not been tested in vivo. The objective of this study was to evaluate the efficacy of a new deep learning-based optical diagnosis system, ATENEA, in a real clinical setting using only high-definition white light endoscopy (WLE) and to compare its performance with endoscopists. Methods ATENEA was prospectively tested in real life on consecutive polyps detected in colorectal cancer screening colonoscopies at Hospital Clínic. No images were discarded, and only WLE was used. The in vivo ATENEA's prediction (adenoma vs non-adenoma) was compared with the prediction of four staff endoscopists without specific training in optical diagnosis for the study purposes. Endoscopists were blind to the ATENEA output. Histology was the gold standard. Results Ninety polyps (median size: 5 mm, range: 2-25) from 31 patients were included of which 69 (76.7 %) were adenomas. ATENEA correctly predicted the histology in 63 of 69 (91.3 %, 95 % CI: 82 %-97 %) adenomas and 12 of 21 (57.1 %, 95 % CI: 34 %-78 %) non-adenomas while endoscopists made correct predictions in 52 of 69 (75.4 %, 95 % CI: 60 %-85 %) and 20 of 21 (95.2 %, 95 % CI: 76 %-100 %), respectively. The global accuracy was 83.3 % (95 % CI: 74%-90 %) and 80 % (95 % CI: 70 %-88 %) for ATENEA and endoscopists, respectively. Conclusion ATENEA can accurately be used for in vivo characterization of colorectal polyps, enabling the endoscopist to make direct decisions. ATENEA showed a global accuracy similar to that of endoscopists despite an unsatisfactory performance for non-adenomatous lesions.
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Affiliation(s)
- Ana García-Rodríguez
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain
| | - Yael Tudela
- Computer Science Department. Autonomous University of Barcelona and Computer Vision Center, Barcelona, Catalonia, Spain
| | - Henry Córdova
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain,IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain
| | - Sabela Carballal
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain,IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain
| | - Ingrid Ordás
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain,IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain
| | - Leticia Moreira
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain,IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain
| | - Eva Vaquero
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain,IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain
| | - Oswaldo Ortiz
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain
| | - Liseth Rivero
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain,IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain
| | - F. Javier Sánchez
- Computer Science Department. Autonomous University of Barcelona and Computer Vision Center, Barcelona, Catalonia, Spain
| | - Miriam Cuatrecasas
- IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain,Pathology Department. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain
| | - Maria Pellisé
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain,IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain
| | - Jorge Bernal
- Computer Science Department. Autonomous University of Barcelona and Computer Vision Center, Barcelona, Catalonia, Spain
| | - Glòria Fernández-Esparrach
- Endoscopy Unit. Gastroenterology Department. ICMDiM. Hospital Clínic of Barcelona. University of Barcelona, Barcelona, Catalonia, Spain,IDIBAPS, Barcelona, Catalonia, Spain,CIBEREHD, Spain
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Colon Capsule Endoscopy in the Diagnosis of Colon Polyps: Who Needs a Colonoscopy? Diagnostics (Basel) 2022; 12:diagnostics12092093. [PMID: 36140494 PMCID: PMC9498104 DOI: 10.3390/diagnostics12092093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 12/09/2022] Open
Abstract
Colon screening programs have reduced colon cancer mortality. Population screening should be minimally invasive, safe, acceptably sensitive, cost-effective, and scalable. The range of screening modalities include guaiac or immunochemical fecal occult blood testing and CT colonography and colonoscopy. A number of carefully controlled studies concur that second-generation capsule endoscopy has excellent sensitivity for polyp detection and a high negative predictive value. Colon capsules fulfill the screening expectation of safety, high sensitivity for polyp detection, and patient acceptance, and appear to straddle the divide between occult blood testing and colonoscopy. While meeting these criteria, there remains the challenges of scaling, capsule practitioner training, resource allocation, and implementing change of practice. Like CT colonography, capsule screening presents the clinician with a decision on the threshold for colonoscopy referral. Overall, colon capsules are an invaluable tool in polyp detection and colon screening and offer a filter that determines “who needs a colonoscopy?”.
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Colorectal Cancer and Polyp Detection Using a New Preparation-Free, Colon-Scan Capsule: A Pilot Study of Safety and Patient Satisfaction. Dig Dis Sci 2022; 67:4070-4077. [PMID: 34708286 DOI: 10.1007/s10620-021-07289-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/12/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Current strategies to prevent colorectal cancer (CRC) vary considerably regarding safety, invasiveness, and patient satisfaction. A known deterrent for patients is the required bowel cleansing for colonoscopy. A new colon-scan capsule system is a unique preparation-free approach that provides structural information on colonic mucosa intended for detection of colorectal polyps and masses. AIMS The aim of this study was to determine safety and patient satisfaction with the colon-scan capsule. METHODS Prospective single-arm pilot study conducted at two tertiary care centers. Patients with a pre-scheduled colonoscopy for CRC screening or surveillance were included. Patients participating in this study underwent the colon-scan capsule and colonoscopy. Safety was defined by the occurrence of procedure or device-related adverse events. Satisfaction was based on survey questionnaires using a scoring system 1 (strongly disagree) to 5 (strongly agree). Patient satisfaction with the colon-scan capsule was compared to colonoscopy. RESULTS Forty patients were included (52.9 [5.7] years; 64.1% females). There were no serious adverse events and no occurrences of capsule retention. The most common (12.5%) complaint was self-limiting abdominal cramping. Satisfaction questionnaires were completed by more than 87% of patients, with patients likely to recommend the capsule (score 4.1 [1.03]) compared to colonoscopy (score 2.8 [1.2]), p = 0.001. CONCLUSIONS The new prepless colon-scan capsule system is an innovative, minimally invasive technology with demonstrated safety and high patient satisfaction. A multicenter pivotal study is planned to validate the performance, safety, and accuracy of polyp detection using the capsule system in comparison with colonoscopy.
