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Jeri-Yabar A, Vittini-Hernandez L, Prado-Nuñez S, Dharmapuri S. Survival Analysis of Metastatic Early-Onset Colorectal Cancer Compared to Metastatic Average-Onset Colorectal Cancer: A SEER Database Analysis. Cancers (Basel) 2024; 16:2004. [PMID: 38893124 PMCID: PMC11171040 DOI: 10.3390/cancers16112004] [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: 05/02/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Early-onset colorectal cancer (EO-CRC) is defined as colorectal cancer diagnosed before the age of 50 years, and its incidence has been increasing over the last decade, now accounting for 10% of all new CRC diagnoses. Average-onset colorectal cancer (AO-CRC) has shown a steady decline in its incidence and related mortality over the past 20 years. The disparities in outcomes and overall survival (OS) between EO-CRC and AO-CRC are controversial. Our study compared OS and cause-specific survival (CSS) between metastatic EO-CRC (mEO-CRC) and metastatic AO-CRC (mAO-CRC) and identified the associated factors. METHODS Data on patient characteristics, tumor characteristics, incidence, and mortality were obtained from the SEER database from 2010 to 2020. We identified 23,278 individuals aged > 18 years with a confirmed diagnosis of all histological subtypes of metastatic CRC (M1 on TNM stage) using ICD-O-3 site codes. mEO-CRC and mAO-CRC were compared. OS distributions and CCS were analyzed using the Kaplan-Meier method and log-rank test to assess differences. A Cox regression model was used to assess the associations between variables. RESULTS mEO-CRC constituted 17.79% of the cases, whereas 82.21% had mAO-CRC. Most patients with mEO-CRC were 45-49 years old (47.66%), male (52.16%) and White (72.57%) and had adenocarcinoma histology (87.30%). Left colon tumors were most prevalent in both groups (40.26%) but were more prevalent in mEO-CRC patients than in mAO-CRC patients (49.63% vs. 38.23%, p < 0.001). Patients with mEO-CRC had higher OS (p < 0.001) and CSS (p < 0.001) than those with mAO-CRC. Patients with mEO-CRC also had significantly better median overall survival (30 months vs. 18 months, p < 0.001). The factors associated with worse OS included mAO-CRC (p < 0.001), mucinous adenocarcinoma (p < 0.001), male sex (p = 0.003), and a lack of surgical intervention (p < 0.001). CONCLUSIONS Most patients with mEO-CRC fall within the range of 45 to 49 years of age. Patients with mEO-CRC were more likely to receive cancer-directed therapy (including chemotherapy and radiotherapy) and had better OS and CSS than those with mAO-CRC. This is likely attributable to the better performance status, fewer comorbidities, and better tolerance to cancer-directed therapy in mEO-CRC patients. The factors associated with worse OS and CSS were age > 50 years, mucinous adenocarcinoma, male sex, and no surgical treatment.
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Affiliation(s)
- Antoine Jeri-Yabar
- Department of Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, NY 10029, USA
| | - Liliana Vittini-Hernandez
- Department of Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, NY 10029, USA
| | | | - Sirish Dharmapuri
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai West, New York, NY 10029, USA;
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Abboud Y, Fraser M, Qureshi I, Srivastava S, Abboud I, Richter B, Jaber F, Alsakarneh S, Al-Khazraji A, Hajifathalian K. Geographical Variations in Early Onset Colorectal Cancer in the United States between 2001 and 2020. Cancers (Basel) 2024; 16:1765. [PMID: 38730717 PMCID: PMC11083665 DOI: 10.3390/cancers16091765] [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: 04/10/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Colorectal cancer remains the second leading cause of cancer-related death in the US. As early-onset colorectal cancer (EO-CRC) becomes more prevalent in the US, research attention has shifted towards identifying at-risk populations. Previous studies have highlighted the rising rate of early-onset adenocarcinoma (ADC) and neuroendocrine tumors (NET) in the US. However, data on geographical variations of EO-CRC are scarce. Hence, our study aims to analyze time trends in EO-CRC incidence rates across various US regions and to assess these trends by sex and histopathological subtypes (ADC and NET). METHODS We analyze data spanning from 2001 to 2020 from the United States Cancer Statistics (USCS) database, covering nearly 98% of the US population. Using SEER*Stat software version (8.4.2, NCI), we calculated EO-CRC incidence rates among adults aged 20-54 years, adjusting for the age standard 2000 US population. The rates were categorized by sex and US geographical regions into west, midwest, northeast, and south. Time trends, reported as annual percentage change (APC) and average APC (AAPC), were generated via Joinpoint Regression software (v.5.0.2, NCI) utilizing the weighted Bayesian Information Criteria "BIC" method to generate the best-fit trends with a two-sided p-value cutoff at 0.05. The rates were also stratified by histopathology into ADC and NET. RESULTS Between 2001 and 2020, a total of 514,875 individuals were diagnosed with early-onset CRC in the US, with 54.78% being men. Incidence rates and trends varied across geographical regions. In the western region (comprising 106,685 patients, 54.85% men), incidence rates significantly increased in both women (AAPC = 1.37, p < 0.001) and men (AAPC = 1.34, p < 0.001). Similarly, in the midwestern region (with 110,380 patients, 55.46% men), there were significant increases in incidence rates among women (AAPC = 1.06, p < 0.001) and men (AAPC = 1.35, p < 0.001). The northeastern region (with 94,758 patients, 54.53% men) also witnessed significant increases in incidence rates for both women (AAPC = 0.71, p < 0.001) and men (AAPC = 0.84, p < 0.001). In contrast, the southern region (with 203,052 patients, 54.48% men) experienced slower increases in incidence rates among both women and men (AAPC = 0.25, p < 0.05 in women; AAPC = 0.66, p < 0.05 in men). When stratified by histopathology, incidence rates for adenocarcinomas (ADC) increased in all regions, most notably in the west (AAPC = 1.45, p < 0.05), and least in the south (AAPC = 0.46, p < 0.05). Conversely, for neuroendocrine tumors (NET), while incidence rates increased similarly across all regions, the pace was notably faster compared to ADC, particularly in the west (AAPC = 3.26, p < 0.05) and slower in the south (AAPC = 2.24, p < 0.05) Discussion: Our analysis of nationwide US data spanning two decades and encompassing over half a million early-onset CRC patients, representing nearly 98% of the US population, highlights significant temporal variation in incidence rates across various geographical regions. The most substantial increases in incidence rates were observed in the west, while the least pronounced changes were noted in the south, affecting both men and women. These trends persisted across the main CRC histopathological subtypes, with NET exhibiting a notably swifter pace of increase compared with ADC. These findings hold important implications for public health strategies and underscore the need for targeted interventions to address the rising burden of early-onset CRC across different regions in the US.
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Affiliation(s)
- Yazan Abboud
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (M.F.); (I.Q.); (S.S.)
| | - Madison Fraser
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (M.F.); (I.Q.); (S.S.)
| | - Imran Qureshi
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (M.F.); (I.Q.); (S.S.)
| | - Shivani Srivastava
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (M.F.); (I.Q.); (S.S.)
| | - Ibrahim Abboud
- School of Medicine, University of California Riverside, Riverside, CA 92521, USA;
| | - Benjamin Richter
- Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (B.R.); (A.A.-K.); (K.H.)
| | - Fouad Jaber
- Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64110, USA; (F.J.); (S.A.)
| | - Saqr Alsakarneh
- Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64110, USA; (F.J.); (S.A.)
| | - Ahmed Al-Khazraji
- Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (B.R.); (A.A.-K.); (K.H.)
| | - Kaveh Hajifathalian
- Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (B.R.); (A.A.-K.); (K.H.)
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Ramadan M, Ghamdi H, Aboalola D, Alorainan N, Alsalmi R, Afash A, Hariri A, Alboloshi A, Samkari A, Alsiary R. Disease burden and projection of total and early-onset colorectal cancer in Gulf cooperation council countries from 1990 to 2019. Neoplasia 2024; 51:100988. [PMID: 38513469 PMCID: PMC10965807 DOI: 10.1016/j.neo.2024.100988] [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: 12/10/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Early-onset colorectal cancer (EO-CRC) incidence and prevalence trends in the rise in high income countries, such as the Gulf Cooperation Council (GCC) countries. The study aimed to offer an up-to-date assessment of the overall burden of CRC, and EO-CRC in GCC countries and project its incidence and mortality in 2030. METHOD The prevalence, incidence, mortality, years of life lived with disability (YLDs), and disability-adjusted life years (DALYs) of CRC were obtained from the Global Burden of Disease (GBD) Study 2019. The incidence and mortality of CRC, and EO-CRC up to 2030 were predicted. RESULTS All GCC countries showed a higher annual average percentage changes (AAPC) AAPC incidence rate for EO-CRC compared to CRC. In Saudi Arabia the number of CRC cases has increased from 1990 1484.57; (95 % UI 1987.98,1083.86) 11.4-fold-increase to 16991.83; (95 % UI 21754.79,12892.12) in 2019. In 2030, the total incidence cases of CRC for the six Gulf countries are expected to reach 13,339 thousand, primarily driven by Saudi Arabia with 7,910.19 cases. In 2030, the CRC mortality rate is projected to be 7,647 cases, with nearly 57 % of CRC mortality cases anticipated in Saudi Arabia. CONCLUSION This study sheds light on the alarming rise in CRC and EO-CRC across Gulf countries from 1990 to 2019, emphasizing Saudi Arabia's significant burden. It projects a concerning increase in CRC incidence and mortality by 2030, primarily in Saudi Arabia, and highlights the need for immediate public health interventions.
