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Abraham S, Foreman N, Sidat Z, Sandhu P, Marrone D, Headley C, Akroyd C, Nicholson S, Brown K, Thomas A, Howells LM, Walter HS. Inequalities in cancer screening, prevention and service engagement between UK ethnic minority groups. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S14-S24. [PMID: 35648663 DOI: 10.12968/bjon.2022.31.10.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
More people in the UK are living with cancer than ever before. With an increasingly ethnically diverse population, greater emphasis must be placed on understanding factors influencing cancer outcomes. This review seeks to explore UK-specific variations in engagement with cancer services in minority ethnic groups and describe successful interventions. The authors wish to highlight that, despite improvement to engagement and education strategies, inequalities still persist and work to improve cancer outcomes across our communities still needs to be prioritised. There are many reasons why cancer healthcare inequities exist for minority communities, reported on a spectrum ranging from cultural beliefs and awareness, through to racism. Strategies that successfully enhanced engagement included language support; culturally-sensitive reminders; community-based health workers and targeted outreach. Focusing on the diverse city of Leicester the authors describe how healthcare providers, researchers and community champions have worked collectively, delivering targeted community-based strategies to improve awareness and access to cancer services.
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Affiliation(s)
- Shalin Abraham
- F2 Academic Foundation Doctor, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Nalini Foreman
- Quality Assistant, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Zahirah Sidat
- Senior Research Practitioner, Hope Clinical Trials Facility, University Hospitals of Leicester NHS Trust, Leicester
| | - Pavandeep Sandhu
- Research Technician, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Domenic Marrone
- Research Technician, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Catherine Headley
- Senior Cancer Services Manager, Leicester City Clinical Commissioning Group, Leicester
| | - Carol Akroyd
- Collaboration for Leadership in Applied Health Research and Care Equality and Diversity Theme Manager, Centre for Ethnic Health Research, University of Leicester, Leicester
| | - Sarah Nicholson
- Hope Clinical Trials Facility Manager/Cancer, Haematology, Urology, Gastroenterology, General Surgery Research Lead, Hope Clinical Trials Facility, University Hospitals of Leicester NHS Trust, Leicester
| | - Karen Brown
- Professor in Translational Cancer Research, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Anne Thomas
- Professor of Cancer Therapeutics, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Lynne M Howells
- Experimental Cancer Medicine Centre Translational Research Manager, Leicester Cancer Research Centre, University of Leicester, Leicester
| | - Harriet S Walter
- Associate Professor of Medical Oncology, Leicester Cancer Research Centre, University of Leicester, Leicester
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Shen L, Kann BH, Taylor RA, Shung DL. The Clinician's Guide to the Machine Learning Galaxy. Front Physiol 2021; 12:658583. [PMID: 33889088 PMCID: PMC8056037 DOI: 10.3389/fphys.2021.658583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/10/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lin Shen
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States.,Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, United States
| | - Benjamin H Kann
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.,Artificial Intelligence in Medicine Program, Brigham and Women's Hospital, Boston, MA, United States
| | - R Andrew Taylor
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Dennis L Shung
- Section of Digestive Diseases, Department of Medicine, Yale School of Medicine, New Haven, CT, United States
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Chandrasinghe PC, Ediriweera DS, Hewavisenthi J, Kumarage SK, Fernando FR, Deen KI. Colorectal cancer burden and trends in a South Asian cohort: experience from a regional tertiary care center in Sri Lanka. BMC Res Notes 2017; 10:535. [PMID: 29084610 PMCID: PMC5663050 DOI: 10.1186/s13104-017-2869-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/24/2017] [Indexed: 11/18/2022] Open
Abstract
Objective Colorectal cancer (CRC) burden is increasing in the south Asian region due to the changing socio-economic landscape and population demographics. There is a lack of robust high quality data from this region in order to evaluate the disease pattern and comparison. Using generalized linear models assuming Poisson distribution and model fitting, authors describe the variation in the landscape of CRC burden along time since 1997 at a regional tertiary care center in Sri Lanka. Results Analyzing 679 patients, it is observed that both colon and rectal cancers have significantly increased over time (pre 2000—61, 2000 to 2004—178, 2005 to 2009—190, 2010 to 2014–250; P < 0.05). Majority of the cancers were left sided (82%) while 77% were rectosigmoid. Over 25% of all CRC were diagnosed in patients less than 50 years and the median age at diagnosis is < 62 years. Increasing trend is seen in the stage at presentation while 33% of the rectal cancers received neoadjuvant chemoradiation. Left sided preponderance, younger age at presentation and advanced stage at presentation was observed. CRC disease pattern in the South Asian population may vary from that observed in the western population which has implications on disease surveillance and treatment.
