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Alharran AM, Aljuma RS, Aljasmi AS, Al-Mutairi MF, M Alenezi DF, Alenezi YY, Alajmi HN, Saad AR, Jaradat AA. Knowledge, Attitudes, and Practices Related to Colorectal Cancer's Prevention and Early Detection Among Older Adults in Kuwait: A Cross-Sectional Study. Cureus 2024; 16:e62323. [PMID: 38873393 PMCID: PMC11175023 DOI: 10.7759/cureus.62323] [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] [Accepted: 06/13/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Worldwide, colorectal cancer is one of the significant public health concerns that imposes a substantial risk of morbidity and mortality. Early detection and management of colorectal cancer are necessary to improve the patient's prognosis and outcomes. Hence, several guidelines recommend screening patients at risk of colorectal cancer periodically. Patients' knowledge and attitudes toward screening measures influence their compliance with the guidelines. This study aimed to determine knowledge, attitudes, and practices related to prevention and early detection among older adults in Kuwait. METHODS A cross-sectional study was conducted among Kuwaiti adults aged between 45 and 75 years attending the outpatient department in Kuwait's seven major hospitals. A convenience sampling technique was used to recruit the participants. A self-administered questionnaire consisted of four parts: sociodemographic and baseline characteristics, knowledge of colorectal cancer screening, attitudes toward colorectal cancer screening, and practices toward colorectal cancer screening. RESULTS A total of 570 Kuwaiti patients were included, and half of them were males (n = 285). Most patients were aged between 45 and 50 years (53.8%), had a secondary school certificate (n = 357, 62.6%), and were unmarried (n = 419, 73.5%). Low levels of knowledge (<50%) and practices (<30%) toward colorectal cancer screening were seen among the participants. Statistically significant correlations were found between patients' knowledge about colorectal cancer screening and their attitudes (r = 0.317, P < 0.001) and practices (r = 0.330, P < 0.001). In addition, a moderately significant association was found between patients' attitudes and practices toward colorectal cancer screening. CONCLUSION The study found that despite positive attitudes, Kuwaiti patients have low levels of knowledge and practice regarding colorectal cancer screening. This suggests a need for targeted, culturally sensitive educational programs and national campaigns to improve screening rates and address knowledge gaps.
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Affiliation(s)
- Abdullah M Alharran
- Department of Medicine and Surgery, College of Medicine, Arabian Gulf University, Manama, BHR
| | - Retaj S Aljuma
- Department of Family and Community Medicine, Arabian Gulf University, Manama, BHR
| | - Aminah S Aljasmi
- Department of Family and Community Medicine, Arabian Gulf University, Manama, BHR
| | | | - Danah F M Alenezi
- Department of Family and Community Medicine, Arabian Gulf University, Manama, BHR
| | - Yaqoub Y Alenezi
- Department of Medicine and Surgery, College of Medicine, Arabian Gulf University, Manama, BHR
| | - Hajar N Alajmi
- Department of Family and Community Medicine, Arabian Gulf University, Manama, BHR
| | - Abdulbadih R Saad
- Department of Family and Community Medicine, Arabian Gulf University, Manama, BHR
| | - Ahmed A Jaradat
- Department of Family and Community Medicine, Arabian Gulf University, Manama, BHR
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Robles J, Prakash A, Vizcaíno JA, Casal JI. Integrated meta-analysis of colorectal cancer public proteomic datasets for biomarker discovery and validation. PLoS Comput Biol 2024; 20:e1011828. [PMID: 38252632 PMCID: PMC10833860 DOI: 10.1371/journal.pcbi.1011828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/01/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
The cancer biomarker field has been an object of thorough investigation in the last decades. Despite this, colorectal cancer (CRC) heterogeneity makes it challenging to identify and validate effective prognostic biomarkers for patient classification according to outcome and treatment response. Although a massive amount of proteomics data has been deposited in public data repositories, this rich source of information is vastly underused. Here, we attempted to reuse public proteomics datasets with two main objectives: i) to generate hypotheses (detection of biomarkers) for their posterior/downstream validation, and (ii) to validate, using an orthogonal approach, a previously described biomarker panel. Twelve CRC public proteomics datasets (mostly from the PRIDE database) were re-analysed and integrated to create a landscape of protein expression. Samples from both solid and liquid biopsies were included in the reanalysis. Integrating this data with survival annotation data, we have validated in silico a six-gene signature for CRC classification at the protein level, and identified five new blood-detectable biomarkers (CD14, PPIA, MRC2, PRDX1, and TXNDC5) associated with CRC prognosis. The prognostic value of these blood-derived proteins was confirmed using additional public datasets, supporting their potential clinical value. As a conclusion, this proof-of-the-concept study demonstrates the value of re-using public proteomics datasets as the basis to create a useful resource for biomarker discovery and validation. The protein expression data has been made available in the public resource Expression Atlas.