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Affiliation(s)
- Majed Ramadan
- Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, P.O.BOX 9515, Jeddah 21423, Kingdom of Saudi Arabia
| | - Hanin Ghamdi
- King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, P.O.BOX 9515, Jeddah 21423, Kingdom of Saudi Arabia
| | - Doaa Aboalola
- Department of Cellular Therapy and Cancer Research, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, P.O.BOX 9515, Jeddah 21423, Kingdom of Saudi Arabia
| | - Noha Alorainan
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University (KAU), P.O Box: 80200, Jeddah, Kingdom of Saudi Arabia
| | - Ragad Alsalmi
- Department of Medicine, Royal College of Surgeons in Ireland, P.O.BOX 123 St Stephen's Green, Dublin 2, D02 YN77, Republic of Ireland
| | - Ahmed Afash
- Ibn Sina National College For medical Studies (ISNC), P.O.BOX 53347, Jeddah 21583, Kingdom of Saudi Arabia
| | - Albaraa Hariri
- Ibn Sina National college for medical Studies (ISNC), P.O.BOX 23814, JEDDAH 9397, Kingdom of Saudi Arabia
| | - Atheer Alboloshi
- Medicine Faculty, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia, P.O.B.O.X 80200
| | - Alaa Samkari
- Department of Medicine, Faculty of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU; Department of Pathology and Laboratory Medicine, Faculty of Medicine, Ministry of National
| | - Rawiah Alsiary
- Department of Cellular Therapy and Cancer Research, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, P.O.BOX 9515, Jeddah 21423, Kingdom of Saudi Arabia.
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Brezina S, Leeb G, Baierl A, Gräf E, Hackl M, Hofer P, Lang H, Klein M, Mach K, Schwarzer R, Wlassits W, Püspök A, Gsur A. Evaluation of the "Burgenland PREvention trial of colorectal cancer Disease with ImmunologiCal Testing" (B-PREDICT)-a population-based colorectal cancer screening program. BMC Gastroenterol 2024; 24:149. [PMID: 38689217 PMCID: PMC11061958 DOI: 10.1186/s12876-024-03242-7] [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: 11/29/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The colorectal cancer (CRC) screening program B-PREDICT is a population based invited two stage screening project using a faecal immunochemical test (FIT) for initial screening followed by a colonoscopy for those with a positive FIT. B-PREDICT was compared with the opportunistic screening colonoscopy (OPP-COL), performed in course of the nationwide screening program. METHODS Within B-PREDICT all residents of the Austrian federal state Burgenland, aged between 40 and 80 are annually invited to FIT testing. All individuals who underwent initial colonoscopy in Burgenland between 01/2003 and 12/2014, were included in this study. Individuals from the FIT-triggered invited screening program B-PREDICT were compared with those from the non-FIT triggered OPP-COL. RESULTS 15 133 individuals from B-PREDICT were compared to 10 045 individuals with OPP-COL. CRC detection rates were 1.34% (CI-95%, [1.15; 1.52]) in B-PREDICT compared to 0.54% in OPP-COL (95%-CI, [0.39; 0.68] p < 0.001). The decrease in the age standardized incidence rates of CRC was more pronounced in the population screened with FIT than in the general population screened with colonoscopy. Changes in incidence rates per year were -4.4% (95%-CI, [-5.1; -3.7]) vs. -1.8% (95%-CI, [-1.9; -1.6] p < 0.001). CONCLUSIONS B-PREDICT shows a two-fold higher detection rate of CRC as well as HRA compared to OPP-COL.
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Affiliation(s)
- Stefanie Brezina
- Center for Cancer Research, Medical University of Vienna, Borschkegasse 8a, Vienna, 1090, Austria
| | - Gernot Leeb
- Department of Internal Medicine, Hospital Oberpullendorf, Oberpullendorf, Austria
| | - Andreas Baierl
- Department of Statistics and Operations Research, University of Vienna, Vienna, Austria
| | - Evelyn Gräf
- Institute of Clinical Pathology and Microbiology, Oberwart, Austria
| | | | - Philipp Hofer
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Harald Lang
- Outpatient Clinic for Medical and Chemical Laboratory Diagnostics, Eisenstadt, Austria
| | | | - Karl Mach
- Department of Internal Medicine, Hospital Oberpullendorf, Oberpullendorf, Austria
| | - Remy Schwarzer
- Department of Internal Medicine II, St. John's Hospital, Eisenstadt, Austria
| | - Wilhelm Wlassits
- Department of Internal Medicine, Hospital Oberpullendorf, Oberpullendorf, Austria
| | - Andreas Püspök
- Department of Internal Medicine II, St. John's Hospital, Eisenstadt, Austria
| | - Andrea Gsur
- Center for Cancer Research, Medical University of Vienna, Borschkegasse 8a, Vienna, 1090, Austria.
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Lawler T, Parlato L, Warren Andersen S. The histological and molecular characteristics of early-onset colorectal cancer: a systematic review and meta-analysis. Front Oncol 2024; 14:1349572. [PMID: 38737895 PMCID: PMC11082351 DOI: 10.3389/fonc.2024.1349572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/16/2024] [Indexed: 05/14/2024] Open
Abstract
Background Early-onset colorectal cancer (CRC), defined as diagnosis before age 50, has increased in recent decades. Although more often diagnosed at advanced stage, associations with other histological and molecular markers that impact prognosis and treatment remain to be clarified. We conducted a systematic review and meta-analysis concerning the prevalence of prognostic and predictive tumor markers for early- vs. late-onset CRC, including oncogene mutations, microsatellite instability (MSI), and emerging markers including immune cells and the consensus molecular subtypes. Methods We systematically searched PubMed for original research articles published between April 2013-January 2024. Included studies compared the prevalence of tumor markers in early- vs. late-onset CRC. A meta-analysis was completed and summary odds ratios (ORs) with 95% confidence intervals (CIs) were obtained from a random effects model via inverse variance weighting. A sensitivity analysis was completed to restrict the meta-analysis to studies that excluded individuals with Lynch syndrome, a hereditary condition that influences the distribution of tumor markers for early-onset CRC. Results In total, 149 articles were identified. Tumors from early-onset CRC are less likely to include mutations in KRAS (OR, 95% CI: 0.91, 0.85-0.98), BRAF (0.63, 0.51-0.78), APC (0.70, 0.58-0.84), and NRAS (0.88, 0.78-1.00) but more likely to include mutations in PTEN (1.68, 1.04-2.73) and TP53 (1.34, 1.24-1.45). After limiting to studies that excluded Lynch syndrome, the associations between early-onset CRC and BRAF (0.77, 0.64-0.92) and APC mutation (0.81, 0.67-0.97) were attenuated, while an inverse association with PIK3CA mutation was also observed (0.88, 0.78-0.99). Early-onset tumors are less likely to develop along the CpG Island Methylator Phenotype pathway (0.24, 0.10-0.57), but more likely to possess adverse histological features including high tumor grade (1.20, 1.15-1.25), and mucinous (1.22, 1.16-1.27) or signet ring histology (2.32, 2.08-2.57). A positive association with MSI status (1.31, 1.11-1.56) was also identified. Associations with immune markers and the consensus molecular subtypes are inconsistent. Discussion A lower prevalence of mutations in KRAS and BRAF is consistent with extended survival and superior response to targeted therapies for metastatic disease. Conversely, early-onset CRC is associated with aggressive histological subtypes and TP53 and PTEN mutations, which may serve as therapeutic targets.
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Affiliation(s)
- Thomas Lawler
- School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Lisa Parlato
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Shaneda Warren Andersen
- School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, United States
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States
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Cho HJ, Lee HS, Kang J. Varying clinical relevance of sarcopenia and myosteatosis according to age among patients with postoperative colorectal cancer. J Nutr Health Aging 2024; 28:100243. [PMID: 38643603 DOI: 10.1016/j.jnha.2024.100243] [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: 01/18/2024] [Revised: 04/03/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES The present retrospective study reviewed the association among sarcopenia, myosteatosis, and overall survival (OS) in patients with postoperative colorectal cancer (CRC) with regard to age. DESIGN A retrospective study was conducted with a five-year follow-up. SETTING Data from all patients with CRC, who underwent surgery between February 2005 and April 2014, were reviewed. PARTICIPANTS Data from 1053 patients (622 male [59.1%], 431 female [40.9%]; mean [± SD] age, 62.8 ± 11.8 years) were analyzed. MEASUREMENTS Patients were divided into three groups according to age: ≤50, 51-74, and ≥75 years. Data, including perioperative parameters, and the presence of sarcopenia and myosteatosis according to skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD), respectively, were collected. Sarcopenia was evaluated using CT by calculating the SMI at the L3 level by dividing the area of the skeletal muscle by height squared (cm2/m2). SMD was also calculated using CT at the L3 level, but by evaluating fat attenuation according to Hounsfield units (HU). RESULTS Patient allocation according to age group was as follows: ≤50 years, n = 147 (14.0%); 51-74 years, n = 742 (70.5%); and ≥75 years, n = 164 (15.5%). The presence of sarcopenia and myosteatosis were statistically significant with increasing age (P = 0.004 and P < 0.001, respectively). The 51-74 years age group exhibited a significant association in OS for myosteatosis (P < 0.001) while the ≥75 years group was significantly associated with sarcopenia (P = 0.04) with regard to OS. Multivariable analysis also revealed a statistically significant association between myosteatosis in the 51-74 years age group (P = 0.033) and sarcopenia in the ≥75 years age group (P = 0.005) even when adjusted for recurrence status. CONCLUSION Different age groups exhibited significantly variable skeletal muscle indices. Although an abundance of irrefutable results demonstrated a correlation between CT-defined sarcopenia, myosteatosis, and clinical prognosis, data regarding age-dependent correlations are scarce. Results of this study demonstrated that sarcopenia and myosteatosis did not influence the prognosis of young patients with postoperative CRC (≤50 years of age), inferring the existence of significantly different skeletal muscle-related parameters according to age. Patients over 75 years of age showed significant association with sarcopenia while those in the 51-74 age group displayed significant link to myosteatosis. Clinicians should consider the impact of sarcopenia and myosteatosis on patient prognosis and should also be aware that the effect may differ according to patient age.
