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Aynalem ZB, Adal AB, Ayele TF, Bayeh GM, Yeshiwas AG, Dessie TM, Tsega TD. Mortality rate and predictors of colorectal cancer patients in Ethiopia: a systematic review and meta-analysis. BMC Cancer 2024; 24:821. [PMID: 38987683 PMCID: PMC11234545 DOI: 10.1186/s12885-024-12597-9] [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: 02/10/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024] Open
Abstract
INTRODUCTION The incidence of colorectal cancer (CRC) has been increasing in Sub-Saharan countries, including Ethiopia. However, the real mortality rate for CRC patients in Ethiopia has not been established. Therefore, this systematic review and meta-analysis aimed to determine the overall mortality rate and identify predictors among CRC patients in Ethiopia. METHODS PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar were searched to identify relevant articles. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. The quality of the included studies was assessed using the Newcastle-Ottawa Scale Critical Appraisal checklist. A random effect model was used to estimate the pooled mortality rate and adjusted hazard ratio (AHR). Publication bias was assessed using funnel plots and Egger's regression test, while heterogeneity was evaluated through the Cochran Q test and I2 statistics. RESULTS After reviewing 74 articles, only 7 studies met the criteria and were included in the analysis. The analysis revealed that the overall mortality rate among CRC patients in Ethiopia was 40.5% (95% confidence interval [CI]: 32.05, 48.87) while the survival rates at 1 year, 3 years, and 5 years were 82.3% (95% CI: 73.33, 91.31), 48.8% (95% CI: 43.35, 54.32), and 26.6% (95% CI: 21.26, 31.91) respectively. Subgroup analysis indicated that studies conducted after 2017 had higher mortality rates compared to those studied earlier (43.0% vs. 38.2%). Older age (AHR: 1.89, 95% CI: 1.27, 2.82); being married (AHR: 2.53, 95% CI: 1.79, 3.57); having comorbidities (AHR: 1.84, 95% CI: 1.45, 2.35); having high CEA levels (AHR: 2.06, CI: 1.35, 3.13); being in stage II (AHR: 4.13, 95% CI: 1.85, 9.22), III (AHR: 8.62, 95% CI: 3.88, 19.15), and IV (AHR: 8.06, CI: 2.89, 22.49) were the most important predictors. CONCLUSION In Ethiopia, the mortality rate among individuals diagnosed with CRC is high, with two out of five patients dying from this disease. Age, marital status, CEA level, comorbidities, and cancer stage were identified as predictors of mortality in CRC patients. Therefore, early detection and screening should be prioritized, particularly for older patients, those who are married, have comorbidities, elevated CEA levels, and advanced cancer stages.
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Affiliation(s)
- Zewdu Bishaw Aynalem
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
| | - Abebaw Bires Adal
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Temesgien Fentahun Ayele
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Gashaw Melkie Bayeh
- Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Almaw Genet Yeshiwas
- Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tadesse Miretie Dessie
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tilahun Degu Tsega
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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Elshami M, Dwikat MF, Al-Slaibi I, Alser M, Albandak ME, Ayyad M, Naji SA, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Nemer RMA, Almadhoun NM, Skaik SM, Albarqi SI, Abu-El-Noor N, Bottcher B. Understanding the interplay of colorectal cancer awareness and attitudes among Palestinians: a national cross-sectional study. BMC Cancer 2024; 24:590. [PMID: 38750448 PMCID: PMC11094844 DOI: 10.1186/s12885-024-12357-9] [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: 01/10/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In Palestine, colorectal cancer (CRC) is the second most common cause of cancer-related mortality after lung cancer. No studies have examined the relationship between CRC awareness and attitudes. This study aimed to investigate the interplay between CRC awareness and attitudes among the Palestinian population. METHODS A nationwide cross-sectional survey was carried out between July 2019 and March 2020. Convenience sampling was used to collect data from hospitals, primary healthcare facilities, and public areas in 11 governorates. Modified, translated-into-Arabic versions of the validated Bowel Cancer Awareness Measure and Cancer Awareness Measure-Mythical Causes Scale were utilized to assess the awareness of CRC signs/symptoms, risk factors, and causation myths. The cumulative awareness score for each domain was computed and stratified into tertiles. The top tertile denoted 'high' awareness, while the remaining two tertiles denoted 'low' awareness. RESULTS The final analysis included 4,623 participants; of whom, 3115 (67.4%) reported positive attitudes toward CRC. In total, 1,849 participants (40.0%) had high awareness of CRC signs/symptoms. There was no association between displaying a high awareness of CRC signs/symptoms and having positive attitudes toward CRC. A total of 1,840 participants (38.9%) showed high awareness of CRC risk factors. Participants with high CRC risk factor awareness were more likely to display positive attitudes toward CRC (OR = 1.22, 95% CI: 1.07-1.39). Only 219 participants (4.7%) had high awareness of CRC causation myths. Participants with high awareness of CRC causation myths were more likely to exhibit positive attitudes toward CRC (OR = 2.48, 95% CI: 1.71-3.58). CONCLUSION A high awareness level of CRC risk factors and causation myths was associated with a greater likelihood of demonstrating positive attitudes toward CRC in terms of perceived susceptibility, importance of early detection, and consequences of developing the disease. Future educational interventions should focus on raising public awareness about CRC, with a particular emphasis on risk factors and causation myths, to maximize the potential for shaping favorable attitudes toward the disease.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside, Cleveland, OH, 7100, 44106, USA.
- Ministry of Health, Gaza, Palestine.
| | - Mohammad Fuad Dwikat
- Department of Internships, An-Najah National University Hospital, Nablus, Palestine
| | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | | | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Khayria Ali Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Iyas Imad Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Conca V, Ciracì P, Boccaccio C, Minelli A, Antoniotti C, Cremolini C. Waiting for the "liquid revolution" in the adjuvant treatment of colon cancer patients: a review of ongoing trials. Cancer Treat Rev 2024; 126:102735. [PMID: 38613871 DOI: 10.1016/j.ctrv.2024.102735] [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: 12/01/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/15/2024]
Abstract
Since colon cancer has a high rate of shedding of tumour fragments into the blood, several research efforts are now focused on the investigation of the minimal residual disease through the detection of ctDNA to tailor the adjuvant therapy of colon cancer patients and optimize its cost/effectiveness balance. The negative prognostic impact of detectable ctDNA in patients' blood after radical surgery for colon cancer is well established. Several clinical trials adopting heterogeneous designs and techniques are now ongoing to translate promises into daily practice by answering five general questions: i) is a ctDNA-guided decision making efficacious in the post-operative management of colon cancer patients? ii) are de-escalation strategies possible in ctDNA-negative cases? iii) are escalation strategies useful to improve the prognosis of ctDNA-positive patients? iv) when MRD is identified at the end of the adjuvant chemotherapy, is another post-adjuvant systemic therapy efficacious? v) can we exploit ctDNA technologies in the follow up of colon cancer patients? This review focuses on currently ongoing trials and how their results may affect the ctDNA "liquid revolution" of early colon cancer.
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Affiliation(s)
- V Conca
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - P Ciracì
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - C Boccaccio
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A Minelli
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - C Antoniotti
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - C Cremolini
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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El Badisy I, BenBrahim Z, Khalis M, Elansari S, ElHitmi Y, Abbass F, Mellas N, El Rhazi K. Risk factors affecting patients survival with colorectal cancer in Morocco: survival analysis using an interpretable machine learning approach. Sci Rep 2024; 14:3556. [PMID: 38346963 PMCID: PMC10861582 DOI: 10.1038/s41598-024-51304-3] [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: 01/02/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
The aim of our study was to assess the overall survival rates for colorectal cancer at 3 years and to identify associated strong prognostic factors among patients in Morocco through an interpretable machine learning approach. This approach is based on a fully non-parametric survival random forest (RSF), incorporating variable importance and partial dependence effects. The data was povided from a retrospective study of 343 patients diagnosed and followed at Hassan II University Hospital. Covariate selection was performed using the variable importance based on permutation and partial dependence plots were displayed to explore in depth the relationship between the estimated partial effect of a given predictor and survival rates. The predictive performance was measured by two metrics, the Concordance Index (C-index) and the Brier Score (BS). Overall survival rates at 1, 2 and 3 years were, respectively, 87% (SE = 0.02; CI-95% 0.84-0.91), 77% (SE = 0.02; CI-95% 0.73-0.82) and 60% (SE = 0.03; CI-95% 0.54-0.66). In the Cox model after adjustment for all covariates, sex, tumor differentiation had no significant effect on prognosis, but rather tumor site had a significant effect. The variable importance obtained from RSF strengthens that surgery, stage, insurance, residency, and age were the most important prognostic factors. The discriminative capacity of the Cox PH and RSF was, respectively, 0.771 and 0.798 for the C-index while the accuracy of the Cox PH and RSF was, respectively, 0.257 and 0.207 for the BS. This shows that RSF had both better discriminative capacity and predictive accuracy. Our results show that patients who are older than 70, living in rural areas, without health insurance, at a distant stage and who have not had surgery constitute a subgroup of patients with poor prognosis.
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Affiliation(s)
- Imad El Badisy
- Mohammed VI Center for Research and Innovation, Rabat, Morocco.
- International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco.
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, Marseille, France.
| | - Zineb BenBrahim
- Faculty of Medicine, Pharmacy & Dental Medicine, Sidi Mohamed Ben Abdillah University, Fez, Morocco
| | - Mohamed Khalis
- Mohammed VI Center for Research and Innovation, Rabat, Morocco
- International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
- Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco
- Laboratory of Biostatistics, Clinical, and Epidemiological Research, Faculty of Medicine and Pharmacy, Department of Public Health, Mohamed V University, Rabat, Morocco
| | - Soukaina Elansari
- Department of Oncology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Youssef ElHitmi
- Department of Oncology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Fouad Abbass
- Laboratory of Epidemiology and Research in Health Sciences, Department of Epidemiology and Public Health, Faculty of Medicine of Fez, Sidi Mohamed Ben Abdillah University, Fez, Morocco
| | - Nawfal Mellas
- Department of Oncology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Department of Epidemiology and Public Health, Faculty of Medicine of Fez, Sidi Mohamed Ben Abdillah University, Fez, Morocco
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Zhao X, Meng Q, Zhou M, Luo J, Hu L. Optimal treatment strategy and prognostic analysis for patients with non-metastatic pT4 colon adenocarcinoma. Front Oncol 2024; 13:1342289. [PMID: 38260849 PMCID: PMC10802841 DOI: 10.3389/fonc.2023.1342289] [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: 11/23/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Objective This study endeavored to explore the optimal treatment strategy and conduct a prognostic analysis for patients diagnosed with pT4M0 (pathologic stage T4) colon adenocarcinoma (COAD). Methods and materials A total of 8,843 patients diagnosed with pT4M0 COAD between January 2010 and December 2015 were included in this study from the Surveillance, Epidemiology, and End Results (SEER) database. These patients were randomly divided into a training set and an internal validation set using a 7:3 ratio. Variables that demonstrated statistical significance (P<0.05) in univariate COX regression analysis or held clinical significance were incorporated into the multivariate COX regression model. Subsequently, this model was utilized to formulate a nomogram. The predictive accuracy and discriminability of the nomogram were assessed using the C-index, area under the curve (AUC), and calibration curves. Decision curve analysis (DCA) was conducted to confirm the clinical validity of the model. Results In the entire SEER cohort, the 3-year overall survival (OS) rate (74.22% vs. 63.20%, P<0.001) and the 3-year cancer-specific survival (CSS) rate (76.25% vs. 66.98%, P<0.001) in the surgery combined with postoperative adjuvant therapy (S+ADT) group surpassed those in the surgery (S) group. Multivariate COX regression analysis of the training set unveiled correlations between age, race, N stage, serum CEA (carcinoembryonic antigen), differentiation, number of resected lymph nodes, and treatment modalities with OS and CSS. Nomograms for OS and CSS were meticulously crafted based on these variables, achieving C-indexes of 0.692 and 0.690 in the training set, respectively. The robust predictive ability of the nomogram was further affirmed through receiver operating characteristic (ROC) and calibration curves in both the training and validation sets. Conclusion In individuals diagnosed with pT4M0 COAD, the integration of surgery with adjuvant chemoradiotherapy demonstrated a substantial extension of long-term survival. The nomogram, which incorporated key factors such as age, race, differentiation, N stage, serum CEA level, tumor size, and the number of resected lymph nodes, stood as a dependable tool for predicting OS and CSS rates. This predictive model held promise in aiding clinicians by identifying high-risk patients and facilitating the development of personalized treatment plans.