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Affiliation(s)
- P C Chandrasinghe
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
| | - D S Ediriweera
- Centre for Health Informatics, Biostatistics and Epidemiology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - J Hewavisenthi
- Department of Pathology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - S K Kumarage
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - F R Fernando
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - K I Deen
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
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Iqbal F, Zaman S, Karandikar S, Hendrickse C, Bowley DM. Engaging with Faith Councils to Develop Stoma-specific Fatawās: A Novel Approach to the Healthcare Needs of Muslim Colorectal Patients. JOURNAL OF RELIGION AND HEALTH 2016; 55:803-811. [PMID: 23999976 DOI: 10.1007/s10943-013-9772-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Intestinal stomas are common. Muslims report significantly lower quality of life following stoma surgery compared to non-Muslims. A fatwā is a ruling on a point of Islamic law according to a recognised religious authority. The use of fatawās to guide health-related decision-making has becoming an increasingly popular practice amongst Muslims, regardless of geographic location. This project aimed to improve the quality of life of Muslim ostomates by addressing faith-specific stoma concerns. Through close collaboration with Muslim ostomates, a series of 10 faith-related questions were generated, which were posed to invited local faith leaders during a stoma educational event. Faith leaders received education concerning the realities of stoma care before generating their fatawās. The event lead to the formulation of a series of stoma-specific fatawās representing Hanafi and Salafi scholarship, providing faith-based guidance for Muslim ostomates and their carers. Enhanced communication between healthcare providers and Islamic faith leaders allows for the delivery of informed fatawās that directly benefit Muslim patients and may represent an efficient method of improving health outcomes in this faith group.
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Affiliation(s)
- Fareed Iqbal
- School of Cancer Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Shafquat Zaman
- Heart of England NHS Foundation Trust, Bordesley Green, Birmingham, B9 5SS, UK
| | - Sharad Karandikar
- Heart of England NHS Foundation Trust, Bordesley Green, Birmingham, B9 5SS, UK
| | - Charles Hendrickse
- Heart of England NHS Foundation Trust, Bordesley Green, Birmingham, B9 5SS, UK
| | - Douglas M Bowley
- Heart of England NHS Foundation Trust, Bordesley Green, Birmingham, B9 5SS, UK
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Ethnic variation in colorectal cancer risk following a positive faecal occult blood test in an English bowel cancer screening programme centre. Eur J Gastroenterol Hepatol 2015; 27:1281-5. [PMID: 26267240 DOI: 10.1097/meg.0000000000000443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIMS The literature on colorectal cancer (CRC) screening and ethnic diversity is dominated by studies from the USA. There are no such published data from the UK bowel cancer screening programme (BCSP) population. The Wolverhampton Bowel Cancer Screening Centre serves a population of 900,000 in the Black Country and South Staffordshire. South Asians (SA) comprise 9% of the population. We aimed to determine the effects of ethnicity and sex on the risk for cancer or adenoma detected by colonoscopy following a positive faecal occult blood test over a 5-year period (2007-2011). METHODS Data were collected from the prospectively maintained BCSP cohort. South Asian patients were identified and compared with those of non-South Asian ethnicity, and colonoscopy outcomes were determined. RESULTS A total of 3552 participants underwent BCSP colonoscopy (non-South Asian=3363; SA=189). There were 271 cancers (7.6%) detected within the non-South Asian group and seven cancers (0.2%) in the South Asian population (P<0.05). The probability of colon cancer is higher [odds ratio (OR)=3.84, P<0.05] in non-South Asians compared with South Asians. Patients in the 65-70-year age group have the highest risk (OR=1.60; P<0.05) for CRC. During the study 1313 adenomas were detected. A total of 771 high-risk and intermediate-risk adenomas were detected in the non-South Asian group, and 14 were detected in the South Asian group. The risk of adenoma in non-South Asians is six times higher than in South Asians (OR=5.99, P<0.001) following positive faecal occult blood testing. CONCLUSION There are fewer colorectal cancers in South Asians compared with the non-South Asian population in this regional study. This is the first such study in the BCSP population.