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Affiliation(s)
- Hye Jung Cho
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeonghyun Kang
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Alinia S, Asghari-Jafarabadi M, Mahmoudi L, Roshanaei G, Safari M. Predicting mortality and recurrence in colorectal cancer: Comparative assessment of predictive models. Heliyon 2024; 10:e27854. [PMID: 38515707 PMCID: PMC10955293 DOI: 10.1016/j.heliyon.2024.e27854] [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: 08/04/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Colorectal cancer (CRC), also known as colorectal cancer, is a significant disease marked by high fatality rates, ranking as the third leading cause of global mortality. The main objective of this study was to assess the accuracy of predictive models in predicting both mortality events and the probability of disease recurrence. Method A retrospective analysis was conducted on a cohort of 284 individuals diagnosed with colorectal cancer between 2001 and 2017. Demographic and clinical data, including gender, disease stage, age at diagnosis, recurrence status, and treatment details, were meticulously recorded. We rigorously evaluated various predictive models, including Decision Trees, Random Forests, Random Survival Forests (RSF), Gradient Boosting, mboost, Deep Learning Neural Network (DLNN), and Cox regression. Performance metrics, such as sensitivity, positive predictive value (PPV), specificity, area under the receiver operating characteristic curve (ROC area), and overall accuracy, were calculated for each model to predict mortality and disease recurrence. The analysis was performed using R version 4.1.3 software and the Python programming language. Results For mortality prediction, the mboost model demonstrated the highest sensitivity at 96.9% (95% CI: 0.83-0.99) and an ROC area of 0.88. It also exhibited high specificity at 80% (95% CI: 0.59-0.93), a positive predictive value of 86.1% (95% CI: 0.70-0.95), and an overall accuracy of 89% (95% CI: 0.78-0.96). Random Forests showed perfect sensitivity of 100% (95% CI: 0.85-1) but had low specificity at 0% (95% CI: 0-0.52) and poor overall accuracy (50%). On the other hand, DLNN had the lowest performance metrics for mortality prediction, with a sensitivity of 24% (95% CI: 0.222-0.268), specificity of 75% (95% CI: 0.73-0.77), and a lower positive predictive value of 42% (95% CI: 0.38-0.45). The Gradient Boosting model showed the best performance in predicting recurrence, achieving perfect sensitivity of 100% (95% CI: 0.87-1) and high specificity at 92.9% (95% CI: 0.76-0.99). It also had a high positive predictive value of 93.3% (95% CI: 0.77-0.99). Gradient Boosting, with an ROC area of 96.4%, and mboost, with an ROC area of 75%, demonstrated remarkable performance. DLNN had the lowest performance metrics for recurrence prediction, with sensitivity at 1.75% (95% CI: 0.01-0.02), specificity at 98% (95% CI: 0.97-0.98), and a lower positive predictive value at 52.6% (95% CI: 0.39-0.65). Conclusion In summary, the mboost model demonstrated outstanding performance in predicting mortality, achieving exceptional results across various evaluation metrics. Random Forests exhibited perfect sensitivity but showed poor specificity and overall accuracy. The DLNN model displayed the lowest performance metrics for mortality prediction. In terms of recurrence prediction, the Gradient Boosting model outperformed other models with perfect sensitivity, high specificity, and positive predictive value. The DLNN model had the lowest performance metrics for recurrence prediction. Overall, the results emphasize the effectiveness of the mboost and Gradient Boosting models in predicting mortality and recurrence in colorectal cancer patients.
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Affiliation(s)
- Shayeste Alinia
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Leila Mahmoudi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ghodratollah Roshanaei
- Modeling of Non-communicable Diseases Research Canter, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maliheh Safari
- Department of Biostatistics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
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Puspitaningtyas H, Hutajulu SH, Fachiroh J, Anggorowati N, Sanjaya GY, Lazuardi L, Sripan P. Diverging likelihood of colon and rectal cancer in Yogyakarta, Indonesia: A cross sectional study. PLoS One 2024; 19:e0301191. [PMID: 38547083 PMCID: PMC10977797 DOI: 10.1371/journal.pone.0301191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/11/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES Colon and rectal cancer are associated with different risk factors and prognostic. However, this discrepancy has not been widely explored in the local population. This study aimed to investigate the site-specific likelihood of colorectal cancer (CRC) incidence in the Yogyakarta province, Indonesia. METHODS This cross-sectional study analyses 1,295 CRC cases diagnosed in 2008-2019 registered in the Yogyakarta population-based cancer registry (PBCR) database. Cases were grouped into colon and rectal cancer. Log-binomial regression was used to determine the relative risk of either colon or rectal cancer across different gender, age group, and rurality of residence. The age-specific rates were calculated by age group and temporal trend for each group were analyzed using joinpoint regression. RESULTS Females displayed higher odds of colon cancer (relative risk/RR = 1.20, 95%CI = 1.02-1.41) and lower odds of rectal cancer (RR = 0.92, 95%CI = 0.85-0.99). Elevated odds of colon cancer were observed in younger age group, especially 30-39 (RR = 1.87, 95%CI = 1.10-3.19), while decreased odds of rectal cancer was apparent in age group 30-39 and 40-49 (RR = 0.75, 95%CI = 0.60-0.93 and RR = 0.82, 95%CI = 0.69-0.98, respectively). Living in urban or rural areas did not significantly influence the odds of either having colon (RR = 0.98, 95%CI = 0.82-1.17) or rectal cancer (RR = 1.01, 95%CI = 0.93-1.10). During 2008-2019, trends of colon cancer in age <50 increased by 8.15% annually while rectal cancer displayed a 9.71% increase annually prior to 2017, followed by a 17.23% decrease until 2019. CONCLUSIONS Yogyakarta population shows higher odds of young-onset colon cancer, especially between age 30-39 years old. Overall observation of trend shows increasing incidence in young-onset colon cancer, and non-significant decrease in rectal cancer.
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Affiliation(s)
- Herindita Puspitaningtyas
- Faculty of Medicine, Public Health and Nursing, Doctorate Program of Health and Medical Science, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Susanna Hilda Hutajulu
- Faculty of Medicine, Public Health and Nursing, Department of Internal Medicine, Division of Hematology and Medical Oncology, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Jajah Fachiroh
- Faculty of Medicine, Public Health and Nursing, Department of Histology and Cell Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nungki Anggorowati
- Faculty of Medicine, Public Health and Nursing, of Anatomical Pathology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Guardian Yoki Sanjaya
- Faculty of Medicine, Public Health and Nursing, of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lutfan Lazuardi
- Faculty of Medicine, Public Health and Nursing, of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Moulana MS, Haiaty S, Bazmani A, Shabkhizan R, Moslehian MS, Sadeghsoltani F, Mostafazadeh M, Asadi MR, Talebi M, Jafari Z, Morovati MR, Farzaei MH, Rahbarghazi R. Tumoricidal properties of thymoquinone on human colorectal adenocarcinoma cells via the modulation of autophagy. BMC Complement Med Ther 2024; 24:132. [PMID: 38532470 DOI: 10.1186/s12906-024-04432-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/12/2024] [Indexed: 03/28/2024] Open
Abstract
Colorectal cancer (CRC) is deadly anaplastic changes in the gastrointestinal tract with high-rate mortality. In recent years, the application of phytocompounds has been extended along with different therapeutic protocols. Here, we monitored the effects of Thymoquinone (TQ) on autophagy via mitochondrial function after modulation of the Wnt/β-catenin signaling pathway.Human colorectal adenocarcinoma HT-29 cells were treated with TQ (60 µM) and 15 µM Wnt3a inhibitor (LGK974) for 48 h. The survival rate was evaluated using an MTT assay. The expression of Wnt-related factors (c-Myc, and Axin), angiogenesis (VE-Cadherin), and mitophagy-related factors (PINK1, OPTN) was assessed using real-time PCR assay. Protein levels of autophagy factors (Beclin-1, LC3, and P62) were monitored using western blotting. Using flow cytometry analysis, the intracellular accumulation of Rhodamine 123 was evaluated. The migration properties were analyzed using a scratch wound healing assay.Data indicated that TQ can reduce the viability of HT-29 cells compared to the control cells (p < 0.05). The expression of VE-Cadherin was inhibited while the expression of PINK1 was induced in treated cells (p < 0.05). Both LGK974 and TQ-treated cells exhibited activation of autophagy flux (Beclin-1↑, LC3II/I↑, and p62↓) compared to the control group (p < 0.05). TQ can increase intracellular accumulation of Rhodamine 123, indicating the inhibition of efflux mechanisms in cancer cells. Along with these changes, the migration of cells was also reduced (p < 0.05).TQ is a potential phytocompound to alter the dynamic growth of human colorectal HT-29 cells via the modulation of autophagy, and mitophagy-related mechanisms.
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Affiliation(s)
- Mohammad Saleh Moulana
- Department of Persian Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sanya Haiaty
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahad Bazmani
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roya Shabkhizan
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Marziyeh Sadat Moslehian
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Sadeghsoltani
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biochemistry and Clinical Laboratories, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Mostafazadeh
- Department of Biochemistry and Clinical Laboratories, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Reza Asadi
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Talebi
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Jafari
- Department of Persian Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Reza Morovati
- Department of Persian Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Department of Traditional Pharmacy, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Reza Rahbarghazi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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10
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Triantafillidis JK, Georgiou K, Konstadoulakis MM, Papalois AE. Early-onset gastrointestinal cancer: An epidemiological reality with great significance and implications. World J Gastrointest Oncol 2024; 16:583-597. [PMID: 38577465 PMCID: PMC10989383 DOI: 10.4251/wjgo.v16.i3.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/17/2023] [Accepted: 01/11/2024] [Indexed: 03/12/2024] Open
Abstract
During the last few years, epidemiological data from many countries suggest that the incidence and prevalence of many cancers of the digestive system are shifting from the older to the younger ages, the so-called "early-onset cancer". This is particularly evident in colorectal cancer and secondarily in other malignant digestive neoplasms, mainly stomach and in a lesser degree pancreas, and biliary tract. It should be emphasized that data concerning digestive neoplasms, except for those referring to the colon and stomach, could be characterized as rather insufficient. The exact magnitude of the shift in younger ages is expected to become clearer shortly, as long as relevant epidemiological data from many parts of the world would be available. The most important question concerns the etiology of this phenomenon, since its magnitude cannot be explained solely by the better diagnostic methodology and the preventive programs applied in many countries. The existing data support the assumption that a number of environmental factors may play a primary role in influencing carcinogenesis, sometimes from childhood. Changes that have appeared in the last decades related mainly to eating habits, consistency of gut microbiome and an increase of obese people interacting with genetic factors, ultimately favor the process of carcinogenesis. Even these factors however, are not entirely sufficient to explain the age-related changes in the frequency of digestive neoplasms. Studies of the individual effect of each of the already known factors or factors likely to be involved in the etiology of this phenomenon and studies using state-of-the-art technologies to accurately determine the degree of the population exposure to these factors are required. In this article, we attempt to describe the epidemiological data supporting the age-shifting of digestive malignancies and their possible pathogenesis. Finally, we propose some measures regarding the attitude of the scientific community to this alarming phenomenon.