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Affiliation(s)
- Javier Robles
- Department of Molecular Biomedicine, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas, Madrid, Spain
- Protein Alternatives SL, Tres Cantos, Madrid, Spain
| | - Ananth Prakash
- European Molecular Biology Laboratory—European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Juan Antonio Vizcaíno
- European Molecular Biology Laboratory—European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - J. Ignacio Casal
- Department of Molecular Biomedicine, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas, Madrid, Spain
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Jiang HH, Xing SW, Tang X, Chen Y, Lin K, He LW, Lin MB, Tang EJ. Novel multiplex stool-based assay for the detection of early-stage colon cancer in a Chinese population. World J Gastroenterol 2022; 28:2705-2732. [PMID: 35979157 PMCID: PMC9260868 DOI: 10.3748/wjg.v28.i24.2705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/14/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Stool DNA (sDNA) methylation analysis is a promising, noninvasive approach for colorectal cancer screening; however, reliable biomarkers for detecting early-stage colon cancer (ECC) are lacking, particularly in the Chinese population.
AIM To identify a novel stool-based assay that can improve the effectiveness of ECC screening.
METHODS A blinded case-control study was performed using archived stool samples from 125 ECC patients, and 125 control subjects with normal colonoscopy. The cohort was randomly divided into training and test sets at a 1.5:1 ratio. Targeted bisulfite sequencing (TBSeq) was conducted on five pairs of preoperative and postop-erative sDNA samples from ECC patients to identify DNA methylation biomarkers, which were validated using pyrosequencing. By logistic regression analysis, a multiplex stool-based assay was developed in the training set, and the detection performance was further assessed in the test set and combined set. The χ2 test was used to investigate the association of detection sensitivity with clinico-pathological features.
RESULTS Following TBSeq, three hypermethylated cytosine-guanine sites were selected as biomarkers, including paired box 8, Ras-association domain family 1 and secreted frizzled-related protein 2, which differed between the groups and were involved in important cancer pathways. An sDNA panel containing the three biomarkers was constructed with a logistic model. Receiver operating characteristic (ROC) analysis revealed that this panel was superior to the fecal immunochemical test (FIT) or serum carcinoembryonic antigen for the detection of ECC. We further found that the combination of the sDNA panel with FIT could improve the screening effectiveness. In the combined set, the sensitivity, specificity and area under the ROC curve for this multiplex assay were 80.0%, 93.6% and 0.918, respectively, and the performance remained excellent in the subgroup analysis by tumor stage. In addition, the detection sensitivity did not differ with tumor site, tumor stage, histological differentiation, age or sex, but was significantly higher in T4 than in T1-3 stage tumors (P = 0.041).
CONCLUSION We identified a novel multiplex stool-based assay combining sDNA methylation biomarkers and FIT, which could detect ECC with high sensitivity and specificity throughout the colon, showing a promising application perspective.