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Hussain M, Khalid AB, Ahsan S, Jafri W, Hamid S, Javed A, Wahab S. Age and site of Colonic Neoplastic Lesions: Implications of screening in South Asia. Pak J Med Sci 2015; 30:1277-80. [PMID: 25674123 PMCID: PMC4320715 DOI: 10.12669/pjms.306.5701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 05/27/2014] [Accepted: 07/28/2014] [Indexed: 11/15/2022] Open
Abstract
UNLABELLED Objective : To evaluate the Age of patients and the site of Colonic Neoplastic Lesions (CNL) and to determine the appropriate screening strategy for Colorectal Carcinoma (CRC) (sigmoidoscopy versus colonoscopy) in our population. Methods : This is a cross sectional study. Data of all patients more than 16 years of age who underwent full colonoscopic examination at the Aga Khan University hospital between January 2011 till December 2013 and were diagnosed to have CRC or advanced adenomas (defined as polyp more than 1 cm and/or having villous morphology on histology) was recorded. Lesions found distal to the splenic flexure were characterized as distal lesions and while lesions found between the splenic flexure and the cecum were characterized as proximal lesions. RESULTS During the study period colonic neoplastic lesions were found in 217 patients; 186 (85.7%) patients had CRC and 31(14.3%) patients had advanced adenomatous polyps. Mean age was 55.8±14 years and amongst them 72 (33.2%) patients were less than 50 years of age while 145 (66.8%) were more than 50 years. In 144 (66.4%) patients lesions were located in the distal colon, 65 (30%) had lesions in the proximal colon while in 8 (3.7%) patients the neoplastic lesions were found both in the proximal and distal colon. The predominant symptoms were bleeding per rectum in 39.6% of patients followed by weight loss in 31.8% of patients. Only 3 patients had familial syndromes with multiple polyps. When patients younger than 50 years of age were compared with patients more than 50 years there was no statistically significant difference between the site of neoplastic lesion as well as the presenting symptoms. (p value 0.85). CONCLUSION Colonic Neoplastic Lesions presented at younger age in our study population and one third of the lesions were found in the right sided colon. Hence screening for CNLs should be implied at an earlier age preferably with colonoscopy. More population based data is required to further validate our results.