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Affiliation(s)
- John K Triantafillidis
- Department of IBD and GI Endoscopy, Metropolitan General Hospital, Holargos 15562, Athens, Greece. Hellenic Society for Gastrointestinal Oncology, 354 Iera Odos, Chaidari 12461, Attica, Greece
| | - Konstantinos Georgiou
- 2nd Department of Surgery, University of Athens School of Medicine, Aretaieion Hospital, Athens 11528, Greece
| | - Manousos M Konstadoulakis
- 2nd Department of Surgery, University of Athens School of Medicine, Aretaieion Hospital, Athens 11528, Greece
| | - Apostolos E Papalois
- 2nd Department of Surgery, University of Athens School of Medicine, Aretaieion Hospital, Athens 11528, Greece
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11
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Wei MY, Cao K, Hong W, Yeung J, Lee M, Gibbs P, Faragher IG, Baird PN, Yeung JM. Artificial intelligence measured 3D body composition to predict pathological response in rectal cancer patients. ANZ J Surg 2024. [PMID: 38456517 DOI: 10.1111/ans.18929] [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: 01/12/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND The treatment of locally advanced rectal cancer (LARC) is moving towards total neoadjuvant therapy and potential organ preservation. Of particular interest are predictors of pathological complete response (pCR) that can guide personalized treatment. There are currently no clinical biomarkers which can accurately predict neoadjuvant therapy (NAT) response but body composition (BC) measures present as an emerging contender. The primary aim of the study was to determine if artificial intelligence (AI) derived body composition variables can predict pCR in patients with LARC. METHODS LARC patients who underwent NAT followed by surgery from 2012 to 2023 were identified from the Australian Comprehensive Cancer Outcomes and Research Database registry (ACCORD). A validated in-house pre-trained 3D AI model was used to measure body composition via computed tomography images of the entire Lumbar-3 vertebral level to produce a volumetric measurement of visceral fat (VF), subcutaneous fat (SCF) and skeletal muscle (SM). Multivariate analysis between patient body composition and histological outcomes was performed. RESULTS Of 214 LARC patients treated with NAT, 22.4% of patients achieved pCR. SM volume (P = 0.015) and age (P = 0.03) were positively associated with pCR in both male and female patients. SCF volume was associated with decreased likelihood of pCR (P = 0.059). CONCLUSION This is the first study in the literature utilizing AI-measured 3D Body composition in LARC patients to assess their impact on pathological response. SM volume and age were positive predictors of pCR disease in both male and female patients following NAT for LARC. Future studies investigating the impact of body composition on clinical outcomes and patients on other neoadjuvant regimens such as TNT are potential avenues for further research.
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Affiliation(s)
- Matthew Y Wei
- Department of Surgery, Western Precinct, University of Melbourne, Melbourne, Victoria, Australia
- Department of Colorectal Surgery, Western Health, Melbourne, Victoria, Australia
| | - Ke Cao
- Department of Surgery, Western Precinct, University of Melbourne, Melbourne, Victoria, Australia
| | - Wei Hong
- Gibbs Lab, Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
| | - Josephine Yeung
- Department of Surgery, Western Precinct, University of Melbourne, Melbourne, Victoria, Australia
| | - Margaret Lee
- Department of Medical Oncology, Western Health, Melbourne, Victoria, Australia
| | - Peter Gibbs
- Gibbs Lab, Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
- Department of Medical Oncology, Western Health, Melbourne, Victoria, Australia
| | - Ian G Faragher
- Department of Colorectal Surgery, Western Health, Melbourne, Victoria, Australia
| | - Paul N Baird
- Department of Surgery, Western Precinct, University of Melbourne, Melbourne, Victoria, Australia
| | - Justin M Yeung
- Department of Surgery, Western Precinct, University of Melbourne, Melbourne, Victoria, Australia
- Department of Colorectal Surgery, Western Health, Melbourne, Victoria, Australia
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12
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Ghulam E, Ramadan M. Age-period-cohort analysis of colorectal cancer mortality in Saudi Arabia from 1990 to 2019. Public Health 2024; 228:43-50. [PMID: 38266347 DOI: 10.1016/j.puhe.2023.11.033] [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: 10/12/2023] [Revised: 11/07/2023] [Accepted: 11/22/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES The current study aimed to describe and estimate the independent effects of age, period, and cohort on colorectal cancer (CRC) mortality in Saudi Arabia from 1990 to 2019. STUDY DESIGN This was an epidemiological study. METHODS Data were obtained from the Global Burden of Disease study 2019. Age-period-cohort modelling was used to compute the net drift, local drift, cross-sectional age curve, longitudinal age curve, and rate ratios (RRs) of period and cohort of CRC mortality in Saudi Arabia. RESULTS In 2019, there were 1629 (95% uncertainty interval [UI]: 1263 to 2045) CRC cancer deaths in Saudi Arabia, and the age-standardised mortality rate of CRC was 9.7 (95% UI: 7.8 to 11.6) per 100,000 population. For men, between 1990 and 2019, the total number of CRC deaths increased dramatically from 199 (95% UI: 130 to 286) in 2019 to 942 (95% UI: 725 to 1228). For the period effects, the relative risk (RR) of mortality rate for both sexes followed similar monotonic increase patterns throughout the study period. CONCLUSIONS Results from this study highlight a concerning increase in CRC mortality rates in Saudi Arabia from 1990 to 2019, particularly among individuals aged 30-50 years. While mortality rates for men were higher at the start of the study period, more favourable trends for men were seen in the later years of the study period, indicating evolving gender disparities. Establishing evidence-based national screening guidelines and adopting multi-level diagnostics, risk assessment, and population-wide screening, especially for younger populations, is crucial.
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Affiliation(s)
- E Ghulam
- Basic Science Department, College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
| | - M Ramadan
- Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Saudi Arabia.
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13
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Di Maggio F, Boccia G, Nunziato M, Filotico M, Montesarchio V, D'Armiento M, Corcione F, Salvatore F. A Novel DNA Variant in SMARCA4 Gene Found in a Patient Affected by Early Onset Colon Cancer. Int J Mol Sci 2024; 25:2716. [PMID: 38473962 DOI: 10.3390/ijms25052716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
Colorectal cancer is the third leading cause of death from neoplasia worldwide. Thanks to new screening programs, we are now seeing an increase in Early Onset of ColoRectal Cancer (EOCRC) in patients below the age of 50. Herein, we report a clinical case of a woman affected by EOCRC. This case illustrates the importance of genetic predisposition testing also in tumor patients. Indeed, for our patient, we used a combined approach of multiple molecular and cellular biology technologies that revealed the presence of an interesting novel variant in the SMARCA4 gene. The latter gene is implicated in damage repair processes and related, if mutated, to the onset of various tumor types. In addition, we stabilized Patient-Derived Organoids from the tumor tissue of the same patient and the result confirmed the presence of this novel pathogenic variant that has never been found before even in early onset cancer. In conclusion, with this clinical case, we want to underscore the importance of including patients even those below the age of 50 years in appropriate screening programs which should also include genetic tests for predisposition to early onset cancers.
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Affiliation(s)
- Federica Di Maggio
- CEINGE-Biotecnologie Avanzate Franco Salvatore, 80145 Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", 80131 Naples, Italy
| | - Giuseppe Boccia
- Department of Public Health, University of Naples "Federico II", 80131 Naples, Italy
| | - Marcella Nunziato
- CEINGE-Biotecnologie Avanzate Franco Salvatore, 80145 Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", 80131 Naples, Italy
| | - Marcello Filotico
- Department of Public Health, University of Naples "Federico II", 80131 Naples, Italy
| | | | - Maria D'Armiento
- Pathology Unit, Department of Public Health, University of Naples "Federico II", 80131 Naples, Italy
| | - Francesco Corcione
- Department of Public Health, University of Naples "Federico II", 80131 Naples, Italy
| | - Francesco Salvatore
- CEINGE-Biotecnologie Avanzate Franco Salvatore, 80145 Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", 80131 Naples, Italy
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14
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Ruiz-Grajales ÁE, Orozco-Puerta MM, Zheng S, H de Bock G, Correa-Cote JC, Castrillón-Martínez E. Clinical and pathological differences between early- and late-onset colorectal cancer and determinants of one-year all-cause mortality among advanced-stage patients: a retrospective cohort study in Medellín, Colombia. Cancer Treat Res Commun 2024; 39:100797. [PMID: 38367413 DOI: 10.1016/j.ctarc.2024.100797] [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: 12/14/2023] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE To identify the differences between early- (EOCRC) and late-onset colorectal cancer (LOCRC), and to evaluate the determinants of one-year all-cause mortality among advanced-stage patients. METHODS A retrospective cohort study was carried out. CRC patients ≥ 18 years old were included. Chi-Square test was applied to compare both groups. Uni- and multivariate regressions were performed to evaluate the determinants of one-year all-cause mortality in all advanced-stage patients regardless of age of onset. RESULTS A total of 416 patients were enrolled; 53.1 % were female. Ninety cases (21.6 %) had EOCRC and 326 (78.4 %) had LOCRC. EOCRC cases were predominantly sporadic (88.9 %). Histology of carcinoma other than adenocarcinoma (p= 0.044) and rectum tumors (p= 0.039) were more prevalent in EOCRC. LOCRC patients were more likely to have smoking history (p < 0.001) and right colon tumors (p = 0.039). Alcohol consumption history (odds ratio [OR]: 3.375, 95 %CI: 1.022-11.150) and stage IV (OR: 12.632, 95 %CI: 3.506-45.513) were associated with higher one-year all-cause mortality among advanced-stage patients, the opposite was noted with left colon tumors (OR: 0.045, 95 %CI: 0.003-0.588). CONCLUSION EOCRC was predominantly sporadic and had more cases of uncommon histological subtypes and rectal tumors. LOCRC was characterized by a higher prevalence of smoking history. Multivariate regression revealed an association between higher one-year all-cause mortality and alcohol consumption history and stage IV in advanced-stage patients. CRC exhibited differences based on age of onset. The evaluated factors associated with CRC mortality provide valuable insights for healthcare professionals, emphasizing the importance of adequate clinical assessment and early CRC diagnosis.