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Affiliation(s)
- Xinyue Zhao
- Graduate School of Dalian Medical University, Dalian, China
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Qinghong Meng
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Mengyun Zhou
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Judong Luo
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Lijun Hu
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
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Elshami M, Naji SA, Dwikat MF, Al-Slaibi I, Alser M, Ayyad M, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Albandak ME, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Bottcher B, Abu-El-Noor N. Myths and Common Misbeliefs About Colorectal Cancer Causation in Palestine: A National Cross-Sectional Study. JCO Glob Oncol 2024; 10:e2300295. [PMID: 38166235 PMCID: PMC10803036 DOI: 10.1200/go.23.00295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/07/2023] [Accepted: 11/06/2023] [Indexed: 01/04/2024] Open
Abstract
PURPOSE To explore public awareness of myths around colorectal cancer (CRC) causation in Palestine and to examine factors associated with good awareness. MATERIALS AND METHODS Convenience sampling was used to recruit adult Palestinians from governmental hospitals, primary health care centers, and public spaces. Recognizing 13 myths around CRC causation was assessed using a translated-into-Arabic version of the Cancer Awareness Measure-Mythical Causes Scale. Awareness level was determined based on the number of CRC mythical causes recognized: poor (0-4), fair (5-9), and good (10-13). Multivariable logistic regression was used to examine the association between sociodemographic characteristics and displaying good awareness. It adjusted for age group, sex, education, occupation, monthly income, residence, marital status, having chronic diseases, being a vegetarian, knowing someone with cancer, and site of data collection. RESULTS Of 5,254 participants approached, 4,877 agreed to participate (response rate, 92.3%). A total of 4,623 questionnaires were included in the final analysis: 2,700 from the West Bank and Jerusalem (WBJ) and 1,923 from the Gaza Strip. Only 219 participants (4.7%) demonstrated good awareness of myths around CRC causation. WBJ participants were twice more likely than those from the Gaza Strip to display good recognition (5.9% v 3.1%). Male sex, living in the WBJ, and visiting hospitals were all associated with an increase in the likelihood of displaying good awareness. Conversely, knowing someone with cancer was associated with a decrease in the likelihood of displaying good awareness. Having a physical trauma was the most recognized CRC causation myth (n = 2,752, 59.5%), whereas eating food containing additives was the least (n = 456, 9.8%). CONCLUSION Only 4.7% displayed good ability to recognize myths around CRC causation. Future educational interventions are needed to help the public distinguish the evidence-based versus mythical causes of CRC.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
- Ministry of Health, Gaza, Palestine
| | | | | | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Khayria Ali Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | | | - Iyas Imad Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Su TT, Adekunjo FO, Schliemann D, Cardwell CR, Htay MNN, Dahlui M, Loh SY, Champion VL, Donnelly M. Testing the validity of a new scale designed to assess beliefs and perceptions about colorectal cancer and colorectal cancer screening in Malaysia: a principal component analysis. BMJ Open 2023; 13:e072166. [PMID: 37652591 PMCID: PMC10476116 DOI: 10.1136/bmjopen-2023-072166] [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: 02/02/2023] [Accepted: 05/31/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVE To conduct a cultural adaptation and validation of the Champion Health Belief Model Scale (CHBMS) for colorectal cancer (CRC) screening (CHBMS-CRC-M) in order to assess and investigate perceptions and beliefs about CRC screening in Malaysia. DESIGNS AND PARTICIPANTS The results from an evidence synthesis and the outcomes from an expert panel discussion were used to shape CHBMS scale content into an assessment of beliefs about CRC screening (CHBMS-CRC). This questionnaire assessment was translated into the official language of Malaysia. An initial study tested the face validity of the new scale or questionnaire with 30 men and women from various ethnic groups. Factorial or structural validity was investigated in a community sample of 954 multiethnic Malaysians. SETTING Selangor state, Malaysia. RESULTS The new scale was culturally acceptable to the three main ethnic groups in Malaysia and achieved good face validity. Cronbach's alpha coefficients ranged from 0.66 to 0.93, indicating moderate to good internal consistency. Items relating to perceived susceptibility to CRC 'loaded' on Factor 1 (with loadings scoring above 0.90); perceived benefits of CRC screening items loaded on factor 2 and were correlated strongly (loadings ranged between 0.63 and 0.83) and perceived barriers (PBA) to CRC screening (PBA) items loaded on factor 3 (range 0.30-0.72). CONCLUSION The newly developed CHBMS-CRC-M fills an important gap by providing a robust scale with which to investigate and assess CRC screening beliefs and contribute to efforts to enhance CRC screening uptake and early detection of CRC in Malaysia and in other Malay-speaking communities in the region.
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Affiliation(s)
- Tin Tin Su
- South East Asia Community Observatory (SEACO), Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
- Centre for Pooulation Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Felix Oluyemi Adekunjo
- Department of Economics, Faculty of Social Sciences, Lagos State University, Lagos, Nigeria
| | - Desiree Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Christopher R Cardwell
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Mila Nu Nu Htay
- Centre for Pooulation Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
| | - Maznah Dahlui
- Centre for Pooulation Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Research Development and Innovation, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
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Zhou Q, Zhan Y, Guo J. A nomogram for predicting cause-specific mortality among patients with cecal carcinoma: a study based on SEER database. BMC Gastroenterol 2023; 23:177. [PMID: 37221487 DOI: 10.1186/s12876-023-02802-7] [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: 02/01/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE Classical Cox proportional hazard models tend to overestimate the event probability in a competing risk setup. Due to the lack of quantitative evaluation of competitive risk data for colon cancer (CC), the present study aims to evaluate the probability of CC-specific death and construct a nomogram to quantify survival differences among CC patients. METHODS Data on patients diagnosed with CC between 2010 and 2015 were collected from the Surveillance, Epidemiology, and End Results Program (SEER) database. Patients were divided into a training dataset for the establishment of the model and a validation dataset to evaluate the performance the model at a ratio of 7:3. To evaluate the ability of multiple variables to predict cause-specific death in CC patients, univariate and multivariate analyses with Fine-Gray models were performed to screen the predictors of cause-specific death, and a nomogram for predicting cause-specific mortality was constructed. Then, the receiver operating characteristic (ROC) curve and the calibration curve were plotted to evaluate the prognostic performance of the nomogram. RESULTS The dataset was randomly divided into a training (n = 16,655) dataset and a validation (n = 7,139) dataset at a ratio of 7:3. In the training dataset, variables including pathological subtypes of tumors, pathological grading (degree of differentiation), AJCC staging, T-staging, surgical type, lymph node surgery, chemotherapy, tumor deposits, lymph node metastasis, liver metastasis, and lung metastasis were identified as independent risk factors for cause-specific death of CC patients. Among these factors, the AJCC stage had the strongest predictive ability, and these features were used to construct the final model. In the training dataset, the consistency index (C-index) of the model was 0.848, and the areas under the receiver operating characteristic curve (AUC) at 1, 3, and 5 years was 0.852, 0.861, and 0.856, respectively. In the validation dataset, the C-index of the model was 0.847, and the AUC at 1 year, 3 years, and 5 years was 0.841, 0.862, and 0.852, respectively, indicating that this nomogram had an excellent and robust predictive performance. CONCLUSION This study can help clinical doctors make better clinical decisions and provide better support for patients with CC.
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Affiliation(s)
- Qianru Zhou
- The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
- Wuhan Central Hospital, No. 26, Shengli Street, Jiang'an District, Wuhan, China.
| | - Yan Zhan
- The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Jipeng Guo
- The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
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El Badisy I, BenBrahim Z, Khalis M, Elansari S, ElHitmi Y, Abbas F, Mellas N, EL Rhazi K. Risk factors affecting patients survival with colorectal cancer in Morocco : Survival Analysis using an Interpretable Machine Learning Approach. RESEARCH SQUARE 2023:rs.3.rs-2435106. [PMID: 36711858 PMCID: PMC9882696 DOI: 10.21203/rs.3.rs-2435106/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The aim of our study was to assess the overall survival rates for colorectal patients in Morocco and to identify strong prognostic factors using a novel approach combining survival random forest and the Cox model. Covariate selection was performed using the variable importance based on permutation and partial dependence plots were displayed to explore in depth the relationship between the estimated partial effect of a given predictor and survival rates. The predictive performance was measured by two metrics, the Concordance Index (C-index) and the Brier Score (BS). Overall survival rates at 1, 2 and 3 years were, respectively, 87% (SE = 0.02; CI-95% = 0.84-0.91), 77% (SE = 0.02; CI-95% = 0.73-0.82) and 60% (SE = 0.03; CI-95% = 0.54-0.66). In the Cox model after adjustment for all covariates, sex, tumor differentiation had no significant effect on prognosis, but rather tumor site had a significant effect. The variable importance obtained from RSF strengthens that surgery, stage, insurance, residency, and age were the most important prognostic factors. The discriminative capacity of the Cox PH and RSF was, respectively, 0.771 and 0.798 for the C-index, while the accuracy of the Cox PH and RSF was, respectively, 0.257 and 0.207 for the Brier Score. This shows that RSF had both better discriminative capacity and predictive accuracy. Our results show that patients who are older than 70, living in rural areas, without health insurance, at a distant stage and who have not had surgery constitute a subgroup of patients with poor prognosis.
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Affiliation(s)
- Imad El Badisy
- Mohammed VI Center for Research & Innovation, Rabat, Morocco. Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Aix Marseille Univ, Marseille, France
| | - Zineb BenBrahim
- Department of Oncology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Mohamed Khalis
- Mohammed VI Center for Research & Innovation, Rabat, Morocco. Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Soukaina Elansari
- Department of Oncology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Youssef ElHitmi
- Department of Oncology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Fouad Abbas
- Department of Epidemiology and Public Health, Faculty of Medicine of Fez, Research Laboratory “Epidemiology and Research in Health Sciences”, Sidi Mohamed Ben Abdillah University, Fez, Morocco
| | - Nawfal Mellas
- Department of Oncology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Karima EL Rhazi
- Department of Epidemiology and Public Health, Faculty of Medicine of Fez, Research Laboratory “Epidemiology and Research in Health Sciences”, Sidi Mohamed Ben Abdillah University, Fez, Morocco
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10
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Maimard Y, Woradet S, Chaimay B. Factors Associated with Mortality among Patients with Colorectal Cancer at the Secondary Care Hospital in Southern Thailand: Hospital-Based Retrospective Cohort Study. Int J Prev Med 2023; 14:13. [PMID: 37033274 PMCID: PMC10080563 DOI: 10.4103/ijpvm.ijpvm_104_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/04/2022] [Indexed: 04/11/2023] Open
Abstract
Background Globally and in Thailand, the incidence of colorectal cancer (CRC) is third-ranked behind lung and breast cancer, respectively. This hospital-based retrospective cohort study aimed to determine factors associated with mortality among patients with CRC. Methods This study was performed by using the secondary data of the cancer registry among patients with CRC registered in Phatthalung Hospital. Two hundred twenty-eight patients with CRC were diagnosed and followed up from January 2014 to December 2018. Multiple logistic regression analysis was used to analyze factors associated with mortality among subjects with CRC. Results The results revealed that the proportion of mortality among subjects with CRC was 50.44% (115 cases) at six months of following up. Subjects who had an increasing age every ten years (adjusted odds ratio [ORadj] = 1.40, 95 percent confidence interval [95% CI]: 1.09-1.80) were diagnosed with CRC at stage 3 (2.64, 1.19-5.84) and at stage 4 (11.63, 2.69-50.15) more likely to die. Also, subjects who received a combination of chemotherapy and radiotherapy treatment (3.44, 1.20-9.85), combination treatment of surgery, and postoperative care (2.46, 1.22-4.94) were more likely to die. Subjects who had not had surgery treatment were more likely to die (35.00, 7.44-168.27). Conclusions In conclusion, factors such as the age of patients, stage of CRC, and treatment were associated with mortality among patients with CRC. Hence, medical and health professionals should consider these factors according to the treatment and optimization in patients with CRC.