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Affiliation(s)
- Manzoor Hussain
- Manzoor Hussain, FCPS Medicine, Fellow Gastroenterology, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi
| | - Abdullah Bin Khalid
- Abdullah bin Khalid, FCPS Medicine, FCPS Gastro, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Ahsan
- Syed Ahsan Ali, FCPS Medicine, Instructor in Dept. of Medicine, Pakistan. National Institute of Liver and Gastrointestinal Diseases, Dow University of Health Sciences, Karachi, Pakistan
| | - Wasim Jafri
- SM Wasim Jafri, FRCP, FACG, Professor of Medicine, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Saeed Hamid
- Saeed S Hamid. FRCP, FACG, Professor and Chair of Medicine, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Anam Javed
- Anam Javed, Medical Student, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Sana Wahab
- Sana Wahab, Medical Student, National Institute of Liver and Gastrointestinal Diseases, Dow University of Health Sciences, Karachi, Pakistan. National Institute of Liver and Gastrointestinal Diseases, Dow University of Health Sciences, Karachi, Pakistan
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Raman R, Kongara R, Kotapalli V, Gowrishankar S, Sastry RA, Nagari B, Bashyam MD. Pathological stage significantly predicts survival in colorectal cancer patients: a study from two tertiary care centers in India. COLORECTAL CANCER 2014. [DOI: 10.2217/crc.14.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
SUMMARY Aims: An increase in incidence of early-onset colorectal cancer (EOCRC) in developing countries, including India, is reported recently; however, systematic analyses of clinico-pathological features and disease prognosis has seldom been undertaken. Materials & methods: We studied clinical data pertaining to 1259 colorectal adenocarcinoma patients from two tertiary cancer centers in south India. Results: Approximately 45% of patients were aged below 50 years and poor grade and late-stage tumors were significantly associated with early disease onset. Although tumor grade and stage significantly influenced disease-free survival independently, significant association between survival and age of onset or tumor location was not detected unlike previous observations. Conclusion: Given the sizeable proportion of EOCRC, implementation of the revised Bethesda guidelines may not be tenable in India. More importantly, the previous observation of EOCRC being significantly associated with poor survival could, in part, be due to a higher proportion of advanced-stage tumors.
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Affiliation(s)
- Ratheesh Raman
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting & Diagnostics, Hyderabad, India
| | - Ravikanth Kongara
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
- Bariatry & Obesity Clinic, Endocare Hospital, Vijayawada, India
| | - Viswakalyan Kotapalli
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting & Diagnostics, Hyderabad, India
| | | | - Regulagadda A Sastry
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
- Department of Surgical Gastroenterology & HPB Surgery, Krishna Institute of Medical Sciences, Hyderabad, India
| | - Bheerappa Nagari
- Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Murali D Bashyam
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting & Diagnostics, Hyderabad, India
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What hinders minority ethnic access to cancer genetics services and what may help? Eur J Hum Genet 2013; 22:866-74. [PMID: 24253862 PMCID: PMC4060110 DOI: 10.1038/ejhg.2013.257] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 09/25/2013] [Accepted: 10/02/2013] [Indexed: 01/09/2023] Open
Abstract
Ethnic disparities in use of cancer genetics services raise concerns about equitable opportunity to benefit from familial cancer risk assessment, improved survival and quality of life. This paper considers available research to explore what may hinder or facilitate minority ethnic access to cancer genetics services. We sought to inform service development for people of South Asian, African or Irish origin at risk of familial breast, ovarian, colorectal and prostate cancers in the UK. Relevant studies from the UK, North America and Australasia were identified from six electronic research databases. Current evidence is limited but suggests low awareness and understanding of familial cancer risk among minority ethnic communities studied. Socio-cultural variations in beliefs, notably stigma about cancer or inherited risk of cancer, are identified. These factors may affect seeking of advice from providers and disparities in referral. Achieving effective cross-cultural communication in the complex contexts of both cancer and genetics counselling, whether between individuals and providers, when mediated by third party interpreters, or within families, pose further challenges. Some promising experience of facilitating minority ethnic access has been gained by introduction of culturally sensitive provider and counselling initiatives, and by enabling patient self-referral. However, further research to inform and assess these interventions, and others that address the range of challenges identified for cancer genetics services are needed. This should be based on a more comprehensive understanding of what happens at differing points of access and interaction at community, cancer care and genetic service levels.