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Affiliation(s)
- Álvaro Esteban Ruiz-Grajales
- Semillero de Investigación en Salud (SEIS), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia.
| | - Manuela María Orozco-Puerta
- Semillero de Investigación en Salud (SEIS), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia.
| | - Senshuang Zheng
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | | | - Esteban Castrillón-Martínez
- Semillero de Investigación en Salud (SEIS), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia; Hospital Alma Máter de Antioquia, Medellín, Colombia.
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15
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Abboud Y, Fraser M, Qureshi I, Hajifathalian K. Early-Onset Colorectal Cancer: Are Neuroendocrine Tumors or Adenocarcinomas the Culprit? Analysis of the Largest U.S. Cancer Incidence Database, 2001-2020. J Clin Med 2024; 13:1098. [PMID: 38398411 PMCID: PMC10889361 DOI: 10.3390/jcm13041098] [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: 01/20/2024] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: While prior data showed an increasing incidence of colorectal cancer (CRC) in young adults, the contribution of adenocarcinoma (ADC) and neuroendocrine tumors (NETs) to this trend is not well studied. Therefore, we conducted a comparative analysis of the incidence rates and time trends of colorectal ADC and NETs in young adults (aged 24-54) using the United States Cancer Statistics (USCS) database. (2) Methods: Age-adjusted CRC incidence rates between 2001 and 2020 were calculated and categorized by sex, histopathology, and stage at diagnosis. Annual percentage change (APC) and average APC (AAPC) were computed via joinpoint regression utilizing weighted Bayesian information criteria to generate the simplest trend. Pairwise comparative analysis of ADC and NETs was conducted using tests of identicalness and parallelism. (3) Results: In this study, 514,875 patients were diagnosed with early-onset-CRC between 2001 and 2020 (54.8% men). While CRC incidence was significantly increased, including both ADC (448,670 patients) and NETs (36,205 patients), a significantly greater increase was seen for NETs (AAPC = 2.65) compared to ADC (AAPC = 0.91), with AAPC difference = 1.73 (p = 0.01) and non-identical non-parallel trends (p-values < 0.001). This was most notable in males (AAPC difference = 1.81, p = 0.03) and for early-stage tumors (AAPC difference = 3.56, p < 0.001). (4) Conclusions: Our study, covering ~98% of the U.S. population provides the first comparative analysis of early-onset CRC histopathological subtypes, showing that the rate of increase of NETs in young adults is much greater than that of ADC. Given that patients with NETs with malignant behavior can experience significant mortality, our findings are importance, highlighting the rapidly increasing NET incidence in young adults and encouraging early screening that can improve outcomes.
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Affiliation(s)
- Yazan Abboud
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07013, USA; (Y.A.); (M.F.); (I.Q.)
| | - Madison Fraser
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07013, USA; (Y.A.); (M.F.); (I.Q.)
| | - Imran Qureshi
- Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07013, USA; (Y.A.); (M.F.); (I.Q.)
| | - Kaveh Hajifathalian
- Department of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
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16
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Tarnawski AS. Editor-in-Chief articles of choice and comments at the year-end of 2023. World J Gastroenterol 2024; 30:1-8. [PMID: 38293322 PMCID: PMC10823905 DOI: 10.3748/wjg.v30.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/06/2024] Open
Abstract
As the Editor-in-Chief of World Journal of Gastroenterology, every week prior to a new issue's online publication, I perform a careful review of all encompassed articles, including the title, clinical and/or research importance, originality, novelty, and ratings by the peer reviewers. Based on this review, I select the papers of choice and suggest pertinent changes (e.g., in the title) to the Company Editors responsible for publication. This process, while time-consuming, is very important for assuring the quality of publications and highlighting important articles that Readers may revisit.
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Affiliation(s)
- Andrzej S Tarnawski
- Department of Gastroenterology Research, University of California Irvine and the Veterans Administration Long Beach Healthcare System, Long Beach, CA 90822, United States
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17
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Wang JL, Yan JP, Fan JR, Li X, Guo X, Li JW, Wu YX, Wang JJ, Chen YL, Li L, Lin C, Qu XL, Liu JH, Zhang YL, Yuan YY, Yu HG, Chen YX, Cai YX, Zhang XD, Zhao S, Xu ZH, Ma L, Ma N, Guo DM, Ma LS. 2023: A year of accomplishments for the 13 Science Citation Index Expanded- and Emerging Sources Citation Index-indexed Baishideng journals. World J Gastroenterol 2024; 30:9-16. [PMID: 38293326 PMCID: PMC10823900 DOI: 10.3748/wjg.v30.i1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/02/2024] [Accepted: 01/02/2024] [Indexed: 01/06/2024] Open
Abstract
In 2023, Baishideng Publishing Group (Baishideng) routinely published 47 open-access journals, including 46 English-language journals and 1 Chinese-language journal. Our successes were accomplished through the collective dedicated efforts of Baishideng staffs, Editorial Board Members, and Peer Reviewers. Among these 47 Baishideng journals, 7 are included in the Science Citation Index Expanded (SCIE) and 6 in the Emerging Sources Citation Index (ESCI). With the support of Baishideng authors, company staffs, Editorial Board Members, and Peer Reviewers, the publication work of 2023 is about to be successfully completed. This editorial summarizes the 2023 activities and accomplishments of the 13 SCIE- and ESCI-indexed Baishideng journals, outlines the Baishideng publishing policy changes and additions made this year, and highlights the unique advantages of Baishideng journals.
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Affiliation(s)
- Jin-Lei Wang
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Jia-Ping Yan
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Jia-Ru Fan
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Xiang Li
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Xu Guo
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Jia-Wei Li
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Yun-Xiaojian Wu
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Jing-Jie Wang
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Yu-Lu Chen
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Li Li
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Cong Lin
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Xin-Liang Qu
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Ji-Hong Liu
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Yan-Liang Zhang
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Ying-Yi Yuan
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Hua-Ge Yu
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Yu-Xi Chen
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Yi-Xuan Cai
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Xiang-Di Zhang
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Si Zhao
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Zi-Hang Xu
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Li Ma
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Na Ma
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Diao-Mei Guo
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
| | - Lian-Sheng Ma
- Baishideng Publishing Group Inc, Pleasanton, CA 94566, United States
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18
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Zhang K, He Q, Cao Q, Chuan J, Qin A, Tang L, Zhang X, Xiao C, Zhu B, Hu M, Chang L, Bu ZX, Fu L, Yang T, Wang Y, Liu W. Evaluating the clinical performance of SDC2/NDRG4 methylation for colorectal cancer detection. Epigenomics 2024; 16:93-108. [PMID: 38226561 DOI: 10.2217/epi-2023-0290] [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] [Indexed: 01/17/2024] Open
Abstract
Purpose: The performance and clinical accuracy of combined SDC2/NDRG4 methylation were evaluated in diagnosing colorectal cancer (CRC) and advanced adenoma. Methods: A total of 2333 participants were enrolled to assess the sensitivity and specificity of biomarkers in diagnosing CRC in a multicenter clinical trial through feces DNA methylation tests. Results: SDC2/NDRG4 methylation showed excellent performance for CRC detection in biomarker research and the real world. Its sensitivity for detecting CRC, early CRC and advanced adenoma were 92.06%, 91.45% and 62.61%, respectively. Its specificity was 94.29%, with a total coincidence rate of 88.28%. When interference samples were included, the specificity was still good (82.61%). Therefore, the SDC2/NDRG4 methylation test showed excellent performance in detecting CRC and advanced adenoma under clinical application.
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Affiliation(s)
- Ke Zhang
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, 410000, China
| | - Qing He
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Qin Cao
- Department of Gastroenterology, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou, 310016, China
| | - Jun Chuan
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Ang Qin
- Department of Endoscope Center, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, Changsha, Hunan, 410013, China
| | - Lin Tang
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Xinyue Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410000, China
| | - Changhe Xiao
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Biyin Zhu
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Meiling Hu
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Lei Chang
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Zhong Xin Bu
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Lanqi Fu
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Ting Yang
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
| | - Yu Wang
- GeneTalks Biotech Co., Ltd, Changsha, Hunan, 410000, PR China
- School of Life Sciences & Technology, Tongji University, Shanghai, 200092, China
| | - Weidong Liu
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, 410000, China
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19
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Constantinou V, Constantinou C. Focusing on colorectal cancer in young adults (Review). Mol Clin Oncol 2024; 20:8. [PMID: 38125745 PMCID: PMC10729308 DOI: 10.3892/mco.2023.2706] [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: 07/25/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023] Open
Abstract
Colorectal cancer (CRC) ranks as the third leading cause of cancer-related mortality worldwide. Recent years have witnessed an increase in the incidence of CRC among adults <50 years old on a global scale. The increased incidence is associated with several modifiable risk factors, including obesity, type II diabetes, physical inactivity and frequent antibiotic use. In younger individuals, haematochezia and abdominal pain are the most common symptoms, predominantly affecting the left-side colon. While certain cases of early-onset CRC (eoCRC) are associated with a genetic predisposition, the majority result from sporadic mutations in the genes APC, KRAS, BRAF and TP53, which trigger uncontrolled cell proliferation and tumour formation. Colorectal carcinogenesis involves three major pathways: The chromosomal instability (CIN), microsatellite instability and CpG island methylator phenotype pathways. Dysregulation of the CIN pathway accounts for 85% of sporadic cases of eoCRC. Notably, eoCRC exhibits a distinctive molecular profile, characterized by a decreased prevalence of BRAF mutations, an increased prevalence of KRAS mutations and LINE-1 hypomethylation, and involvement of the Microsatellite and Chromosomal Stable pathway. Prevention strategies for eoCRC primarily centre on lifestyle modifications and the development of screening programs targeting younger populations. Further exploration into the molecular mechanisms involved in the identification of novel risk factors associated with eoCRC is imperative. These efforts, in conjunction with the development of specific screening strategies, hold the potential to reduce morbidity and mortality in the future.