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Affiliation(s)
- Yameela Maimard
- Department of Disease Control, Institute for Urban Disease Control and Prevention, Ministry of Public Health, Bangkok, Thailand
| | - Somkiattiyos Woradet
- Department of Public Health, Faculty of Health and Sport Science, Thaksin University, Phatthalung Campus, Phatthalung, Thailand
- ASEAN Cancer Epidemiology and Prevention Research Group (ACEP), Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Bhunyabhadh Chaimay
- Department of Public Health, Faculty of Health and Sport Science, Thaksin University, Phatthalung Campus, Phatthalung, Thailand
- ASEAN Cancer Epidemiology and Prevention Research Group (ACEP), Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
- Address for correspondence: Dr. Bhunyabhadh Chaimay, Department of Public Health, Faculty of Health and Sports Science, Thaksin University, Phatthalung Campus, 93210, Thailand. E-mail:
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11
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Sui GY, Wang F, Lee J, Roh YS. Mitochondrial Control in Inflammatory Gastrointestinal Diseases. Int J Mol Sci 2022; 23:14890. [PMID: 36499214 PMCID: PMC9736936 DOI: 10.3390/ijms232314890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Mitochondria play a central role in the pathophysiology of inflammatory bowel disease (IBD) and colorectal cancer (CRC). The maintenance of mitochondrial function is necessary for a stable immune system. Mitochondrial dysfunction in the gastrointestinal system leads to the excessive activation of multiple inflammatory signaling pathways, leading to IBD and increased severity of CRC. In this review, we focus on the mitochondria and inflammatory signaling pathways and its related gastrointestinal diseases.
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Affiliation(s)
- Guo-Yan Sui
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Feng Wang
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju 28160, Republic of Korea
| | - Jin Lee
- Department of Pathology, School of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Yoon Seok Roh
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju 28160, Republic of Korea
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12
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Elshami M, Dwikat MF, Al-Slaibi I, Alser M, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Naji SA, Hmdan FK, Ayyad MM, Sweity RR, Jneed RT, Assaf KA, Albandak ME, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Bottcher B, Abu-El-Noor N. Awareness of Colorectal Cancer Risk Factors in Palestine: Where Do We Stand? JCO Glob Oncol 2022; 8:e2200070. [PMID: 35696626 PMCID: PMC9225594 DOI: 10.1200/go.22.00070] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To assess the public awareness level of colorectal cancer (CRC) risk factors in Palestine and identify factors associated with the good awareness level. A national study in Palestine finds low awareness of colorectal cancer risk factors.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
- Ministry of Health, Gaza, Palestine
| | | | | | | | | | - Wejdan S. Isleem
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Shoruq A. Naji
- Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine
| | - Fatima K. Hmdan
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | - Remah T. Jneed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khayria A. Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | | | - Iyas I. Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Belal K. Alhabil
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Marah N. Alarda
- Faculty of Dentistry, Arab American University, Palestine, Jenin
| | | | | | - Omar A. Aljbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Christy T. Giacaman
- Faculty of Nursing and Health Sciences, Bethlehem University, Bethlehem, Palestine
| | - Ali Y. Alnaga
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Ranin M. Abu Nemer
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | | | - Sondos M. Skaik
- Faculty of Medicine, Al-Quds Abu Dis University Al-Azhar Branch of Gaza, Gaza, Palestine
| | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Lin Y, Liu S, Hong L, Shao L, Wu J. Postoperative locoregional recurrence pattern and treatment management of stage pT4 sigmoid colon cancer: a retrospective cohort study. Radiat Oncol 2022; 17:95. [PMID: 35562804 PMCID: PMC9107167 DOI: 10.1186/s13014-022-02064-9] [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: 03/13/2022] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to explore the pattern of locoregional recurrence after surgery in patients with non-metastatic stage pT4 sigmoid colon cancer and the role of adjuvant radiotherapy on survival. METHODS We retrospectively analyzed data from 208 patients who underwent surgery in our hospital. The patients were randomly divided into training and validation groups at a 1:1 ratio. Patients at high risk for locoregional recurrence were screened using Cox regression analysis. Based on the data of 2,886 patients in the Surveillance, Epidemiology, and End Results (SEER) database, the effect of adjuvant radiotherapy on overall survival (OS) and cancer-specific survival (CSS) was evaluated by Kaplan-Meier curves. RESULTS Of the 208 patients, 57 (27.4%) presented with locoregional recurrences (14 anastomotic and 43 abdominal or pelvic lymph node recurrences). Multivariate analysis showed that serum CEA, differentiation, lymph node dissection number, and N stage were independent predictors of locoregional recurrence-free survival (all p < 0.05). A risk-stratification model was constructed, and a total score of ≥ 6.5 points was considered the high-risk group for locoregional recurrence. Both the training and validation sets presented that the model had a good predictive ability (area under the curve = 0.828 and 0.724, respectively). Analysis of SEER data revealed that adjuvant radiotherapy significantly prolonged OS and CSS in the high-risk population (all p < 0.05, vs. no radiotherapy). CONCLUSIONS Patients with a total risk score of 6.5 or more had a high likelihood of locoregional recurrence, and perhaps adjuvant radiotherapy could improve their survival.
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Affiliation(s)
- Yaobin Lin
- College of Clinical Medicine for Oncology, Fujian Medical University, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, Fujian, China
| | - Shan Liu
- Department of Hematology-Oncology, Fujian Children's Hospital, Fuzhou, 350014, Fujian, China
| | - Liang Hong
- College of Clinical Medicine for Oncology, Fujian Medical University, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, Fujian, China
| | - Lingdong Shao
- College of Clinical Medicine for Oncology, Fujian Medical University, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, Fujian, China
| | - Junxin Wu
- College of Clinical Medicine for Oncology, Fujian Medical University, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, Fujian, China. .,Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, 350014, Fujian, China.
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14
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Wismayer R, Kiwanuka J, Wabinga H, Odida M. Prognostic Factors for Survival of Colorectal Adenocarcinoma Patients in Uganda. Cancer Manag Res 2022; 14:875-893. [PMID: 35250313 PMCID: PMC8896376 DOI: 10.2147/cmar.s354360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background In Uganda, similar to other countries in East Africa, the incidence of colorectal cancer (CRC) has been steadily increasing. This increase in incidence is accompanied by a poor prognosis. There is limited knowledge on factors responsible for the poor outcome of patients with CRC in Uganda. Cancer survival analysis is one way of determining some of these prognostic factors. The aim of this study was to determine prognostic factors associated with CRC survival in Ugandan patients. Methods This was a retroprospective cohort study involving patients with linked data in the Kampala cancer registry and medical records from hospitals in Uganda. Participants with a diagnosis of colorectal adenocarcinoma between 1st January 2008 and 31st December 2018 were included. Variables included patients’ demographic data, grade, stage and location of CRC, data on whether a patient was operated on, type of operation, treatment modalities and date of diagnosis. Our outcome variable was time to death after diagnosis. We computed and compared survival using the Log rank test and used Cox proportional hazards regression to determine factors associated with survival. Results A total of 247 patients were included in the study with a mean (SD) age of 53.3 (15.7) years and a female: male ratio of 1.14:1. The proportions of patients surviving at 1, 2 and 3 years were 65.2% (95% CI: 58.8–70.9), 42.0% (95% CI:35.6–48.3) and 33.3% (95% CI:27.3–39.4) respectively. In multivariate analysis, factors associated with increased mortality included clinical stage II (aHR = 2.44, 95% CI: 1.10–5.41, p=0.028), stage III (aHR=2.65, 95% CI: 1.31–5.39, p=0.007) and stage IV (aHR=5.47, 95% CI: 2.40–12.48, p<0.001). Curative surgery alone (aHR=0.63, 95% CI: 0.39–1.01, p=0.057) and curative surgery with chemotherapy (aHR=0.53, 95% CI: 0.32–0.88, p=0.015) were associated with a better survival. Conclusion The survival rate among CRC patients in Uganda is low. Advanced stage CRC accelerates mortality, while surgery alone or in combination with chemotherapy improves survival. Implementation of national screening programmes for early diagnosis of CRC and increasing surgery and oncology infrastructure is recommended to improve the CRC survival rate in the Ugandan population.
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Affiliation(s)
- Richard Wismayer
- Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda
- Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda
- Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- Correspondence: Richard Wismayer, Email ;
| | - Julius Kiwanuka
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Henry Wabinga
- Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Michael Odida
- Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda
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15
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Colorectal cancer survival rates in Makassar, Eastern Indonesia: A retrospective Cohort Study. Ann Med Surg (Lond) 2022; 74:103211. [PMID: 35059192 PMCID: PMC8760491 DOI: 10.1016/j.amsu.2021.103211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 12/24/2022] Open
Abstract
Background Materials and methods Results Conclusion Colorectal cancer is relatively common in Indonesia, and its incidence is slowly increasing. Most Indonesian cases are detected at an advanced stage owing to educational, cultural, social, and economic factors. Histopathology, tumor stage and history of definitive surgery significantly affected recurrence-free survival. Chemotherapy and radiotherapy treatments had significantly different recurrence-free survival rates.
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16
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Cho SM, Esmail A, Abdelrahim M. Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAF V600E-Mutant CRC: A Case Report and Review. Front Pharmacol 2022; 12:795381. [PMID: 34975492 PMCID: PMC8716546 DOI: 10.3389/fphar.2021.795381] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/05/2021] [Indexed: 01/08/2023] Open
Abstract
Mutation of the BRAF proto-oncogene is found in approximately 10% of colorectal cancers (CRC), with much of the mutation conferred by a V600E mutation. Unlike other CRC subtypes, BRAF-mutant CRC have had relatively limited response to conventional therapies and overall poor survival. We present the case of a 75-year-old man with severe nonischemic cardiomyopathy on a LifeVest who was found to have a transverse colonic mass with widespread hepatic metastatic disease and was subsequently found to have BRAFV600E-mutant CRC (MSI High/dMMR). After a failed therapy with FOLFOX and pembrolizumab, the patient was started on a regimen of vemurafenib, irinotecan, and cetuximab (VIC) based on the SWOG 1406 trial which had shown improved progression-free survival and response rate for the treatment of BRAFV600E-mutant metastatic CRC. After 40 cycles of VIC, the patient attained complete response and is in remission off chemotherapy with significant improvement. This case highlights the effectiveness of the triple-regimen of vemurafenib, irinotecan, and cetuximab as a treatment option for BRAFV600E-mutant CRC, which is a treatment regimen based on the SWOG 1406 trial, and also demonstrates the synergistic role of BRAFV600E inhibitors and EGFR inhibitors in the treatment of BRAFV600E-mutant CRC.