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Affiliation(s)
- Hui-Hong Jiang
- Department of General Surgery, Yangpu Hospital, Tongji University, Shanghai 200090, China
- Institute of Gastrointestinal Surgery and Translational Medicine, Tongji University School of Medicine, Shanghai 200090, China
| | - Si-Wei Xing
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
- Center for Clinical Research and Translational Medicine, Yangpu Hospital, Tongji University, Shanghai 200090, China
| | - Xuan Tang
- Department of General Surgery, Yangpu Hospital, Tongji University, Shanghai 200090, China
| | - Ying Chen
- Institute of Gastrointestinal Surgery and Translational Medicine, Tongji University School of Medicine, Shanghai 200090, China
- Center for Clinical Research and Translational Medicine, Yangpu Hospital, Tongji University, Shanghai 200090, China
| | - Kang Lin
- Department of General Surgery, Yangpu Hospital, Tongji University, Shanghai 200090, China
- Center for Clinical Research and Translational Medicine, Yangpu Hospital, Tongji University, Shanghai 200090, China
| | - Lu-Wei He
- Institute of Gastrointestinal Surgery and Translational Medicine, Tongji University School of Medicine, Shanghai 200090, China
- Center for Clinical Research and Translational Medicine, Yangpu Hospital, Tongji University, Shanghai 200090, China
| | - Mou-Bin Lin
- Department of General Surgery, Yangpu Hospital, Tongji University, Shanghai 200090, China
- Institute of Gastrointestinal Surgery and Translational Medicine, Tongji University School of Medicine, Shanghai 200090, China
- Center for Clinical Research and Translational Medicine, Yangpu Hospital, Tongji University, Shanghai 200090, China
| | - Er-Jiang Tang
- Institute of Gastrointestinal Surgery and Translational Medicine, Tongji University School of Medicine, Shanghai 200090, China
- Center for Clinical Research and Translational Medicine, Yangpu Hospital, Tongji University, Shanghai 200090, China
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Ma L, Gong J, Zhao M, Kong X, Gao P, Jiang Y, Liu Y, Feng X, Si S, Cao Y. A Novel Stool Methylation Test for the Non-Invasive Screening of Gastric and Colorectal Cancer. Front Oncol 2022; 12:860701. [PMID: 35419280 PMCID: PMC8995552 DOI: 10.3389/fonc.2022.860701] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Because of poor compliance or low sensitivity, existing diagnostic approaches are unable to provide an efficient diagnosis of patients with gastric and colorectal cancer. Here, we developed the ColoCaller test, which simultaneously detects the methylation status of the SDC2, TFPI2, WIF1, and NDRG4 genes in stool DNA, to optimize the screening of gastric and colorectal cancer in high-risk populations. Methods A total of 217 stool samples from patients with gastrointestinal cancer and from patients with negative endoscopy were prospectively collected, complete with preoperative and postoperative clinical data from patients. The methylation of these samples was detected using ColoCaller, which was designed by selecting CpGs with a two-step screening strategy, and was interpreted using a prediction model built using libSVM to evaluate its clinical value for gastric and colorectal cancer screening. Results Compared to pathological diagnosis, the sensitivity and specificity of the ColoCaller test in 217 stool DNA samples were 95.56% and 91.86%, respectively, for colorectal cancer, and 67.5% and 97.81%, respectively, for gastric cancer. The detection limit was as low as 1% in 8 ng of DNA. Conclusion In this study, we developed and established a new test, ColoCaller, which can be used as a screening tool or as an auxiliary diagnostic approach in high-risk populations with gastric and colorectal cancer to promote timely diagnosis and treatment.