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Affiliation(s)
- Virginia Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, CY-1700 Nicosia, Cyprus
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, CY-1700 Nicosia, Cyprus
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20
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Benesch MGK, Nelson ED, O’Brien SBL. Location Has Prognostic Impact on the Outcome of Colorectal Mucinous Adenocarcinomas. Cancers (Basel) 2023; 16:147. [PMID: 38201574 PMCID: PMC10778219 DOI: 10.3390/cancers16010147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Mucinous (colloid) adenocarcinomas (MAs) are a rare histological subtype of tumors defined by extracellular mucin comprising more than 50% of the tumor. These tumors are on a continuum of mucin-producing malignancies with signet ring cell adenocarcinomas (SRCCs), which instead produce intracellular mucin. Mucin-containing cancers occur primarily in the stomach and colon, where for SRCCs, outcomes are relatively worse in the proximal stomach and the rectum. It is not known if MAs have similar outcomes. In this study, we use the Surveillance, Epidemiology, and End Results (SEER) database to examine the effects of tumor localization, age, sex, and stage on colorectal and gastric cancer outcomes for MAs. For right colon cancers, MAs are more common, particularly in females, and have slightly better or equivalent outcomes across all stages and ages compared to conventional adenocarcinomas, but outcomes are progressively worse compared to conventional adenocarcinomas for left colon and rectal cancers. Unlike SRCCs, MAs have similar outcomes to conventional adenocarcinomas in all stomach locations. Overall, these results suggest that MAs have an intrinsically different tumor biology in the left colon and rectum that promotes pathogenesis. Decoding this phenomenon could lead to more effectively tailored patient treatment regimens.
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Affiliation(s)
- Matthew G. K. Benesch
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (E.D.N.); (S.B.L.O.)
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21
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Madej M, Gola J, Chrobak E. Synthesis, Pharmacological Properties, and Potential Molecular Mechanisms of Antitumor Activity of Betulin and Its Derivatives in Gastrointestinal Cancers. Pharmaceutics 2023; 15:2768. [PMID: 38140110 PMCID: PMC10748330 DOI: 10.3390/pharmaceutics15122768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Gastrointestinal (GI) cancers are an increasingly common type of malignancy, caused by the unhealthy lifestyles of people worldwide. Limited methods of treatment have prompted the search for new compounds with antitumor activity, in which betulin (BE) is leading the way. BE as a compound is classified as a pentacyclic triterpene of the lupane type, having three highly reactive moieties in its structure. Its mechanism of action is based on the inhibition of key components of signaling pathways associated with proliferation, migration, interleukins, and others. BE also has a number of biological properties, i.e., anti-inflammatory, hepatoprotective, neuroprotective, as well as antitumor. Due to its poor bioavailability, betulin is subjected to chemical modifications, obtaining derivatives with proven enhanced pharmacological and pharmacokinetic properties as a result. The method of synthesis and substituents significantly influence the effect on cells and GI cancers. Moreover, the cytotoxic effect is highly dependent on the derivative as well as the individual cell line. The aim of this study is to review the methods of synthesis of BE and its derivatives, as well as its pharmacological properties and molecular mechanisms of action in colorectal cancer, hepatocellular carcinoma, gastric cancer, and esophageal cancer neoplasms.
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Affiliation(s)
- Marcel Madej
- Department of Molecular Biology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 40-055 Katowice, Poland;
- Silesia LabMed, Centre for Research and Implementation, Medical University of Silesia, 40-752 Katowice, Poland
| | - Joanna Gola
- Department of Molecular Biology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Elwira Chrobak
- Department of Organic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 40-055 Katowice, Poland;
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22
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Danpanichkul P, Moolkaew P, Kanjanakot Y, Polpichai N, Jaroenlapnopparat A, Kim D, Lukens FJ, Wassef W, Fallon MB, Chen VL, Lui R, Wijarnpreecha K. Rising incidence and impact of early-onset colorectal cancer in the Asia-Pacific with higher mortality in females from Southeast Asia: a global burden analysis from 2010 to 2019. J Gastroenterol Hepatol 2023; 38:2053-2060. [PMID: 37644698 DOI: 10.1111/jgh.16331] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/15/2023] [Accepted: 08/02/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND AND AIM Early-onset colorectal cancer (CRC) is a growing global health concern, especially in the Asia-Pacific region. However, comprehensive research on this topic from the region is lacking. Our study aims to investigate trends in early-onset CRC in Asia over 10 years, filling this research gap. METHODS This study utilized data from the Global Burden of Disease Study 2019 to assess temporal trends in early-onset CRC in the Asia-Pacific. The analysis included estimating annual frequencies and age-standardized rates (ASRs) of early-onset CRC incidence, death, and disability-adjusted life-years (DALYs) by gender. RESULTS The incidence of early-onset CRC significantly increased in both regions with higher increase and in the Western Pacific region. Notable increases were observed among males in the Western Pacific and females in Southeast Asia (SEA). Mortality rates remained stable in the Western Pacific but increased by 10.6% in SEA, especially among females. DALYs due to CRC also increased significantly in SEA, with a greater rise among females. The Western Pacific had the highest CRC incidence, and in SEA, the mortality rate was higher in females than males. CONCLUSIONS Our study reveals a substantial increase in early-onset CRC in the Asia-Pacific underscoring the urgency for effective interventions. Thus, a comprehensive approach comprising controlled risk reduction, health promotion to heightened disease awareness, and implementation of effective screening strategies should be executed timely to mitigate the burden of early-onset CRC.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pinyada Moolkaew
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Yatawee Kanjanakot
- Department of Surgery, School of Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Natchaya Polpichai
- Department of Internal Medicine, Weiss Memorial Hospital, Chicago, Illinois, USA
| | | | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - Frank J Lukens
- Division of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Wahid Wassef
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
| | - Michael B Fallon
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Rashid Lui
- Department of Clinical Oncology, and Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Institute of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
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23
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E Y, Sun S, Fan X, Lu C, Ji P, Huang Y, Sun J, Yang X, Yu C. Prediction of liver and lung metastases in patients with early-onset colorectal cancer by nomograms based on heterogeneous and homogenous risk factors. Cancer Med 2023; 12:20712-20726. [PMID: 37902182 PMCID: PMC10709735 DOI: 10.1002/cam4.6633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/26/2023] [Accepted: 10/07/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Identifying the risk factors for distant metastasis in early-onset colorectal cancer (EOCRC) is crucial for elucidating its etiology and facilitating preventive treatment. This study aims to characterize the variability in EOCRC incidence and discern both heterogeneous and homogeneous risk factors associated with synchronous liver, lung, and hepato-lung metastases. METHODS This study included patients with EOCRC enrolled in the SEER database between 2010 and 2015 and divided patients into three groups by synchronous liver, lung, and hepato-lung metastases. Each group of patients with different metastasis types was randomly assigned to the development and validation cohort in a ratio of 7:3. Logistic regression was used to analyze the heterogeneous and homogenous risk factors for synchronous liver, lung, and hepato-lung metastases in the development cohort of patients. Nomograms were built to calculate the risk of metastasis, and the receiver operating characteristic (ROC) curve and calibration curve were used to quantitatively evaluate their performance. RESULTS A total of 16,336 eligible patients with EOCRC were included in this study, of which 17.90% (2924/16,336) had distant metastases. The overall incidences of synchronous liver, lung, and hepato-lung metastases were 11.90% (1921/16,146), 2.42% (390/16,126), and 1.50% (241/16,108), respectively. Positive CEA values before treatment, increased lymphatic metastases, and deeper invasion of intestinal wall were positively correlated with three distant types of metastases. On the contrary, the correlation of age, ethnicity, location of primary tumor, and histologic grade among the three types was inconsistent. The ROC curve and calibration curve proved to have fine performance in predicting distant metastases of EOCRC. CONCLUSIONS There are significant differences in the incidence of distant metastases in EOCRC, and related risk factors are heterogeneous and homogenous. Although limited risk factors were incorporated in this study, the established nomograms indicated good predictive performance.
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Affiliation(s)
- Yimin E
- Department of General SurgeryThe Second Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Sizheng Sun
- Department of General SurgeryThe Second Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Xiaoyu Fan
- Department of General SurgeryThe Second Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Chen Lu
- Department of General SurgerySir Run Run Hospital Nanjing Medical UniversityNanjingChina
| | - Pengcheng Ji
- Department of General SurgerySir Run Run Hospital Nanjing Medical UniversityNanjingChina
| | - Yicheng Huang
- Department of General SurgeryThe Second Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Jing Sun
- Department of General SurgeryThe Second Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Xiaojun Yang
- Department of General SurgeryThe Second Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Chunzhao Yu
- Department of General SurgeryThe Second Affiliated Hospital of Nanjing Medical UniversityNanjingChina
- Department of General SurgerySir Run Run Hospital Nanjing Medical UniversityNanjingChina
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24
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Peng Y, Liu QZ, Xu D, Fu JY, Zhang LX, Qiu L, Lin JG. M 4IDP stimulates ROS elevation through inhibition of mevalonate pathway and pentose phosphate pathway to inhibit colon cancer cells. Biochem Pharmacol 2023; 217:115856. [PMID: 37838274 DOI: 10.1016/j.bcp.2023.115856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/26/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023]
Abstract
Maintaining redox homeostasis is an essential feature of cancer cells, and disrupting this homeostasis to cause oxidative stress and induce cell death is an important strategy in cancer therapy. M4IDP, a zoledronic acid derivative, can cause the death of human colorectal cancer cells by increasing the level of intracellular reactive oxygen species (ROS). However, its potential molecular mechanism is unclear. Our in vitro studies showed that treatment with M4IDP promoted oxidative stress in HCT116 cells, as measured by the decreased ratios of GSH/GSSG and NADPH/NADP+ and increased level of MDA. M4IDP could cause the decrease of GSH content, the increase of GSSG content, the decrease of NADPH content and pentose phosphate pathway flux, the downregulation of G6PD expression, the upregulation of unprenylated Rap1A and total expression of RhoA and CDC42. The increase of ROS and cytotoxicity induced by M4IDP could be reversed by the supplementation of NADPH, the overexpression of G6PD and the supplementation of GGOH. In vivo studies showed that M4IDP inhibited tumor growth in the human colorectal cancer xenograft mouse model, which was accompanied with a decreased [18F]FDG uptake. Collectively, these results provide evidence that M4IDP can promote oxidation in colon cancer cells by inhibiting mevalonate pathway and pentose phosphate pathway and produce therapeutic effect. This study revealed for the first time a possible mechanism of bisphosphonate-induced increase of ROS in malignant tumor cells. This is helpful for the development of new molecular therapeutic targets and can provide new ideas for the combined therapy of bisphosphonates in tumors.