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Yi M, Xu J, Liu P, Chang GJ, Du XL, Hu CY, Song Y, He J, Ren Y, Wei Y, Yang J, Hunt KK, Li X. Comparative analysis of lifestyle factors, screening test use, and clinicopathologic features in association with survival among Asian Americans with colorectal cancer. Br J Cancer 2013; 108:1508-14. [PMID: 23470470 PMCID: PMC3629437 DOI: 10.1038/bjc.2013.97] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Colorectal cancer (CRC) diagnoses and disease-specific survival (DSS) vary between ethnic groups in the United States. However, few studies have assessed differences among Asian subgroups. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients with invasive CRC between 1988 and 2008. Differences in clinicopathologic features, and DSS rates were compared among Asian subgroups. The California Health Interview Survey was used to examine risk factors and screening patterns for CRC. Results: The study included 359 374 patients with 8.4% Asian. Patients in all Asian subgroups were younger (median: 68 years) at diagnosis than non-Hispanic white (NHW) patients (median: 72 years). Most Asian subgroups, except Hawaiians, had better DSS than NHW patients although Asian subgroups had more advanced disease than NHW. Indian/Pakistani patients had a higher 5-year DSS than other Asian subgroups. Obesity proportions were lower in Asian subgroups (<50.2%) than in NHW (59.8%). Vietnamese men and Korean women had the lowest proportions of CRC screening. Advance tumour stages were highly associated with worse DSS in each ethnicity group. High tumour grades were associated with worse DSS in NHW, Filipino, and Chinese. Older age at diagnosis was associated with worse DSS in most ethnicity groups except Hawaiian and Vietnamese. Conclusion: Disparities exist between Asians and NHW with CRC, and among various Asian subgroups. Differences in cancer clinicopathologic features, patients' behavioural habits, lifestyle, and screening patterns may explain some differences in CRC survival observed among ethnic groups.
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Affiliation(s)
- M Yi
- Department of Translational Medicine, The First Affiliated Hospital of Xian Jiaotong University, School of Medicine, Xian, China.
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Mayberry JF, Farrukh A. Gastroenterology and the provision of care to Panjabi patients in the UK. Frontline Gastroenterol 2012; 3:191-198. [PMID: 28839663 PMCID: PMC5517281 DOI: 10.1136/flgastro-2012-100119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2012] [Indexed: 02/04/2023] Open
Abstract
Panjabi is spoken by 1.3 million people in the UK. It is the second most common language used in the country and is the first choice of 75% of Panjabis. It is becoming more common. For many patients it forms part of the barrier which limits access to gastrointestinal services. The provision of appropriate support services is woeful and yet seldom leads to formal complaints. This review considers the impact of gastrointestinal disorders on the Panjabi community and assesses some of the interventions that could be developed to ensure equity of care.
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Affiliation(s)
- John Francis Mayberry
- Department of Digestive Diseases, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Affifa Farrukh
- Department of Digestive Diseases, University Hospitals of Leicester NHS Trust, Leicester, UK
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Hebbar S, Fuggle WJ, Nevill AM, Veitch AM. Colorectal cancer incidence and trend in UK South Asians: a 20-year study. Colorectal Dis 2012; 14:e319-22. [PMID: 22284437 DOI: 10.1111/j.1463-1318.2012.02960.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIMS South Asians comprise 13.6% of the Wolverhampton population. We aimed to compare the incidence and trend of colorectal cancer in this subgroup with the non South Asian population over a 20-year period. METHOD Patients of South Asian origin diagnosed with colorectal cancer from 1989 to 2008 were identified from the hospital histopathology database and compared with those of non South Asian origin. 1991 and 2001 census data were used to standardize for differing age and sex distributions in the two study populations. RESULTS The median unadjusted incidence of colorectal cancer from 1989 to 2008 was 6.17 per 100,000 per year in South Asians compared with 71.70 per 100,000 per year in non South Asians (77.79% white British). The age and sex adjusted odds ratio for colorectal cancer in South Asians was 0.2 (P < 0.001). There was an equal increased trend in the incidence in both the South Asians and non South Asians over the study period (0.8% per year). In patients < 50 years, the gender difference in the incidence of cancer was not significant, but as age increased this rose significantly (males > females). CONCLUSION There was a markedly lower incidence of colorectal cancer in South Asians compared with non South Asians, maintained over 20 years. Colorectal cancer incidence increased by a small and similar amount over the period in both groups. There was a male preponderance of colorectal cancer in both populations over 50 years.