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Affiliation(s)
- Su Min Cho
- Department of Medicine, Houston Methodist Hospital, Houston, TX, United States
| | - Abdullah Esmail
- Section of GI Oncology, Department of Medical Oncology, Houston Methodist Cancer Center, Houston, TX, United States
| | - Maen Abdelrahim
- Section of GI Oncology, Department of Medical Oncology, Houston Methodist Cancer Center, Houston, TX, United States.,Cockrell Center of Advanced Therapeutics Phase I Program, Houston Methodist Research Institute, Houston, TX, United States.,Weill Cornell Medical College, New York, NY, United States
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17
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González N, Loroño A, Aguirre U, Lázaro S, Baré M, Redondo M, Briones E, Sarasqueta C, Bilbao A, de Larrea NF, Quintana JM. Risk scores to predict mortality 2 and 5 years after surgery for colorectal cancer in elderly patients. World J Surg Oncol 2021; 19:252. [PMID: 34446044 PMCID: PMC8394051 DOI: 10.1186/s12957-021-02356-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/01/2021] [Indexed: 12/09/2022] Open
Abstract
Background The aim of this study was to identify predictors of mortality in elderly patients undergoing colorectal cancer surgery and to develop a risk score. Methods This was an observational prospective cohort study. Individuals over 80 years diagnosed with colorectal cancer and treated surgically were recruited in 18 hospitals in the Spanish National Health Service, between June 2010 and December 2012, and were followed up 1, 2, 3, and 5 years after surgery. Sociodemographic and clinical data were collected. The primary outcomes were mortality at 2 and between 2 and 5 years after the index admission. Results The predictors of mortality 2 years after surgery were haemoglobin ≤ 10 g/dl and colon locations (HR 1.02; CI 0.51–2.02), ASA class of IV (HR 3.55; CI 1.91–6.58), residual tumour classification of R2 (HR 7.82; CI 3.11–19.62), TNM stage of III (HR 2.14; CI 1.23–3.72) or IV (HR 3.21; CI 1.47–7), LODDS of more than − 0.53 (HR 3.08; CI 1.62–5.86)) and complications during admission (HR 1.73; CI 1.07–2.80). Between 2 and 5 years of follow-up, the predictors were no tests performed within the first year of follow-up (HR 2.58; CI 1.21–5.46), any complication due to the treatment within the 2 years of follow-up (HR 2.47; CI 1.27–4.81), being between 85 and 89 and not having radiotherapy within the second year of follow-up (HR 1.60; CI 1.01–2.55), no colostomy closure within the 2 years of follow-up (HR 4.93; CI 1.48–16.41), medical complications (HR 1.61; CI 1.06–2.44), tumour recurrence within the 2 years of follow-up period (HR 3.19; CI 1.96–5.18), and readmissions at 1 or 2 years of follow-up after surgery (HR 1.44; CI 0.86–2.41). Conclusion We have identified variables that, in our sample, predict mortality 2 and between 2 and 5 years after surgery for colorectal cancer older patients. We have also created risks scores, which could support the decision-making process. Trial registration ClinicalTrials.gov, NCT02488161.
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Affiliation(s)
- Nerea González
- Osakidetza Basque Health Service, Galdakao - Usansolo Hospital (Research Unit), Galdakao, Basque Country, Spain. .,Kronikgune Institute for Health Services Research, Barakaldo, Basque Country, Spain. .,Health Services Research on Chronic Patients Network, REDISSEC, Galdakao, Basque Country, Spain.
| | - Ane Loroño
- Osakidetza Basque Health Service, Galdakao - Usansolo Hospital (Research Unit), Galdakao, Basque Country, Spain
| | - Urko Aguirre
- Osakidetza Basque Health Service, Galdakao - Usansolo Hospital (Research Unit), Galdakao, Basque Country, Spain.,Health Services Research on Chronic Patients Network, REDISSEC, Galdakao, Basque Country, Spain
| | - Santiago Lázaro
- Health Services Research on Chronic Patients Network, REDISSEC, Galdakao, Basque Country, Spain.,Osakidetza Basque Health Service, Galdakao-Usansolo Hospital (Surgery Department), Galdakao, Basque Country, Spain
| | - Marisa Baré
- Health Services Research on Chronic Patients Network, REDISSEC, Galdakao, Basque Country, Spain.,Clinical Epidemiology and Cancer Screening, Parc Taulí University Hospital, Parc del Taulí, 1, 08208 Sabadell, Barcelona, Spain
| | - Maximino Redondo
- Health Services Research on Chronic Patients Network, REDISSEC, Galdakao, Basque Country, Spain.,Andalusian Health Service, Resarch Unit, Costa del Sol Hospital, Autovía A-7 Km, 187-29603, Marbella, Malaga, Spain
| | - Eduardo Briones
- UDG Public Health, AP Sevilla district, Av. de Jerez, 41013, Sevilla, Spain
| | - Cristina Sarasqueta
- Health Services Research on Chronic Patients Network, REDISSEC, Galdakao, Basque Country, Spain.,Biodonostia Health Research Institute, Donostia Universitary Hospital, Begiristain Doktorea Pasealekua, 20014, Donostia-San Sebastian, Guipuzkoa, Spain
| | - Amaia Bilbao
- Health Services Research on Chronic Patients Network, REDISSEC, Galdakao, Basque Country, Spain.,Osakidetza Basque Health Service, Research Unit, Basurto Universitary Hospital, Montevideo Etorb., 18, 48013, Bilbao, Bizkaia, Spain
| | - Nerea Fernández de Larrea
- Epidemiology National Centre, Institute of Health Carlos III, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José María Quintana
- Osakidetza Basque Health Service, Galdakao - Usansolo Hospital (Research Unit), Galdakao, Basque Country, Spain.,Health Services Research on Chronic Patients Network, REDISSEC, Galdakao, Basque Country, Spain
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Liu G, Lai D, Jiang Y, Yang H, Zhao H, Zhang Y, Liu D, Pang Y. Demethylzeylasteral Exerts Antitumor Effects via Disruptive Autophagic Flux and Apoptotic Cell Death in Human Colorectal Cancer Cells and Increases Cell Chemosensitivity to 5-Fluorouracil. Anticancer Agents Med Chem 2021; 22:851-863. [PMID: 34102996 DOI: 10.2174/1871520621666210608104021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/23/2021] [Accepted: 04/12/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Demethylzeylasteral (ZST93), a pharmacologically active triterpenoid monomer extracted from Tripterygium wilfordii Hook F (TWHF), has been reported to exert antineoplastic effects in several cancer cell types. However, the anti-tumour effects of ZST93 in human colorectal cancer (CRC) cells are unknown. OBJECTIVE The aim of the present study was to evaluate the antitumor effects of ZST93 on cell cycle arrest, disruptive autophagic flux, apoptotic cell death, and enhanced chemosensitivity to 5-FU in humans CRC cells. METHODS The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT) assay, colony formation assay, flow cytometry, immunoblotting, immunofluorescence, 5-ethynyl-20-deoxyuridine (EdU) incorporation assay, and autophagy analysis were used to evaluate the effects of ZST93 on cell viability, cell cycle progression, apoptosis and autophagy in two human CRC cell lines. Moreover, ZST93's combined anti-tumour effects with 5-fluorouracil (5-FU) were evaluated. RESULTS ZST93 inhibited CRC cell proliferation and growth. It was responsible for blocked cell cycle transition by arresting CRC cells in the G0/G1 phase via down-regulation of CDK4, CDK6, Cyclin D1, and c-MYC. Moreover, ZST93 induced suppressive autophagic flux and caspase-3-dependent cell death, which were further strengthened by the blocking of the autophagy process using chloroquine (CQ). Moreover, ZST93 enhanced CRC cells' chemosensitivity to 5-FU via modulation of autophagy and apoptosis. CONCLUSION ZST93 exerts anti-tumour effects via disruptive autophagic flux and apoptotic cell death in human CRC cells and increases cell chemosensitivity to 5-FU. These results provide insights into the utilisation of ZST93 as an adjuvant or direct autophagy inhibitor and suggest ZST93 as a novel therapeutic strategy for treating CRC.
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Affiliation(s)
- Guiyuan Liu
- The Affiliated Hospital of Chongqing Three Gorges Medical College, Chongqing, China
| | - Dengxiang Lai
- The Affiliated Hospital of Chongqing Three Gorges Medical College, Chongqing, China
| | - Yi Jiang
- The Affiliated Hospital of Chongqing Three Gorges Medical College, Chongqing, China
| | - Hongjing Yang
- Chongqing Engineering Research Center of Antitumor Natural Drugs, Chongqing Three Gorges Medical College, Chongqing, China
| | - Hui Zhao
- The Affiliated Hospital of Chongqing Three Gorges Medical College, Chongqing, China
| | - Yonghui Zhang
- Chongqing Engineering Research Center of Antitumor Natural Drugs, Chongqing Three Gorges Medical College, Chongqing, China
| | - Dan Liu
- Chongqing Engineering Research Center of Antitumor Natural Drugs, Chongqing Three Gorges Medical College, Chongqing, China
| | - Yi Pang
- Chongqing Engineering Research Center of Antitumor Natural Drugs, Chongqing Three Gorges Medical College, Chongqing, China
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Lin Y, Wang L, Shao L, Zhang X, Lin H, Wang Y, Wu J. Prognostic analysis and beneficiary identification of adjuvant external beam radiotherapy for stage pT4b sigmoid colon cancer. Sci Rep 2021; 11:11782. [PMID: 34083644 PMCID: PMC8175676 DOI: 10.1038/s41598-021-91172-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/17/2021] [Indexed: 12/31/2022] Open
Abstract
The clinical efficacy of adjuvant radiotherapy in sigmoid colon cancer remains questioned. To evaluate the clinical efficacy of adjuvant external beam radiotherapy (EBRT) for patients with pathologic stage T4b sigmoid colon cancer. Patients with stage pT4b sigmoid colon cancer receiving adjuvant EBRT or not followed by surgery between 2004 and 2016 were extracted from the Surveillance, Epidemiology, and End Results database. Analysis of overall survival (OS) was performed using Kaplan-Meier curves and prognostic factors were identified using Cox proportional hazards regression models with 95% confidence intervals within the entire cohort. A risk-stratification system was then developed based on the β regression coefficient. Among 2073 patients, 284 (13.7%) underwent adjuvant EBRT. The median OS in the group receiving adjuvant EBRT was significantly longer than that in the non-radiotherapy group (p < 0.001). Age, serum carcinoembryonic antigen (CEA) level, perineural invasion, lymph node dissection (LND) number, and adjuvant EBRT were independent factors associated with OS. A risk-stratification system was generated, which showed that low-risk patients had a higher 5-year survival rate than high-risk patients (75.6% vs. 42.3%, p < 0.001). Adjuvant EBRT significantly prolonged the 5-year survival rate of high-risk patients (62.6% vs. 38.3%, p = 0.009) but showed no survival benefit among low-risk patients (87.7% vs. 73.2%, p = 0.100). Our risk-stratification model comprising age, serum CEA, perineural invasion, and LND number predicted the outcomes of patients with stage pT4b sigmoid colon cancer based on which subgroup of high-risk patients should receive adjuvant EBRT.
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Affiliation(s)
- Yaobin Lin
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, China
| | - Lei Wang
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, China
| | - Lingdong Shao
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, China
| | - Xueqing Zhang
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, China
| | - Huaqin Lin
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, China
| | - Youjia Wang
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, China
| | - Junxin Wu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, 350014, China.
