Streptococcus bovis prosthetic valve endocarditis associated with silent colonic carcinoma

Epidemiology of Colorectal Cancer in Saudi Arabia: A Review

Colorectal cancer (CRC) is the second leading cause of cancer death in the world, originating from the glandular epithelial cells of the large intestine and the rectum. This article aims to review the epidemiology of CRC in Saudi Arabia, focusing on prevalence, incidence, risk factors, preventive measures, and outcomes. This narrative review utilized the PubMed database for data extraction, including freely accessible studies published in the last 15 years. Sixteen articles from different study designs were included, while awareness and non-English language studies were excluded. In 2020, the incidence and mortality rate of CRC in Saudi Arabia were 14.6% and 1.48% among all cancers, respectively. From 2006 to 2016, the number of colon cancer and rectal cancer cases increased by 8% and 7%, respectively. Risk factors for CRC in Saudi Arabia include low education level, unemployment, physical inactivity, excess weight, poor knowledge of foods rich in fiber, cigarette smoking, reduced serum vitamin D and calcium levels, and certain gene mutations. National guidelines in Saudi Arabia recommend CRC screening for all individuals above 45 years using colonoscopy, flexible sigmoidoscopy, or fecal occult blood test. The 10-year survival rate for CRC in Saudi Arabia is 44.6%. The overall 5-year survival rate for the Ministry of National Guard-Health Affairs is 52.0%. To lower the incidence and mortality of CRC, primary, secondary, and tertiary prevention are all very important. The most crucial aspect is to concentrate on primary prevention, which may involve raising public awareness of CRC risk factors and strategies for reducing or eliminating them.

Diagnostic Evaluation of Streptococcus gallolyticus Infection in Patients with Colon Diseases by Polymerase Chain Reaction (PCR) and Culturing Methods

Background: Different types of Streptococcus gallolyticus are associated with malignant bowel cancer. Objectives: The aim of this study was to compare two culture and molecular methods in identifying Streptococcus gallolyticus in patients with colon diseases. Methods: A descriptive study was conducted to detect Streptococcus gallolyticus in 55 patients with colon diseases referring to hospitals in Babol and Chalus, Iran. A polymerase chain reaction and culture technique were performed. Detection of Streptococcus gallolyticus after deoxyribonucleic acid (DNA) extraction from designed primers (PCO3, PCO4) was used for SODA gene. From the general culture medium, brain heart infusion (BHI) broth and specific medium for bacterial growth and detection were used. Then, the characteristics of the two methods were evaluated. Results: Of 55 biopsy samples of patients with colon diseases, 3 samples (5.5%) with 95% confidence interval were positive and 52 (94.5%) were reported negative in terms of DNA of Streptococcus gallolyticus. According to the culture test, 9 (16.4%) were positive and 46 (83.6%) were negative for diagnosis of Streptococcus gallolyticus bacteria. Based on the diagnostic agreement between the two methods, the ratio of 9 positive cases of culture method to 3 positive cases by polymerase chain reaction (PCR) method (3.6%) were reported positive both in terms of molecular and positive culture, and 7 (12.7%) out of 9 (16.4%) were negative. To investigate the agreement between the culture and PCR methods, the Kappa test was used, which was statistically significant (P < 0.015). Other studies which have been conducted using the culture method, reported a significant relationship between the family history of colorectal cancer, diabetes, and the presence of Streptococcus gallolyticus bacteria. Conclusions: Considering the advantages, disadvantages, and the characteristics of both methods, none of them can be considered as a comprehensive, standard test at present. The simultaneous use of the two methods is recommended in cases where achieving fast results prevails, or when there is a likelihood of sample infection or late-growing microorganisms.