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Affiliation(s)
- S Hebbar
- Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
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Gnosa S, Shen YM, Wang CJ, Zhang H, Stratmann J, Arbman G, Sun XF. Expression of AEG-1 mRNA and protein in colorectal cancer patients and colon cancer cell lines. J Transl Med 2012; 10:109. [PMID: 22643064 PMCID: PMC3464714 DOI: 10.1186/1479-5876-10-109] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 05/29/2012] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Astrocyte elevated gene 1 (AEG-1), an important oncogene, has been shown to be overexpressed in several types of cancers. In colorectal cancer (CRC), the protein level of AEG-1 is up-regulated in tumour tissue compared to normal mucosa, showing prognostic significance. Since little is known about the transcriptional level of AEG-1 expression and its biological pathway in CRC the aim of the present study was to examine the relationship of AEG-1 mRNA expression, the protein level and clinicopathological variables as well as its biology pathway in CRC. MATERIAL AND METHODS The mRNA expression of AEG-1 was analysed by qPCR in fresh frozen patient samples including 156 primary tumours, along with the corresponding normal mucosa, and in five colon cancer cell lines, SW480, SW620, KM12C, KM12SM and KM12L4a. AEG-1 protein expression was investigated by immunohistochemistry in paraffin-embedded materials from 74 distant normal mucosa, 107 adjacent mucosa, 158 primary tumour, 35 lymph node metastasis and 9 liver metastasis samples. In addition, the AEG-1 protein expression was elucidated in the cell lines by Western blot. RESULTS The lymph node metastatic cell line SW620 had a significantly higher AEG-1 mRNA (0.27 ± 0.02) expression compared to the primary tumour cell line SW480 (0.17 ± 0.04, p = 0.026). AEG-1 expression at the mRNA level and/or the protein level was significantly up-regulated gradually from normal mucosa to primary CRC, and then to lymph node metastasis and finally to liver metastasis (p < 0.05). There were significant associations of AEG-1 mRNA expression with tumour location (p = 0.047), as well as mRNA and protein expression with the tumour stage (p < 0.03). Furthermore AEG-1 protein expression was positively related to biological variables including NF-κB, p73, Rad50 and apoptosis (p < 0.05). CONCLUSION AEG-1 is up-regulated, at the mRNA and the protein level, during CRC development and aggressiveness, and is related to tumour location and stage. It may play its role in CRC through the NF-κB signaling pathway.
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Affiliation(s)
- Sebastian Gnosa
- Division of Oncology, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
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Siriwardana RC, Wijesuriya SRE, Kumarage SK, Deen KI. Synchronous liver metastasis in colorectal cancer in Sri Lanka. Indian J Gastroenterol 2010; 29:149-51. [PMID: 20740338 DOI: 10.1007/s12664-010-0041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 08/09/2010] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess the incidence of synchronous colorectal liver metastasis in patients referred to a tertiary referral center in Sri Lanka and to evaluate the differences in the clinicopathological features of patients with and without synchronous metastasis. METHODS Records of 438 patients were retrospectively analyzed. Patients were classified into metastatic group (n = 34, 8%) and non metastastatic group (n = 404, 92%). In the two groups macroscopic features compared were: tumor size (2 cm, 2-5 cm, and >5 cm), site of primary tumor and side of liver involved. Carcinoembryonic antigen (CEA) levels were recorded. At microscopy, tumor differentiation, invasion and nodal status were evaluated. RESULTS The rectum was the primary site of the tumor in a majority (60%) of patients. There was no difference in the distribution of the primary site and size of the tumor, pathological stage, lymphatic infiltration and the degree of tumor differentiation in two groups (p > 0.05). Patients with metastasis had higher levels of CEA, higher frequency of vascular infiltration and N3 nodes involved (p < 0.05). CONCLUSION The incidence of synchronous colorectal liver metastasis seems to be lower in our patients. Association of higher CEA level, advanced nodal stage and presence of vascular invasion needs to be further assessed with risk of developing metachronous liver metastasis.
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