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20
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Lee SHF, Abdul Rahman H, Abidin N, Ong SK, Leong E, Naing L. Survival of colorectal cancer patients in Brunei Darussalam: comparison between 2002-09 and 2010-17. BMC Cancer 2021; 21:477. [PMID: 33926405 PMCID: PMC8086270 DOI: 10.1186/s12885-021-08224-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Brunei Darussalam in 2017, posing a major burden on society. Methods This retrospective cohort study (n = 1035 patients diagnosed with CRC in Brunei Darussalam from 1st January 2002 until 31st December 2017) aims to compare the overall survival rates of CRC patients (2002–2017), to compare survival rates between two study periods (2002–2009 and 2010–2017) and to identify prognostic factors of CRC. Kaplan-Meier estimator and log-rank tests were performed to analyse the overall survival rates of CRC patients. Multiple Cox regression was performed to determine the prognostic factors of CRC with adjusted hazard ratios (Adj. HRs) reported. Results The 1-, 3- and 5-year survival rates of CRC patients are 78.6, 62.5, and 56.0% respectively from 2002 to 2017. The 1-, 3-, and 5-year survival rates of CRC patients for 2002–2009 are 82.2, 69.6, and 64.7%; 77.0, 59.1, and 51.3% for 2010–2017 respectively. A significant difference in CRC patients’ survival rate was observed between the two study periods, age groups, ethnic groups, cancer stages, and sites of cancer (p < 0.05). The Adjusted Hazard Ratios (Adj. HRs) were significantly higher in the 2010–17 period (Adj. HR = 1.78, p < 0.001), older age group ( ≥ 60 years) (Adj. HR = 1.93, p = 0.005), distant cancer (Adj. HR = 4.69, p < 0.010), tumor at transverse colon and splenic flexure of colon (Adj. HR = 2.44, p = 0.009), and lower in the Chinese(Adj. HR = 0.63, p = 0.003). Conclusion This study highlights the lower survival rates of CRC patients in 2010–2017, Malays, older patients, distant cancer, and tumors located at the latter half of the proximal colon (transverse colon), and predominantly LCRC (splenic flexure, descending colon, sigmoid colon, overlapping lesion colon and colon (NOS), as well as the rectosigmoid junction and rectum (NOS)). Age, ethnicity, cancer stage, and tumor location are significant prognostic factors for CRC. These findings underscore the importance of public health policies and programmes to enhance awareness on CRC from screening to developing strategies for early detection and management, to reduce CRC-associated mortality.
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Affiliation(s)
- Shirley H F Lee
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam.
| | - Hanif Abdul Rahman
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam
| | - Nadiah Abidin
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam.,School of Medicine, National University of Ireland Galway, University Road, Galway, H91 TK33, Ireland
| | - Sok King Ong
- Non-Communicable Diseases Prevention Unit, Ministry of Health, Commonwealth Drive, Bandar Seri Begawan, BB3910, Brunei Darussalam.,Early Detection & Cancer Prevention Services, Pantai Jerudong Specialist Centre, Bandar Seri Begawan, BG3122, Brunei Darussalam
| | - Elvynna Leong
- Faculty of Science, Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam
| | - Lin Naing
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Tungku Link Road, Bandar Seri Begawan, BE1410, Brunei Darussalam
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21
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Wang Y, Zhang J, Cao H, Han F, Zhang H, Xu E. Methylation status of ADAM12 promoter are associated with its expression levels in colorectal cancer. Pathol Res Pract 2021; 221:153449. [PMID: 33930608 DOI: 10.1016/j.prp.2021.153449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is a kind of malignant tumor of digestive system severely affecting human health. The occurrence of CRC is a polygenic and multi-step complex process involving genetic and epigenetic alterations. ADAM12 (a disintegrin and metalloproteases 12), is a gene that was commonly hypermethylated in esophageal cancer using whole-genome methylation microarray in our previous study. METHODS We detected the methylation frequencies of the CpG island in ADAM12 promoter using bisulfite-pyrosequencing in CRC cell lines and tissue samples. The expression of ADAM12 was detected by quantitative real-time PCR (qRT-PCR) and immunohistochemistry (IHC). A systematic and comprehensive analysis of relationship of DNA hypermethylation and ADAM12 expression in CRC was performed in our samples and TCGA database. RESULTS The expression of ADAM12 in hypermethylated cell lines was significantly lower than that in hypomethylated cell lines, and demethylation agent 5-Aza-dC could demethylate ADAM12 promoter region and reactivate ADAM12 expression effectively. In 74 pairs of colorectal cancer and normal tissues, bisulfite-pyrosequencing results showed significantly hypermethylation of ADAM12 in CRC compared with adjacent normal mucosa, accompanied with lower expression of ADAM12 in CRC tissues compared to that of the normal tissues. In addition, there was a statistically significant negative correlation between ADAM12 protein expression and methylation levels (rho =-0.28, p = 0.015). CONCLUSION Promoter hypermethylation was probably a mechanism of ADAM12 epigenetic silencing in CRC.
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Affiliation(s)
- Yan Wang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Jing Zhang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China; Department of Pathology, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, China.
| | - Hui Cao
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China; Department of Pathology and Pathophysiology, Cheng Du Medical College, Chengdu 610500, China.
| | - Fengyan Han
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Honghe Zhang
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Enping Xu
- Department of Pathology and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
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22
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Teka MA, Yesuf A, Hussien FM, Hassen HY. Histological characteristics, survival pattern and prognostic determinants among colorectal cancer patients in Ethiopia: A retrospective cohort study. Heliyon 2021; 7:e06366. [PMID: 33718651 PMCID: PMC7920880 DOI: 10.1016/j.heliyon.2021.e06366] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 12/21/2020] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
Background The incidence of colorectal cancer (CRC) and associated mortality are rising in low- and middle-income countries. In Ethiopia, colorectal cancer is among the leading causes of cancer morbidity and mortality in both sexes. Although some studies provided estimations on the national burden and regional distribution, the histological characteristics, survival pattern and determinants among colorectal cancer patients are not well-documented. Aim This study aimed to describe the histological characteristics, to determine the patterns of survival, and identify factors that determine mortality rate among CRC patients in Ethiopia. Methods A retrospective cohort study was conducted among CRC patients registered at cancer treatment center of Tikur Anbessa Specialized Hospital, from January 2012 to December 2016. Data were extracted from a total of 161 patient medical records using a pretested abstraction form and supplemented by phone calls with the patients/caregivers. To determine colorectal cancer specific survival overtime, we performed a Kaplan-Meier survival analysis and significance of variation in survival across covariates and treatment categories was tested using log-rank test. A multivariable Cox proportional-hazards model was performed to identify determinants of survival after diagnosis with colorectal cancer. Results Overall, the median survival time was 21 months [95%CI: 16-35], with two-, three- and five-year CRC-specific survival rates of 46.8%, 39.5% and 28.7% respectively. In the multivariable Cox regression model, the rate of death due to CRC is significantly higher for patients with elevated baseline carcinoembryonic antigen (CEA) level (Adjusted Hazard Ratio (AHR) = 2.31, 95%CI: 1.27-4.19), stage IV at diagnosis (AHR = 2.66, 95%CI: 1.44-4.91), and mucinous or signet-ring cell carcinoma histology type (AHR = 4.92, 95%CI: 1.75-13.80). Moreover, patients who underwent surgery showed a better survival than those who did not (AHR = 0.35, 95%CI: 0.14-0.88). Conclusion In Ethiopia, patients diagnosed with CRC showed a low rate of cancer-specific survival. Histology type, stage of cancer and CEA level at diagnosis, and the type of treatment a patient received significantly determine mortality rate. Hence, cancer screening programs could help to detect the disease at an earlier stage and to initiate available treatments timely so as to extend the lifespan of CRC patients.
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Affiliation(s)
- Mohammed Ahmed Teka
- Ethiopian Field Epidemiology Training Program, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Aman Yesuf
- Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Foziya Mohammed Hussien
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Science, Wollo University, Ethiopia
| | - Hamid Yimam Hassen
- Department of Public Health, Faculty of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
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23
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Motsuku L, Chen WC, Muchengeti MM, Naidoo M, Quene TM, Kellett P, Mohlala MI, Chu KM, Singh E. Colorectal cancer incidence and mortality trends by sex and population group in South Africa: 2002-2014. BMC Cancer 2021; 21:129. [PMID: 33549058 PMCID: PMC7866437 DOI: 10.1186/s12885-021-07853-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/28/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND South Africa (SA) has experienced a rapid transition in the Human Development Index (HDI) over the past decade, which had an effect on the incidence and mortality rates of colorectal cancer (CRC). This study aims to provide CRC incidence and mortality trends by population group and sex in SA from 2002 to 2014. METHODS Incidence data were extracted from the South African National Cancer Registry and mortality data obtained from Statistics South Africa (STATS SA), for the period 2002 to 2014. Age-standardised incidence rates (ASIR) and age-standardised mortality rates (ASMR) were calculated using the STATS SA mid-year population as the denominator and the Segi world standard population data for standardisation. A Joinpoint regression analysis was computed for the CRC ASIR and ASMR by population group and sex. RESULTS A total of 33,232 incident CRC cases and 26,836 CRC deaths were reported during the study period. Of the CRC cases reported, 54% were males and 46% were females, and among deaths reported, 47% were males and 53% were females. Overall, there was a 2.5% annual average percentage change (AAPC) increase in ASIR from 2002 to 2014 (95% CI: 0.6-4.5, p-value < 0.001). For ASMR overall, there was 1.3% increase from 2002 to 2014 (95% CI: 0.1-2.6, p-value < 0.001). The ASIR and ASMR among population groups were stable, with the exception of the Black population group. The ASIR increased consistently at 4.3% for black males (95% CI: 1.9-6.7, p-value < 0.001) and 3.4% for black females (95% CI: 1.5-5.3, p-value < 0.001) from 2002 to 2014, respectively. Similarly, ASMR for black males and females increased by 4.2% (95% CI: 2.0-6.5, p-value < 0.001) and 3.4% (, 95%CI: 2.0-4.8, p-value < 0.01) from 2002 to 2014, respectively. CONCLUSIONS The disparities in the CRC incidence and mortality trends may reflect socioeconomic inequalities across different population groups in SA. The rapid increase in CRC trends among the Black population group is concerning and requires further investigation and increased efforts for cancer prevention, early screening and diagnosis, as well as better access to cancer treatment.
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Affiliation(s)
- Lactatia Motsuku
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
- Department of Global Health, South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Wenlong Carl Chen
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Mazvita Molleen Muchengeti
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Megan Naidoo
- Department of Global Health, Centre for Global Surgery, Stellenbosch University, Cape Town, South Africa
| | - Tamlyn Mac Quene
- Department of Global Health, Centre for Global Surgery, Stellenbosch University, Cape Town, South Africa
| | - Patricia Kellett
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
| | - Matshediso Ivy Mohlala
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa
| | - Kathryn M Chu
- Department of Global Health, Centre for Global Surgery, Stellenbosch University, Cape Town, South Africa
| | - Elvira Singh
- National Cancer Registry, National Health Laboratory Service, 1 Modderfontein road, Sandringham, Johannesburg, 2131, South Africa.