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Affiliation(s)
- Ying Peng
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China; Department of Radiopharmaceuticals, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Qing-Zhu Liu
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China
| | - Dong Xu
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China
| | - Jia-Yu Fu
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China; Department of Radiopharmaceuticals, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Li-Xia Zhang
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China
| | - Ling Qiu
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China; Department of Radiopharmaceuticals, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Jian-Guo Lin
- NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China; Department of Radiopharmaceuticals, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
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25
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Shen MH, Liu CY, Chang KW, Lai CL, Chang SC, Huang CJ. Propolis Has an Anticancer Effect on Early Stage Colorectal Cancer by Affecting Epithelial Differentiation and Gut Immunity in the Tumor Microenvironment. Nutrients 2023; 15:4494. [PMID: 37960147 PMCID: PMC10648826 DOI: 10.3390/nu15214494] [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: 09/13/2023] [Revised: 10/10/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common cancers and is the second leading cause of cancer-related death in the world. Due to the westernization of diets, young patients with CRC are often diagnosed at advanced stages with an associated poor prognosis. Improved lifestyle choices are one way to minimize CRC risk. Among diet choices is the inclusion of bee propolis, long recognized as a health supplement with anticancer activities. Understanding the effect of propolis on the gut environment is worth exploring, and especially its associated intratumoral immune changes and its anticancer effect on the occurrence and development of CRC. In this study, early stage CRC was induced with 1,2-dimethylhydrazine (DMH) and dextran sulfate sodium (DSS) for one month in an animal model, without and with propolis administration. The phenotypes of early stage CRC were evaluated by X-ray microcomputed tomography and histologic examination. The gut immunity of the tumor microenvironment was assessed by immunohistochemical staining for tumor-infiltrating lymphocytes (TILs) and further comparative quantification. We found that the characteristics of the CRC mice, including the body weight, tumor loading, and tumor dimensions, were significantly changed due to propolis administration. With further propolis administration, the CRC tissues of DMH/DSS-treated mice showed decreased cytokeratin 20 levels, a marker for intestinal epithelium differentiation. Additionally, the signal intensity and density of CD3+ and CD4+ TILs were significantly increased and fewer forkhead box protein P3 (FOXP3) lymphocytes were observed in the lamina propria. In conclusion, we found that propolis, a natural supplement, potentially prevented CRC progression by increasing CD3+ and CD4+ TILs and reducing FOXP3 lymphocytes in the tumor microenvironment of early stage CRC. Our study could suggest a promising role for propolis in complementary medicine as a food supplement to decrease or prevent CRC progression.
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Affiliation(s)
- Ming-Hung Shen
- Department of Surgery, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243089, Taiwan;
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
| | - Chih-Yi Liu
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
- Department of Pathology, Sijhih Cathay General Hospital, New Taipei City 221037, Taiwan
| | - Kang-Wei Chang
- Taipei Neuroscience Institute, Taipei Medical University, Taipei City 110301, Taiwan;
- Laboratory Animal Center, Taipei Medical University, Taipei City 110301, Taiwan
| | - Ching-Long Lai
- Division of Basic Medical Sciences, Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City 333324, Taiwan;
- Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Taoyuan City 333324, Taiwan
| | - Shih-Chang Chang
- Division of Colorectal Surgery, Department of Surgery, Cathay General Hospital, Taipei City 106438, Taiwan;
| | - Chi-Jung Huang
- Department of Biochemistry, National Defense Medical Center, Taipei City 114201, Taiwan
- Department of Medical Research, Cathay General Hospital, Taipei City 106438, Taiwan
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26
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Meza-Espinoza JP, Peralta-Leal V, Durán-González J, Macías-Gómez N, Bocanegra-Alonso A, Leal-Ugarte E. XRCC1 R194W and R399Q Polymorphisms and Colorectal Cancer Risk in a Northeastern Mexican Population. Genet Res (Camb) 2023; 2023:5565646. [PMID: 37829155 PMCID: PMC10567464 DOI: 10.1155/2023/5565646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common cancers worldwide. Its etiopathogenesis is complex, mainly influenced by genetic instability caused by the accumulation of mutations. The XRCC1 gene, which is involved in DNA repair, has been associated with CRC through the R194W (C194T) and R399Q (G399A) polymorphisms, but the results are inconsistent. Here, we analyzed the association of these polymorphisms with sporadic CRC in a northeastern Mexican population, including 155 male CRC patients and 155 male controls. Genotyping was performed using the RFLP method. An association with CRC was found for the 399A allele (G vs A; OR = 1.48 (1.03-2.13), P=0.034) and for the 399AA genotype in a codominant model (AA vs GG; OR = 3.11 (1.06-9.10), P=0.031). In contrast, there were no significant differences between CRC patients and controls for the C194T polymorphism (C vs T; OR = 0.82 (0.52-1.31), P=0.41). These results are consistent with many similar studies, but further research is needed to verify whether the XRCC1 R194W and R399Q polymorphisms play a role in CRC etiology. The functional significance of these polymorphisms is unclear, but some studies suggest that they influence DNA repair capacity and, thus, cancer risk.
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Affiliation(s)
- Juan Pablo Meza-Espinoza
- Facultad de Medicina e Ingeniería en Sistemas Computacionales de Matamoros, Universidad Autónoma de Tamaulipas, Sendero Nacional km 3, CP 87349, Col. San José, Matamoros, Tamaulipas, Mexico
| | - Valeria Peralta-Leal
- Facultad de Medicina e Ingeniería en Sistemas Computacionales de Matamoros, Universidad Autónoma de Tamaulipas, Sendero Nacional km 3, CP 87349, Col. San José, Matamoros, Tamaulipas, Mexico
| | - Jorge Durán-González
- Facultad de Medicina e Ingeniería en Sistemas Computacionales de Matamoros, Universidad Autónoma de Tamaulipas, Sendero Nacional km 3, CP 87349, Col. San José, Matamoros, Tamaulipas, Mexico
| | - Nelly Macías-Gómez
- Centro Universitario del Sur, Universidad de Guadalajara, Av. Enrique Arreola Silva # 883, Col. Centro, Ciudad Guzmán, Jalisco, Mexico
| | - Anabel Bocanegra-Alonso
- Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Calle 16 y Lago de Chapala, Col. Aztlán, Reynosa, Tamaulipas, Mexico
| | - Evelia Leal-Ugarte
- Facultad de Medicina e Ingeniería en Sistemas Computacionales de Matamoros, Universidad Autónoma de Tamaulipas, Sendero Nacional km 3, CP 87349, Col. San José, Matamoros, Tamaulipas, Mexico
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Ramadan M. Assessing the contribution of nine preventable risk factors attributed to the burden of early onset colorectal cancer in Gulf Cooperation Council (GCC) countries. Prev Med Rep 2023; 35:102389. [PMID: 37691888 PMCID: PMC10483048 DOI: 10.1016/j.pmedr.2023.102389] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/27/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023] Open
Abstract
Alarming trends in the incidence and prevalence of early onset colorectal cancer (EO-CRC) have been noted, with the highest increases in regions with a high-middle Socio-demographic Index (SDI), including the Gulf Cooperation Council (GCC) nations. This study aims to assess the contribution of nine preventable risk factors attributed to the burden of early onset colorectal cancer in GCC countries. The Global Burden of Disease (GBD) 2019 was the source of our data. This database offers comprehensive and accessible epidemiological information on 369 diseases and injuries, along with 87 risk factors, from 1990 to 2019. Nine EO-CRC risk factors were included in the study. In 2019, the highest attributable proportions of risk factors for male EO-CRC were high-body mass index ranging from (20.43% to 26.21%). The second highest attributable proportions of risk factors for EO-CRC in male was the diet low in milk, and the first highest attributable proportions of risk factors for EO-CRC for female was the diet low in milk. The attributable proportions of physical inactivity risk factor were consistently higher among female in Saudi Arabia, Kuwait, and Qatar, while it was slightly lower among higher among male in United Arab Emirates, Oman, and Bahrain. This study highlights the significant role of high-body mass index and low milk consumption as major preventable risk factors for early onset colorectal cancer in GCC countries. Promoting healthier lifestyles and physical activity can help control BMI levels and reduce the incidence of EO-CRC.
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Affiliation(s)
- Majed Ramadan
- Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, P.O.BOX 9515, Jeddah 21423, Saudi Arabia
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Ionescu VA, Gheorghe G, Bacalbasa N, Chiotoroiu AL, Diaconu C. Colorectal Cancer: From Risk Factors to Oncogenesis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1646. [PMID: 37763765 PMCID: PMC10537191 DOI: 10.3390/medicina59091646] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/05/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023]
Abstract
Colorectal cancer is the second leading cause of cancer-related mortality worldwide. Numerous pathophysiological mechanisms, such as abnormal cell proliferation, cell differentiation, resistance to apoptosis, invasion of structures adjacent to colorectal tumor cells, and distant metastasis, are involved in colorectal carcinogenesis. These processes are initiated by the complex interaction of a number of genetic and environmental factors, including sedentary lifestyle, obesity, alcohol consumption, smoking, or gut microbiota. Despite the significant progress achieved in the diagnostic and therapeutic management of patients with colorectal cancer, there has been recently a noteworthy increase in the incidence of colorectal cancer in individuals below the age of 50 years. Early-onset colorectal cancer has a different frequency of oncogenic mutations, a higher prevalence of mucinous histology, a distinct deoxyribonucleic acid (DNA) methylation profile, a more distal location, and lower survival rates. A significant improvement in the prognosis of these patients can be achieved through the detection and removal of modifiable risk factors, along with the implementation of personalized screening strategies for individuals at high risk for this malignancy. Furthermore, gaining comprehension of the pathophysiological mechanisms by which these risk factors contribute to the process of oncogenesis may facilitate the discovery of novel therapeutic targets.