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Thai T, Louden DKN, Adamson R, Dominitz JA, Doll JA. Peer evaluation and feedback for invasive medical procedures: a systematic review. BMC MEDICAL EDUCATION 2022; 22:581. [PMID: 35906652 PMCID: PMC9335975 DOI: 10.1186/s12909-022-03652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is significant variability in the performance and outcomes of invasive medical procedures such as percutaneous coronary intervention, endoscopy, and bronchoscopy. Peer evaluation is a common mechanism for assessment of clinician performance and care quality, and may be ideally suited for the evaluation of medical procedures. We therefore sought to perform a systematic review to identify and characterize peer evaluation tools for practicing clinicians, assess evidence supporting the validity of peer evaluation, and describe best practices of peer evaluation programs across multiple invasive medical procedures. METHODS A systematic search of Medline and Embase (through September 7, 2021) was conducted to identify studies of peer evaluation and feedback relating to procedures in the field of internal medicine and related subspecialties. The methodological quality of the studies was assessed. Data were extracted on peer evaluation methods, feedback structures, and the validity and reproducibility of peer evaluations, including inter-observer agreement and associations with other quality measures when available. RESULTS Of 2,135 retrieved references, 32 studies met inclusion criteria. Of these, 21 were from the field of gastroenterology, 5 from cardiology, 3 from pulmonology, and 3 from interventional radiology. Overall, 22 studies described the development or testing of peer scoring systems and 18 reported inter-observer agreement, which was good or excellent in all but 2 studies. Only 4 studies, all from gastroenterology, tested the association of scoring systems with other quality measures, and no studies tested the impact of peer evaluation on patient outcomes. Best practices included standardized scoring systems, prospective criteria for case selection, and collaborative and non-judgmental review. CONCLUSIONS Peer evaluation of invasive medical procedures is feasible and generally demonstrates good or excellent inter-observer agreement when performed with structured tools. Our review identifies common elements of successful interventions across specialties. However, there is limited evidence that peer-evaluated performance is linked to other quality measures or that feedback to clinicians improves patient care or outcomes. Additional research is needed to develop and test peer evaluation and feedback interventions.
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Affiliation(s)
| | | | - Rosemary Adamson
- University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
| | - Jason A Dominitz
- University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
- National Gastroenterology and Hepatology Program, Veterans Affairs Administration, Washington, DC, USA
| | - Jacob A Doll
- University of Washington, Seattle, WA, USA.
- VA Puget Sound Health Care System, Seattle, WA, USA.
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Trejo MJ, Batai K, Chen Y, Brezina S, Chow HHS, Ellis N, Lance P, Hsu CH, Pogreba-Brown K, Bishop M, Gsur A, Jacobs ET. Genome-Wide Association Study of Metachronous Colorectal Adenoma Risk among Participants in the Selenium Trial. Nutr Cancer 2022; 75:143-153. [PMID: 35815403 PMCID: PMC10120393 DOI: 10.1080/01635581.2022.2096910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/02/2022] [Accepted: 06/28/2022] [Indexed: 12/15/2022]
Abstract
Genetic variants related to colorectal adenoma may help identify those who are at highest risk of colorectal cancer development or illuminate potential chemopreventive strategies. The purpose of this genome-wide association study was to identify genetic variants that are associated with risk of developing a metachronous colorectal adenoma among 1,215 study participants of European descent from the Selenium Trial. Associations of variants were assessed with logistic regression analyses and validated in an independent case-control study population of 1,491 participants from the Colorectal Cancer Study of Austria (CORSA). No statistically significant genome-wide associations between any variant and metachronous adenoma were identified after correction for multiple comparisons. However, an intron variant of FAT3 gene, rs61901554, showed a suggestive association (P = 1.10 × 10-6) and was associated with advanced adenomas in CORSA (P = 0.04). Two intronic variants, rs12728998 and rs6699944 in NLRP3 were also observed to have suggestive associations with metachronous lesions (P = 2.00 × 10-6) in the Selenium Trial and were associated with advanced adenoma in CORSA (P = 0.03). Our results provide new areas of investigation for the genetic basis of the development of metachronous colorectal adenoma and support a role for FAT3 involvement in the Wnt/β-catenin pathway leading to colorectal neoplasia.Trial Registration number: NCT00078897 (ClinicalTrials.gov).
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Affiliation(s)
- Mario Jesus Trejo
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Ken Batai
- Department of Urology, University of Arizona, Tucson, AZ, USA
| | - Yuliang Chen
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Stefanie Brezina
- Center for Cancer Research, Medical University of Vienna, Vienna, Austria
| | - H-H Sherry Chow
- University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Molecular and Cellular Biology, College of Science, University of Arizona, Tucson, AZ, USA
| | - Nathan Ellis
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, USA
| | - Peter Lance
- University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Molecular and Cellular Biology, College of Science, University of Arizona, Tucson, AZ, USA
| | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Kristen Pogreba-Brown
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Maria Bishop
- Department of Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Andrea Gsur
- Center for Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Elizabeth T Jacobs
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
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