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
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24
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Etissa EK, Assefa M, Ayele BT. Prognosis of colorectal cancer in Tikur Anbessa Specialized Hospital, the only oncology center in Ethiopia. PLoS One 2021; 16:e0246424. [PMID: 33529268 PMCID: PMC7853488 DOI: 10.1371/journal.pone.0246424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 01/16/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction Colorectal cancer is the third most commonly diagnosed cancer in males and the second in females worldwide. According to the Addis Ababa cancer registry, it is the first in male and fourth in female in Ethiopia. However, there have not been studies on prognostic factors and survival of colorectal cancer. Hence, this study aimed to estimate survival time and identify prognostic factors. Methods In this institution based retrospective study, medical records review of 422 colorectal cancer patients and telephone interview was used as sources of data. Survival time was estimated using Kaplan-Meier estimator. Prognostic factors were identified using the multivariable Cox regression model. Results Patients diagnosed with rectal cancer had 76% (HR: 1.761, 95% CI: 1.173–2.644) increased risk of dying compared to colon cancer patients. Node positive patients were 3.146 (95% CI: 1.626–6.078) times likely to die compared to node-negative and metastatic cancer were 4.221 (95% CI: 2.788–6.392) times likely to die compared to non-metastatic patients. Receiving adjuvant therapy reduced the risk of death by 36.1% (HR: 0.639 (95% CI: 0.418–0.977)) compared to patients who had an only surgical resection. The median survival time was 39 months and the overall five years survival rate was 33%. Conclusions The overall survival rate was low and a majority of the patients were young at presentation. Patient’s survival is largely influenced by the advanced cancer stage at presentation and delays in the administration of adjuvant therapy. Receiving adjuvant therapy was among the good prognostic factors.
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Affiliation(s)
- Eyob Kebede Etissa
- GAMBY College of Medical and Business Sciences, Addis Ababa, Ethiopia
- * E-mail:
| | - Mathewos Assefa
- Oncology Department, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Birhanu Teshome Ayele
- Faculty of Medicine and Health Sciences, Division of Epidemiology and Biostatistics, Stellenbosch University, Stellenbosch, South Africa
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25
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Wu W, Yang J, Li D, Huang Q, Zhao F, Feng X, Yan H, Lyu J. Competitive Risk Analysis of Prognosis in Patients With Cecum Cancer: A Population-Based Study. Cancer Control 2021; 28:1073274821989316. [PMID: 33491489 PMCID: PMC8482702 DOI: 10.1177/1073274821989316] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: The presence of competing risks means that the results obtained using the classic Cox proportional-hazards model for the factors affecting the prognosis of patients diagnosed with cecum cancer (CC) may be biased. Objective: The purpose of this study was to establish a competitive risk model for patients diagnosed with CC to evaluate the relevant factors affecting the prognosis of patients, and to compare the results with the classical COX proportional risk model. Methods: We extracted data on patients diagnosed with CC registered between 2004 and 2016 in the Surveillance, Epidemiology, and End Results (SEER) database. The univariate analysis utilized the cumulative incidence function and Gray’s test, while a multivariate analysis was performed using the Fine-Gray, cause-specific (CS), and Cox proportional-hazards models. Results: The 54463 eligible patients diagnosed with CC included 24387 who died: 12087 from CC and 12300 from other causes. The multivariate Fine-Gray analysis indicated that significant factors affecting the prognosis of patients diagnosed with CC include: age, race, AJCC stage, differentiation grade, tumor size, surgery, radiotherapy, chemotherapy and regional lymph nodes metastasis. Due to the presence of competitive risk events, COX model results could not provide accurate estimates of effects and false-negative results occurred. In addition, COX model misestimated the direction of association between regional lymph node metastasis and cumulative risk of death in patients diagnosed with CC. Competitive risk models tend to be more advantageous when analyzing clinical survival data with multiple endpoints. Conclusions: The present study can help clinicians to make better clinical decisions and provide patients diagnosed with CC with better support.
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Affiliation(s)
- Wentao Wu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Jin Yang
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Daning Li
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fanfan Zhao
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Xiaojie Feng
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Hong Yan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
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26
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Schliemann D, Ismail R, Donnelly M, Su TT. Anticipated delay in help-seeking for cancer symptoms: Findings from a nationwide study of Malaysian adults. Cancer Epidemiol 2021; 71:101882. [PMID: 33433363 DOI: 10.1016/j.canep.2020.101882] [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: 08/11/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND To investigate the relationship between anticipated delay in help-seeking and cancer symptom recognition and the extent to which this relationship varied according to socio-demographic and health-related characteristics. METHODS A cross-sectional telephone survey was conducted of 1895 adults aged ≥40 years who were randomly selected across Malaysia and interviewed using the Awareness and Beliefs about Cancer questionnaire, which was previously validated and culturally adapted by the research team. Logistic regression analysis was used to test the associations between anticipated delay for help seeking >2 weeks and socio-demographic and health-related variables. RESULTS Anticipated delay in help-seeking was reported for persistent cough (19.3 %), rectal bleeding (6.1 %) and breast changes (2.5 %). Difficulty in accessing a doctor was associated with anticipated delayed help-seeking for breast changes and rectal bleeding (adjusted ORs 7.58; 95 % CI 1.98, 28.94 and 2.37; 95 % CI 1.21, 4.66, respectively); not recognising the symptom 'unexplained bleeding' as a colorectal cancer warning sign was associated with anticipated delayed help-seeking for rectal bleeding (adjusted OR 1.54; 95 % CI 1.03, 2.31); and ethnicity was associated with anticipated delay for rectal bleeding and persistent cough. CONCLUSIONS Generally, anticipated delay to help-seeking for cancer symptoms in Malaysia (a middle-income country) appeared to be a less significant problem compared to other countries including high-income countries. There appeared to be a significant association between social variation indicators in Malaysia and anticipated delay in help-seeking.
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Roshidi Ismail
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Malaysia; Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Malaysia; Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia.
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27
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Wang T, Li LY, Chen YF, Fu SW, Wu ZW, Du BB, Yang XF, Zhang WS, Hao XY, Guo TK. Ribosome assembly factor URB1 contributes to colorectal cancer proliferation through transcriptional activation of ATF4. Cancer Sci 2020; 112:101-116. [PMID: 32888357 PMCID: PMC7780016 DOI: 10.1111/cas.14643] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/17/2020] [Accepted: 08/25/2020] [Indexed: 12/11/2022] Open
Abstract
Ribosome assembly factor URB1 is essential for ribosome biogenesis. However, its latent role in cancer remains unclear. Analysis of The Cancer Genome Atlas database and clinical tissue microarray staining showed that URB1 expression was upregulated in colorectal cancer (CRC) and prominently related to clinicopathological characteristics. Silencing of URB1 hampered human CRC cell proliferation and growth in vitro and in vivo. Microarray screening, ingenuity pathway analysis, and JASPAR assessment indicated that activating transcription factor 4 (ATF4) and X‐box binding protein 1 (XBP1) are potential downstream targets of URB1 and could transcriptionally interact through direct binding. Silencing of URB1 significantly decreased ATF4 and cyclin A2 (CCNA2) expression in vivo and in vitro. Restoration of ATF4 effectively reversed the malignant proliferation phenotype of URB1‐silenced CRC cells. Dual‐luciferase reporter and ChIP assays indicated that XBP1 transcriptionally activated ATF4 by binding with its promoter region. X‐box binding protein 1 colocalized with ATF4 in the nuclei of RKO cells, and ATF4 mRNA expression was positively regulated by XBP1. This study shows that URB1 contributes to oncogenesis and CRC growth through XBP1‐mediated transcriptional activation of ATF4. Therefore, URB1 could be a potential therapeutic target for CRC.
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Affiliation(s)
- Tao Wang
- Department of Colorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, China.,The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Lai-Yuan Li
- Department of Colorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, China
| | - Yi-Feng Chen
- Department of Colorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, China
| | - Si-Wu Fu
- The School of Medical College, Northwest Minzu University, Lanzhou, China
| | - Zhi-Wei Wu
- The School of Preclinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, China
| | - Bin-Bin Du
- Department of Colorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, China
| | - Xiong-Fei Yang
- Department of Colorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, China
| | - Wei-Sheng Zhang
- Department of Colorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, China
| | - Xiang-Yong Hao
- Department of General Surgery, Gansu Provincial People's Hospital, Lanzhou, China
| | - Tian-Kang Guo
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China.,Department of General Surgery, Gansu Provincial People's Hospital, Lanzhou, China
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A 5-year evaluation of using stool-based test for opportunistic colorectal cancer screening in primary health institutions across Malaysia. Cancer Epidemiol 2020; 69:101829. [PMID: 32998070 DOI: 10.1016/j.canep.2020.101829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The immunochemical fecal occult blood test (iFOBT) has been widely used for opportunistic colorectal cancer (CRC) screening in average-risk individuals seeking care from public health clinics in Malaysia. This study provides a 5-year outcome evaluation of such a practice. METHODS The findings for a few outcome indicators, ranging from the iFOBT uptake to the CRC and polyp detection rates, were generated from the data contributed by 583 public health clinics between 2014 and 2018. The trends in their changes were also evaluated. RESULTS The iFOBT uptake constantly increased over the years (p < 0.001), totaling 2.29 % (n = 127,957) as at 2018. Nearly 10 % (n = 11,872) of the individuals screened had a positive test result. Of those who underwent colonoscopy (n = 6,491), 4.04 % (n = 262) and 13.93 % (n = 904) were found to have CRC and polyps, respectively. CONCLUSION An uptrend in the CRC screening uptake was witnessed following the introduction of the iFOBT in public health clinics.
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Harrington LX, Wei JW, Suriawinata AA, Mackenzie TA, Hassanpour S. Predicting colorectal polyp recurrence using time-to-event analysis of medical records. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE PROCEEDINGS. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE 2020; 2020:211-220. [PMID: 32477640 PMCID: PMC7233054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Identifying patient characteristics that influence the rate of colorectal polyp recurrence can provide important insights into which patients are at higher risk for recurrence. We used natural language processing to extract polyp morphological characteristics from 953 polyp-presenting patients' electronic medical records. We used subsequent colonoscopy reports to examine how the time to polyp recurrence (731 patients experienced recurrence) is influenced by these characteristics as well as anthropometric features using Kaplan-Meier curves, Cox proportional hazards modeling, and random survival forest models. We found that the rate of recurrence differed significantly by polyp size, number, and location and patient smoking status. Additionally, right-sided colon polyps increased recurrence risk by 30% compared to left-sided polyps. History of tobacco use increased polyp recurrence risk by 20% compared to never-users. A random survival forest model showed an AUC of 0.65 and identified several other predictive variables, which can inform development of personalized polyp surveillance plans.
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Lim KG, Lee CS, Chin DHJ, Ooi YS, Veettil SK, Ching SM, Burud IAS, Zakaria J. Clinical characteristics and predictors of 5-year survival among colorectal cancer patients in a tertiary hospital in Malaysia. J Gastrointest Oncol 2020; 11:250-259. [PMID: 32399266 DOI: 10.21037/jgo.2020.02.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Colorectal cancer is the second most common cancer in Malaysia. Its disease burden is likely to increase over time owing to its current trends in this region. This study was undertaken to determine the 5-year survival rate and prognostic factors for survival in colorectal cancer patients treated in a tertiary hospital, in Malaysia. Methods We reviewed the records of colorectal cancer patients treated in Hospital Tuanku Ja'afar Seremban, Malaysia from 2008 to 2012. Survival analysis at five years was performed using the Kaplan-Meier method. Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. Results Of the 275 patients, 43.3% were colon cancers, 51.8% were rectal cancers. Only 2.2% were diagnosed in Stage I. 28.7%, 33.1%, and 16.7% were in Stage II, III and IV respectively; 62/79 (78%) of Stage II patients were in Stage IIb; 15.7% of patients were below the age of 50 and fewer of them presented early (P=0.002). The overall 5-year survival was 46.5%. It was 67.9%, 50.5% and 12.8% for Stage I&II, III and IV patients respectively. Early stage of cancer (P<0.001) and age below the mean (P=0.01) were the most significant factor in predicting better survival. Gender and ethnic group were not associated with late presentation nor survival. Neither was there a difference between colon and rectum cancers nor patients who received elective surgical treatment compared to patients receiving other treatment first (P=0.085). Conclusions Late presentation is the most important predictor for poor outcome for colorectal cancer in Seremban. Patients under the age of 50 years present late more often, but do not have poorer survival.