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Affiliation(s)
- Liang Ma
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Jian Gong
- Department of Research and Development, Apexbio Biotechnology (Suzhou) Co., Ltd., Suzhou, China
| | - Meimei Zhao
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Xiaomu Kong
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Peng Gao
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Yongwei Jiang
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Yi Liu
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Xiaoyan Feng
- Department of Research and Development, Apexbio Biotechnology (Suzhou) Co., Ltd., Suzhou, China
| | - Shuang Si
- Department of General Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Yongtong Cao
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
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Wu X, Wang J, Ye Z, Wang J, Liao X, Liv M, Svn Z. Risk of Colorectal Cancer in Patients With Irritable Bowel Syndrome: A Meta-Analysis of Population-Based Observational Studies. Front Med (Lausanne) 2022; 9:819122. [PMID: 35308554 PMCID: PMC8924657 DOI: 10.3389/fmed.2022.819122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/28/2022] [Indexed: 12/12/2022] Open
Abstract
Background and Aims Evidence on the association between irritable bowel syndrome (IBS) and colorectal cancer (CRC) risk is inconsistent. Therefore, we aimed to examine whether IBS leads to an increased risk for CRC using a systematic review and meta-analysis approach. Methods PubMed, Embase, and Web of Science were systematically searched to identify all relevant literature published through July 30, 2021. The pooled risk ratios (RRs) and corresponding 95% confidence intervals (CIs) for CRC after diagnosis of IBS were computed using random-and fixed-effects models and stratified by age, follow-up time, gender, and study design. The quality of included studies was assessed by the Newcastle-Ottawa scale. Results We included six studies consisting of 1,085,024 participants. Overall, the risk of detecting CRC after the initial IBS diagnosis was significantly higher than non-IBS controls (RR = 1.52, 95% CI: 1.04-2.22, P = 0.032). The peak of elevated risk occurred within the first year of IBS diagnosis (RR = 6.84, 95% CI: 3.70-12.65, P < 0.001), and after 1 year, the risk of CRC was similar to that of the general population (RR = 1.02, 95% CI: 0.88-1.18, P = 0.813). Notably, we found that the RR of CRC was more significant in IBS patients younger than 50 years compared to those older than 50 years (RR = 2.03, 95% CI: 1.17-3.53, P = 0.012 vs. 1.28, 95%CI: 0.94-1.75, P = 0.118, respectively). Gender and study design did not affect the results. Conclusion The risk of CRC within one year of the initial IBS diagnosis was increased approximately six-fold, whereas the long-term risk was not increased. However, current evidence does not support that IBS leads to an increased incidence of CRC, and the early excess risk is more likely attributable to misclassification resulting from overlapping symptoms rather than causation. Clinicians must remain vigilant for the CRC risk in patients younger than 50 years with IBS-like symptoms to avoid delaying necessary screening.
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Affiliation(s)
- Xinhui Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jingxi Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Zhen Ye
- Hengyang Medical School, University of South China, Hengyang, China
| | - Jin Wang
- Hengyang Medical School, University of South China, Hengyang, China
| | - Xibei Liao
- Hengyang Medical School, University of South China, Hengyang, China
| | - Mengsi Liv
- Hengyang Medical School, University of South China, Hengyang, China
| | - Zhen Svn
- Hengyang Medical School, University of South China, Hengyang, China
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Mazouji O, Ouhajjou A, Incitti R, Mansour H. Updates on Clinical Use of Liquid Biopsy in Colorectal Cancer Screening, Diagnosis, Follow-Up, and Treatment Guidance. Front Cell Dev Biol 2021; 9:660924. [PMID: 34150757 PMCID: PMC8213391 DOI: 10.3389/fcell.2021.660924] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most common cancers worldwide, being the third most diagnosed in the world and the second deadliest. Solid biopsy provides an essential guide for the clinical management of patients with colorectal cancer; however, this method presents several limitations, in particular invasiveness, and cannot be used repeatedly. Recently, clinical research directed toward the use of liquid biopsy, as an alternative tool to solid biopsy, showed significant promise in several CRC clinical applications, as (1) detect CRC patients at early stage, (2) make treatment decision, (3) monitor treatment response, (4) predict relapses and metastases, (5) unravel tumor heterogeneity, and (6) detect minimal residual disease. The purpose of this short review is to describe the concept, the characteristics, the genetic components, and the technologies used in liquid biopsy in the context of the management of colorectal cancer, and finally we reviewed gene alterations, recently described in the literature, as promising potential biomarkers that may be specifically used in liquid biopsy tests.
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Affiliation(s)
- Omayma Mazouji
- GES-LCM2E, FPN, Mohamed First University, Oujda, Morocco
| | | | - Roberto Incitti
- Computational Bioscience Research Center (CBRC), King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Hicham Mansour
- GES-LCM2E, FPN, Mohamed First University, Oujda, Morocco
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Editorial: Colon cancer detection and prevention in the age of COVID-19. Curr Opin Gastroenterol 2021; 37:37-38. [PMID: 33060395 DOI: 10.1097/mog.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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