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Affiliation(s)
- Vlad Alexandru Ionescu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (V.A.I.); (N.B.)
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
- Department of Cellular and Mollecular Pathology, Stefan S. Nicolau Institute of Virology, Romanian Academy, 030304 Bucharest, Romania
| | - Gina Gheorghe
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (V.A.I.); (N.B.)
- Department of Cellular and Mollecular Pathology, Stefan S. Nicolau Institute of Virology, Romanian Academy, 030304 Bucharest, Romania
- Gastroenterology Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Nicolae Bacalbasa
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (V.A.I.); (N.B.)
- Department of Visceral Surgery, Center of Excellence in Translational Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | | | - Camelia Diaconu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (V.A.I.); (N.B.)
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
- Academy of Romanian Scientists, 050085 Bucharest, Romania
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29
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Lingas EC. Early-Onset Colon Cancer: A Narrative Review of Its Pathogenesis, Clinical Presentation, Treatment, and Prognosis. Cureus 2023; 15:e45404. [PMID: 37854763 PMCID: PMC10579844 DOI: 10.7759/cureus.45404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2023] [Indexed: 10/20/2023] Open
Abstract
Colon cancer remains a leading cause of cancer-related deaths, and there has been a rise in the incidence of early-onset colon cancer or colon cancer diagnosed before the age of 50 years old. Early-onset colon cancer has several differences in clinical presentation, as well as histopathology, genetic alteration, and molecular profiling. Early-onset colon cancer can be differentiated into familial type that includes hereditary familial syndrome and sporadic type. Demographic variance also exists in both developing and developed countries. Due to the rising incidence of colon cancer diagnosed in younger age, it is imperative to examine the available evidence regarding the mortality rate of early-onset colon cancer. Colon cancer is affected by numerous modifiable and non-modifiable risk factors. Increasing obesity and lifestyle disorders in the younger population, such as smoking, may influence this increasing trend. There are existing guidelines for colon cancer screening in both average-risk and high-risk individuals. This narrative review aims to highlight the pathogenesis of early-onset CRC; its clinical presentation, treatment, prognosis; and how it differs from late-onset CRC.
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Affiliation(s)
- Elvina C Lingas
- Hospital Medicine, New York University (NYU) Langone Health Long Island Community Hospital, Patchogue, USA
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30
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Maqbool M, Khan A, Shahzad A, Sarfraz Z, Sarfraz A, Aftab H, Jaan A. Predictive biomarkers for colorectal cancer: a state-of-the-art systematic review. Biomarkers 2023; 28:562-598. [PMID: 37585692 DOI: 10.1080/1354750x.2023.2247185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Colorectal cancer (CRC) poses a substantial health burden, with early detection paramount for improved prognosis. This study aims to evaluate potential CRC biomarkers and detection techniques. MATERIALS AND METHODS This systematic review, reported in adherence to PRISMA Statement 2020 guidelines, collates the latest research on potential biomarkers and detection/prognosis methods for CRC, spanning the last decade. RESULTS Out of the 38 included studies, diverse biomarkers and detection methods emerged, with DNA methylation markers like SFRP2 and SDC2, microRNAs including miR-1290, miR-506, and miR-4316, and serum and plasma markers such as NTS levels and U2 snRNA fragments standing out. Methylated cfDNA and m5C methylation alteration in immune cells of the blood, along with circular RNA, showed promise as diagnostic markers. Meanwhile, techniques involving extracellular vesicles and lateral flow immunoassays exhibited potential for swift and effective CRC screening. DISCUSSION Our state-of-the-art review identifies potential biomarkers, including SFRP2, SDC2, miR-1290, miR-506, miR-4316, and U2 snRNA fragments, with significant potential in enhancing CRC detection. However, comprehensive validation studies and a rigorous evaluation of clinical utility and cost-effectiveness remain necessary before integration into routine clinical practice. CONCLUSION The findings emphasize the need for continued research into biomarkers and detection methods to improve patient outcomes.
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Affiliation(s)
- Moeez Maqbool
- Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan
| | - Aden Khan
- Fatima Jinnah Medical University, Lahore, Pakistan
| | | | | | | | - Hinna Aftab
- CMH Lahore Medical and Dental College, Lahore, Pakistan
| | - Ali Jaan
- Rochester General Hospital, Rochester, NY, USA
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Foppa C, Maroli A, Luberto A, La Raja C, Spaggiari P, Bonifacio C, De Zanet S, Montorsi M, Piscuoglio S, Terracciano LM, Santoro A, Spinelli A. Early Age of Onset Is an Independent Predictor for a Worse Response to Neoadjuvant Therapies in Sporadic Rectal Cancer Patients. Cancers (Basel) 2023; 15:3750. [PMID: 37509411 PMCID: PMC10378654 DOI: 10.3390/cancers15143750] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/15/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
The incidence of rectal cancer (RC) is increasing in the population aged ≤ 49 (early-onset RC-EORC). EORC patients are more likely to present with locally advanced disease at diagnosis than late-onset RC (LORC; aged ≥ 50) patients. As a consequence, more EORC patients undergo neoadjuvant therapies. The response to treatment in EORC patients is still unknown. This study aims to explore the effect of age of onset on the pathological response to neoadjuvant therapies in sporadic locally advanced RC (LARC) patients. Based on an institutional prospectively maintained database, LARC patients undergoing neoadjuvant therapies and radical surgery between January 2010 and December 2022 were allocated to the EORC and LORC groups. The primary endpoint was the rate of incomplete response (Dworak 0-2). A total of 326 LORC and 79 EORC patients were included. Pre-neoadjuvant tumor features were comparable. A significantly higher rate of incomplete response was observed in EORC patients (49% vs. 35%; p = 0.028). From multivariable analysis, early age of onset, smoking and extramural invasion presented as independent risk factors for a worse response. This study demonstrates that an early age of onset is related to a worse response and calls for different multimodal strategies in this group of patients.
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Affiliation(s)
- Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Annalisa Maroli
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Antonio Luberto
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Carlotta La Raja
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Paola Spaggiari
- Division of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Cristiana Bonifacio
- Division of Diagnostic Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Stefano De Zanet
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Marco Montorsi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Division of General and Digestive Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Salvatore Piscuoglio
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, 4001 Basel, Switzerland
- Department of Biomedicine, University Hospital Basel, University of Basel, 4001 Basel, Switzerland
| | - Luigi Maria Terracciano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Division of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Division of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
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Ullah F, Pillai AB, Omar N, Dima D, Harichand S. Early-Onset Colorectal Cancer: Current Insights. Cancers (Basel) 2023; 15:3202. [PMID: 37370811 DOI: 10.3390/cancers15123202] [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: 04/24/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Over the past decade, the incidence of colorectal cancer has increased in individuals under the age of 50 years. Meanwhile, the incidence has gradually decreased in the older population. As described herein, we reviewed the available literature to summarize the current landscape of early-onset colorectal cancer, including risk factors, clinicopathological presentation, genetic makeup of patients, and management. Currently, early-onset colorectal cancer is treated similarly as late-onset colorectal cancer, yet the available literature shows that early-onset colorectal cancer is more aggressive and different, and this remains a significant unmet need. A detailed understanding of early-onset colorectal cancer is needed to identify risk factors for the increased incidence and tailor treatments accordingly.
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Affiliation(s)
- Fauzia Ullah
- Department of Translational Hematology and Oncology Research, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | - Ashwathy Balachandran Pillai
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Najiullah Omar
- Department of Translational Hematology and Oncology Research, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | - Danai Dima
- Department of Translational Hematology and Oncology Research, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | - Seema Harichand
- Department of Internal Medicine, Mission Cancer + Blood, University of Iowa, Des Moines, IA 50309, USA
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Danpanichkul P, Ongsupankul S, Moolkaew P, Yamsiri R, Panpradist N. Increased Incidence of Early-Onset Colorectal Cancer in Low Sociodemographic Index Countries: Higher Rising Burden in Young Females. Cureus 2023; 15:e38998. [PMID: 37323313 PMCID: PMC10262921 DOI: 10.7759/cureus.38998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction Early-onset colorectal cancer (EOCRC) is becoming a growing concern due to its increased incidence among younger individuals, particularly in areas with limited healthcare access and funding, such as in countries with a low sociodemographic index (SDI). However, there are limited studies regarding this problem. Therefore, our study primarily aims to address the dearth of knowledge in this area by assessing the trends in EOCRC in low SDI countries over 10 years. Methods In this study, we analyzed data from the Global Burden of Disease Study 2019 to investigate the changes in EOCRC over time in low SDI countries. Our analysis involved determining the yearly frequencies and age-standardized rates (ASRs) of EOCRC incidence, death, and disability-adjusted life years (DALYs) by gender. Results In 2019, the number of newly diagnosed EOCRC cases in low SDI countries was 7,716, while the global cases were 225,736. The incidence rates of EOCRC increased significantly higher in low SDI countries compared to the global average between 2010 and 2019, with a 1.38-fold higher increase among females. Mortality rates and DALYs also increased in the low SDI countries, with the annual percentage change from 2010 to 2019 of 0.96 (95% uncertainty interval (UI): 0.88-1.03) and 0.91 (95% UI: 0.83-0.98), respectively. Conclusion Our research highlights a significant rise in CRC in low SDI countries, particularly in the female population. Therefore, it emphasizes the need for prompt and efficient interventions, including but not limited to effective screening methods and mitigation of risk factors.
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Affiliation(s)
| | - Sorawit Ongsupankul
- Department of Internal Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, USA
| | - Pinyada Moolkaew
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, THA
| | - Ranchana Yamsiri
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, THA
| | - Nuttada Panpradist
- Global Center for Integrated Health of Women, Adolescents, and Children (Global WACh), University of Washington, Seattle, USA
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