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Affiliation(s)
- Kean Ghee Lim
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Chit Seng Lee
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Daniel Hong Jeng Chin
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Yong Song Ooi
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Sajesh K Veettil
- School of Pharmacy/School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia
| | - Ismail Abdul Sattar Burud
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Jasiah Zakaria
- Department of Surgery, Hospital Tuanku Ja'afar Seremban, Negeri Sembilan, Malaysia
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Atinafu BT, Bulti FA, Demelew TM. Survival Status and Predictors of Mortality Among Colorectal Cancer Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Followup Study. J Cancer Prev 2020; 25:38-47. [PMID: 32266178 PMCID: PMC7113412 DOI: 10.15430/jcp.2020.25.1.38] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 01/05/2023] Open
Abstract
Colorectal cancer is one of the commonest cancer types that has a great public health impact both in developed and developing countries. However, in Ethiopia, the survival status of colorectal cancer patients was not well understood. Therefore, the aim of this study was to determine the survival status and predictors of mortality among colorectal cancer patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia in 2019. The institution-based retrospective follow-up study was conducted with 621 subjects who were selected from patients registered between January 1, 2013 and December 30, 2017 with follow-up until December 30th, 2018. Data were collected from patient record review charts. A Kaplan-Meier analysis with a log-rank test, and bivariate and multivariable analysis using the Cox proportional hazard model were used. Of the 621 colorectal cancer patients who were included in the analysis, 202 (32.5%) died. The overall mortality rate was 20.3% per year (95% CI: 17.7-23.3). The overall survival was 18.1% with median survival time of 34.8 months (95% CI: 30.4-36.8). Comorbidity (adjusted hazard ratio [AHR] = 1.8, 95% CI: 1.3-2.5); stage (II [AHR = 3.8, 95% CI: 1.3-11.1], III [AHR = 8.0, 95% CI: 2.8-23.3], IV [AHR = 17.6, 95% CI: 6.1-50.7]); smoking (AHR = 1.6, 95% CI: 1.1-2.3); alcohol consumption (AHR = 1.5, 95% CI: 1.07-2.2); age ≥ 70 (AHR = 1.7, 95% CI: 1.02-2.9); and marital status (married [AHR = 2.4, 95% CI: 1.5-3.8], widowed [AHR = 2.4, 95% CI: 1.2-4.6], divorced [AHR = 2.0, 95% CI: 1.1-3.7]) were significant predictors of colorectal cancer mortality. It is crucial to implement early detection and screening, giving priority to rural dweller, comorbid patients and advanced stage diagnosed patients.
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Affiliation(s)
- Bantalem Tilaye Atinafu
- Department of Nursing, Health Science College, Debre Berhan University, Debre Birhan, Ethiopia
| | - Fekadu Aga Bulti
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tefera Mulugeta Demelew
- Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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32
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Tan HCL, Tan JH, Nur Dzainuddin NA, Chan KK. First Feasibility Study and Short-term Outcomes of Laparoscopic-Assisted Anterior Resection in Colorectal Cancer in Malaysia. Ann Coloproctol 2020; 36:94-101. [PMID: 32178501 PMCID: PMC7299566 DOI: 10.3393/ac.2019.05.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/10/2019] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The purpose of this study was to demonstrate the feasibility and safety of laparoscopic-assisted anterior resection (LAAR) for colorectal cancer in a local Asian population. METHODS This is a retrospective review of all patients with colorectal cancer operated from November 2017 to October 2018. Main variables of interest were demography, type and surgery, length of stay (LOS), and the involvement of proximal and distal doughnut. Postoperative complications were analysed using chi-square or Fisher exact and Mann-Whitney tests. RESULTS There were 23 patients with a mean age of 62.5 ± 12.2 years. The mean time from diagnosis to surgery was 97.1 ± 154.84 days. There were 12 patients in the LAAR group and 11 in the open anterior resection (OAR) group. Duration of surgery was shorter in OAR (129.58 ± 51.38 minutes) compared to LAAR (147.91 ± 39.37 minutes). Mean LOS was shorter in the LAAR group with 5±1.5 days compared to the OAR group of 7.42 ± 4.25 days. However, there was no significant P-value for both duration of surgery (P = 0.322) or LOS (P = 0.87). A total of 3 complications were recorded after OAR and 2 after LAAR. Both groups had clear proximal and distal margins with 16 (12-18.5) harvested lymph nodes in LAAR and 18 (16-22) in OAR, which were equal (P = 0.155). CONCLUSION This study reports a shorter LOS in the minimally invasive group of 2 days with similar oncologic resection outcomes. This shows that LAAR is feasible in Malaysia and has potential outcome benefits.
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Affiliation(s)
- Henry Chor Lip Tan
- Colorectal Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia.,Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Jih Huei Tan
- Colorectal Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia.,Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | | | - Koon Khee Chan
- Colorectal Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
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Leong E, Ong SK, Madli F, Tan A, Lai D, Basir N, Ramlee N, Chong VH. Survival Rates and Associated Factors of Colorectal Cancer Patients in Brunei Darussalam. Asian Pac J Cancer Prev 2020; 21:259-265. [PMID: 31983194 PMCID: PMC7294032 DOI: 10.31557/apjcp.2020.21.1.259] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Indexed: 01/16/2023] Open
Abstract
Background: Colorectal cancer (CRC) is the third most common cancer in both men and women. In most Asian countries, both the incidence and mortality rates of CRC are gradually increasing. In Brunei Darussalam, CRC ranks first and second in lifetime risk among men and women respectively. This study aims to report the overall survival rates and associated factors of CRC in Brunei Darussalam. Methods: This is a retrospective study examining CRC data for the period 2007 to 2017 retrieved from a population based cancer registry in Brunei Darussalam. A total of 728 patients were included in the analysis. Kaplan Meier method was used to estimate survival rates. Univariate analysis using log-rank test was used to examine the differences in survival between groups. Multivariate analysis using Cox PH regression was used to estimate hazard of death and obtain significant predictors that influence CRC patients’ survival. Results: The median survival time for colorectal, colon and rectal cancer patients were 57.0, 85.8 and 40.0 months respectively. The overall 1-, 3- and 5- year survival rates for CRC patients were 78.0%, 57.7% and 49.6% respectively. In univariate analysis, age at diagnosis, ethnicity, cancer stage, tumour location and histology were found to have significant difference in CRC patients’ survival. In the Cox PH analysis, older age (≥70 years), cancer stage, ethnicity and other histological type were determined as associated factors of CRC patients’ survival. Conclusion: This study found the overall 5-year survival rate of CRC in Brunei Darussalam is similar to that in some Asian countries such as Singapore and Malaysia. However, more efforts need to be carried out in order to raise awareness of CRC and improve the survival of CRC patients.
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Affiliation(s)
- Elvynna Leong
- Faculty of Science, Universiti Brunei Darussalam, Jln Tungku Link, Brunei Darussalam.,Institute of Applied Data Analytics, Universiti Brunei Darussalam, Jln ungku Link, Brunei Darussalam
| | - Sok King Ong
- NCD Prevention Unit, Ministry of Health, Commonwealth Drive, Brunei Darussalam
| | - Fadhliah Madli
- Faculty of Science, Universiti Brunei Darussalam, Jln Tungku Link, Brunei Darussalam
| | - Abby Tan
- Faculty of Science, Universiti Brunei Darussalam, Jln Tungku Link, Brunei Darussalam
| | - Daphne Lai
- Faculty of Science, Universiti Brunei Darussalam, Jln Tungku Link, Brunei Darussalam.,Institute of Applied Data Analytics, Universiti Brunei Darussalam, Jln ungku Link, Brunei Darussalam
| | - Norwani Basir
- Gastroenterology and Hepatology Unit, Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam
| | - Noraslinah Ramlee
- Early Detection & Cancer Prevention Services, Pantai Jerudong Specialist Centre, Brunei Darussalam
| | - Vui Heng Chong
- Gastroenterology and Hepatology Unit, Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam
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Xu X, Zhang C, Xia Y, Yu J. Over expression of METRN predicts poor clinical prognosis in colorectal cancer. Mol Genet Genomic Med 2019; 8:e1102. [PMID: 31859449 PMCID: PMC7057108 DOI: 10.1002/mgg3.1102] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/12/2019] [Accepted: 12/05/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The role of meteorin (METRN) in colorectal cancer has not been reported previously. We aimed to explore the relationship between METRN and colorectal cancer (CRC) prognosis. METHODS Data were retrieved from the Gene Expression Omnibus database. Gene expression values were log2 transformed and normalized by quantile normalization. Missing values were imputed with the R impute package. Differentially expressed genes were analyzed using the R limma package. METRN expression was compared between normal and CRC tissues and among different stages and subtypes of CRC. We assessed the relationship between METRN and KRAS/BRAF mutations in CRC. Five-year overall (OS), disease-free (DFS), and disease-specific survival (DSS) rates were determined by Kaplan-Meier analysis and analyzed by log-rank test. RESULTS METRN was expressed at a higher level in CRC (p = .0011) than in normal tissues, especially in advanced stages (p = .0343). METRN expression levels were higher in the MSI (dMMR) subtype (p < .001) and usually with BRAF mutations (p < .0001). METRN overexpression was associated with poor prognosis and low OS (p = .01014), DFS (p = .0146), and DSS (p < .0001) rates. CONCLUSION METRN overexpression is a predictive factor for poor prognosis in patients with CRC.
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Affiliation(s)
- Xin Xu
- Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chihao Zhang
- Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Xia
- Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiwei Yu
- Department of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Implication of Microsatellite Instability Pathway in Outcome of Colon Cancer in Moroccan Population. DISEASE MARKERS 2019; 2019:3210710. [PMID: 31885734 PMCID: PMC6925747 DOI: 10.1155/2019/3210710] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/16/2019] [Accepted: 09/13/2019] [Indexed: 01/25/2023]
Abstract
Background Tumors with microsatellite instability (MSI tumors) have distinct clinicopathological features. However, the relation between these tumor subtypes and survival in colon cancer remains controversial. The aim of this study was to evaluate the overall survival (OS) in patients with MSI phenotype, in FES population. Methods The expression of MMR proteins was evaluated by immunohistochemistry for 330 patients. BRAF, KRAS, and NRAS mutations were examined by Sanger sequencing and pyrosequencing methods. The association of MSI status with a patient's survival was assessed by the Kaplan-Meier method and log-rank test. Results The mean age was 54.6 years (range of 19-90 years). The MSI status was found in 11.2% of our population. MSI tumors were significantly associated with male gender, younger patients, stage I-II, right localization, and a lower rate of lymph node and distant metastasis. The OS tends to be longer in MSI tumors than MSS tumors (109.71 versus 74.08), with a difference close to significance (P = 0.05). Conclusion Our study demonstrates that MSI tumors have a particular clinicopathological features. The results of survival analysis indicate that the MSI status was not predictive of improved overall survival in our context with a lower statistical significance (P = 0.05) after multivariate analysis.
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Onyoh EF, Hsu WF, Chang LC, Lee YC, Wu MS, Chiu HM. The Rise of Colorectal Cancer in Asia: Epidemiology, Screening, and Management. Curr Gastroenterol Rep 2019; 21:36. [PMID: 31289917 DOI: 10.1007/s11894-019-0703-8] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE OF REVIEW Colorectal cancer (CRC) remains the third most commonly diagnosed cancer globally, and its incidence and mortality rates have been on the rise in Asia. In this paper, we summarize the recent trends and screening challenges of CRC in this region. RECENT FINDINGS In 2018, Asia had the highest proportions of both incident (51.8%) and mortality (52.4%) CRC cases (all genders and ages) per 100,000 population in the world. In addition, there has been a rising trend of this disease across Asia with some regional geographic variations. This rise in CRC can be attributed to westernized dietary lifestyle, increasing population aging, smoking, physical inactivity, and other risk factors. In curbing the rising trend, Japan, South Korea, Singapore, and Taiwan have launched nationwide population-based screening programs. CRC screening across this region has been found to be effective and cost-effective compared with no screening at all. The emergence of new therapies has caused a reduction in case fatality; however, these new options have had a limited impact on cure rates and long-term survival due to the great disparity in treatment capacity/resources and screening infrastructures among Asian countries with different degrees of economic development. CRC is still rising in Asia, and implementation of screening is necessary for moderate- to high-incidence countries and construction of treatment capacity is the priority task in low-incidence and low-income countries. Unless countries in Asia implement CRC screening, the incidence and mortality rates of this disease will continue to rise especially with the rapidly rising population growth, economic development, westernized lifestyle, and increasing aging.
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Affiliation(s)
- Elias F Onyoh
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- AIDS Care and Prevention Program, Cameroon Baptist Convention Health Services, Bamenda, Cameroon
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
| | - Wen-Feng Hsu
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Li-Chun Chang
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Yi-Chia Lee
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Han-Mo Chiu
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan.
- Department of Internal Medicine, College of Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan.
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Phimha S, Promthet S, Suwanrungruang K, Chindaprasirt J, Bouphan P, Santong C, Vatanasapt P. Health Insurance and Colorectal Cancer Survival in Khon Kaen, Thailand. Asian Pac J Cancer Prev 2019; 20:1797-1802. [PMID: 31244302 PMCID: PMC7021590 DOI: 10.31557/apjcp.2019.20.6.1797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/04/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Evidence from healthcare studies demonstrates that patients’ health insurance affects service accessibility and the outcome of treatment. However, assessment on how colorectal cancer survival relates to health insurance is limited. Objective: The study examined the association between health insurance and colorectal cancer survival in Khon Kaen, Thailand. Methods: The retrospective cohort study was conducted with 1,931 colorectal cancer patients from Khon Kaen cancer registry between January 1, 2003 and December 31, 2012, and was followed-up until December 31, 2015. Relative survival was used to estimate the survival rate. Cox proportional hazard regression was used to estimate the relationship between health insurance and colorectal cancer survival, represented with the hazard ratio. Result: Most of the participants were males, and the median age was 62 years. The median survival time was 2.25 years (95% CI: 2.00-2.51). The five-year observed survival rate and relative survival rate were 36.87 (95% CI: 34.66-39.08) and, 42.28 (95% CI: 39.75-44.81), respectively. The factors that showed significant associations with poorer survival after adjustment for gender and age were non-surgical treatments (HRadj=1.88;95%CI=1.45-2.45), advanced stage (III+IV) (HRadj=2.50; 95%CI=2.00-3.12), histological grading in poorly differentiated (HRadj=1.84; 95%CI=1.32-2.56), and Universal Coverage Scheme (HRadj=1.37;95%CI=1.09-1.72). Conclusion: The survival of colorectal cancer patients in the Universal Coverage Scheme was likely to be poorer than in the Civil Servant Medical Benefit Scheme. This indicates an urgent need for a national program for colorectal cancer screening in the general population and access to health insurance.
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Affiliation(s)
- Surachai Phimha
- Doctor of Philosophy Program in Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
| | - Supannee Promthet
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
| | - Krittika Suwanrungruang
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
- Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jarin Chindaprasirt
- Division of Oncology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Prachak Bouphan
- Department of Public Health Administration Health Promotion Nutrition, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Chalongpon Santong
- Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Patravoot Vatanasapt
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
- Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Hutajulu SH, Paramita DK, Santoso J, Sani MIA, Amalia A, Wulandari G, Ghozali A, Kurnianda J. Correlation between vascular endothelial growth factor-A expression and tumor location and invasion in patients with colorectal cancer. J Gastrointest Oncol 2018; 9:1099-1108. [PMID: 30603129 DOI: 10.21037/jgo.2018.07.01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Vascular endothelial growth factor-A (VEGF-A) has been observed as the predominant angiogenic factor in colorectal cancer (CRC) and the assessment of microvessel density (MVD) has been used to quantify tumor neoangiogenesis. This study aimed to determine clinicopathological and prognostic significance of both angiogenic markers in the local CRC patients. Methods We analyzed tissue samples obtained from 81 cases with CRC. VEGF-A expression and MVD counts were immunohistochemically detected using anti VEGF-A and CD31. The assessments of both markers were classified as low and high. Correlation between VEGF-A expression and MVD value and clinicopathological characteristics were examined using Chi-square test. The overall survival (OS) was plotted using the Kaplan-Meier method. Results High VEGF-A expression was found more frequently in the rectal location (P=0.042) and T4 tumors (P=0.041) compared to their counterparts. Older patients tended to show a higher MVD value compared to younger cases (P=0.062). In addition, survival analysis showed that males had a worse OS compared to females (P=0.029), and VEGF-A expression and MVD count did not correlate with patients' survival. Conclusions There were significant differences of VEGF-A expression according to tumor location and T invasion. Sex, but not angiogenic markers, had an influence on the survival of CRC patients.
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Affiliation(s)
- Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Dewi Kartikawati Paramita
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Joyo Santoso
- Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Muhammad Ivan Aulia Sani
- Study Program of Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Aghnia Amalia
- Study Program of Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gatri Wulandari
- Study Program of Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ahmad Ghozali
- Department of Anatomical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
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Liu W, Song Y, Zhang C, Gao P, Huang B, Yang J. The protective role of all-transretinoic acid (ATRA) against colorectal cancer development is achieved via increasing miR-3666 expression and decreasing E2F7 expression. Biomed Pharmacother 2018; 104:94-101. [PMID: 29772445 DOI: 10.1016/j.biopha.2018.05.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/04/2018] [Accepted: 05/07/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Colorectal cancer (CRC) is one of the most common malignancies with high morbidity and mortality rates worldwide. This study aimed to investigate whether miR-3666 was involved in inhibitory effects of all-transretinoic acid (ATRA) on the development of colorectal cancer (CRC). MATERIAL AND METHODS Surgical specimens of CRC tissues and adjacent non-tumor mucosa were collected for determining miR-3666 expression. Human CRC HCT116 cells were treated with different doses of ATRA (10, 20, 40, and 60 μM, respectively) and/or transfected with miR-3666 mimic, miR-3666 inhibitor, E2F7 siRNAs or their controls, respectively. After different treatments, cell viability, apoptosis, migration and invasion were detected. The regulatory relationship between miR-3666 and E2F7 was investigated. Furthermore, the association between MAPK/ERK pathway and ATRA or miR-3666/E2F7 was explored. RESULTS The miR-3666 was lowly expressed in CRC tissues, while E2F7 was highly expressed. ATRA decreased HCT116 cell viability, migration, and invasion, and induced apoptosis, indicating that ATRA inhibited the malignant behaviors of HCT116 cells. Moreover, ATRA increased miR-3666 expression, and effects of ATRA on the malignant behaviors of HCT116 cells were achieved by positive regulating miR-3666 expression. Furthermore, E2F7 was a target gene of miR-3666, and knockdown of E2F7 reversed the combined effects of ATRA and miR-3666 inhibitor on the malignant behaviors of HCT116 cells. Besides, ATRA inhibited the activation of MAPK/ERK signaling pathway, which was reversed by inhibition of miR-3666. CONCLUSIONS Our results reveal that ATRA protects against CRC development possible via increasing miR-3666 expression and decreasing E2F7 expression. MiR-3666/E2F7 may play a key role in regulating the inhibitory effects of ATRA on HCT116 cells via suppressing the activation of MAPK/ERK signaling pathway.
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Affiliation(s)
- Weihong Liu
- Yunnan Provincial Key Laboratory of Entomological Biopharmaceutical Research and Development, Dali University, Dali, Yunnan, 671000, China; The Libraries of Dali University, Dali, Yunnan, 671003, China
| | - Yanqiu Song
- Yunnan Provincial Key Laboratory of Entomological Biopharmaceutical Research and Development, Dali University, Dali, Yunnan, 671000, China
| | - Chenggui Zhang
- Yunnan Provincial Key Laboratory of Entomological Biopharmaceutical Research and Development, Dali University, Dali, Yunnan, 671000, China
| | - Pengfei Gao
- Yunnan Provincial Key Laboratory of Entomological Biopharmaceutical Research and Development, Dali University, Dali, Yunnan, 671000, China
| | - Bisheng Huang
- Department of Agriculture and biological Science, Dali University, Dali, Yunnan, 671003, China
| | - Jianfang Yang
- Yunnan Provincial Key Laboratory of Entomological Biopharmaceutical Research and Development, Dali University, Dali, Yunnan, 671000, China; School of Foreign Languages, Dali University, Dali, Yunnan, 671003, China.
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Xu X, Wang J, Han K, Li S, Xu F, Yang Y. Antimalarial drug mefloquine inhibits nuclear factor kappa B signaling and induces apoptosis in colorectal cancer cells. Cancer Sci 2018; 109:1220-1229. [PMID: 29453896 PMCID: PMC5891192 DOI: 10.1111/cas.13540] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 02/08/2018] [Accepted: 02/10/2018] [Indexed: 12/15/2022] Open
Abstract
Nuclear factor kappa B (NF‐κB) signaling pathway is activated in many colorectal cancer (CRC) cells and in the tumor microenvironment, which plays a critical role in cancer initiation, development, and response to therapies. In the present study, we found that the widely used antimalarial drug mefloquine was a NF‐κB inhibitor that blocked the activation of IκBα kinase, leading to reduction of IκBα degradation, decrease of p65 phosphorylation, and suppressed expression of NF‐κB target genes in CRC cells. We also found that mefloquine induced growth arrest and apoptosis of CRC cells harboring phosphorylated p65 in culture and in mice. Furthermore, expression of constitutive active IKKβ kinase significantly attenuated the cytotoxic effect of the compound. These results showed that mefloquine could exert antitumor action through inhibiting the NF‐κB signaling pathway, and indicated that the antimalarial drug might be repurposed for anti‐CRC therapy in the clinic as a single agent or in combination with other anticancer drugs.
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Affiliation(s)
- Xin Xu
- Suzhou Institute of Systems Medicine, Center for Systems Medicine, Chinese Academy of Medical Sciences, Suzhou, China
| | - Jun Wang
- Department of Emergency Medicine, First Affiliated Hospital, Soochow University, Suzhou, China
| | - Kunkun Han
- The Asclepius Technology Company Group and Asclepius Cancer Research Center, Suzhou, China
| | - Shaoyan Li
- Suzhou Institute of Systems Medicine, Center for Systems Medicine, Chinese Academy of Medical Sciences, Suzhou, China
| | - Feng Xu
- Department of Emergency Medicine, First Affiliated Hospital, Soochow University, Suzhou, China
| | - Yili Yang
- Suzhou Institute of Systems Medicine, Center for Systems Medicine, Chinese Academy of Medical Sciences, Suzhou, China.,State Key Laboratory of Innovative Natural Medicine and TCM Injections, Jiangxi Qingfeng Pharmaceutical Co. Ltd, Ganzhou, China
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Nasserinejad M, Pourhoseingholi MA, Rezasoltani S, Akbari S, Baghestani AR, Shojaee S, Yaghoob-Taleghani M, Nazemalhosseini-Mojarad E. Single-nucleotide polymorphism of Exo1 gene is associated with risk of colorectal cancer based on robust Bayesian approach. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2018; 11:S146-S148. [PMID: 30774822 PMCID: PMC6348001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Maryam Nasserinejad
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohamad Amin Pourhoseingholi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sama Rezasoltani
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Setareh Akbari
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ahmad Reza Baghestani
- Physiotherapy Research Center, Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadjad Shojaee
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Yaghoob-Taleghani
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ehsan Nazemalhosseini-Mojarad
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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