The immunomodulatory effects of Candida albicans isolated from the normal gastrointestinal microbiome of the elderly on colorectal cancer

UNSTRUCTURED Older patients account for a significant proportion of patients undergoing colorectal cancer surgery, and are vulnerable to a number of pre-operative risk factors that are not often present in younger patients. Three pre-operative risk factors more prevalent in the elderly are frailty, sarcopenia, and malnutrition. Whilst each of these has been studied in isolation, there is little information on the interplay between them in older surgical patients. One particular area of increasing interest is the use of urine metabolomics for objective evaluation of dietary profiles and malnutrition. Herein we describe the design, cohort, and standard operating procedures of a planned prospective study of older surgical patients undergoing colorectal cancer resection across multiple institutions in the United Kingdom. These procedures include serial frailty evaluations (Clinical Frailty Scale and Groningen Frailty Indicator), functional assessments (with hand grip strength and 4-metre walk test), muscle mass evaluations using computerized tomography morphometric analysis and evaluation of nutritional status using analysis of urinary dietary biomarkers. As these are all areas of common derangement in the elderly surgical population, prospectively studying them in concert will allow for analysis of their interplay as well as the development of predictive models for those at risk for commonly tracked surgical complications and outcomes.

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Screeners vs. Non-screeners for Colorectal Cancer among People over 50 Years of Age: Factual and Psychological Discriminants

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-2263 ◽

2020 ◽

Author(s):

Andrada Ciucă ◽

Ramona Moldovan ◽

Sebastian Pintea ◽

Dan Dumitrașcu ◽

Adriana Băban

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Positive Family History ◽

Psychosocial Interventions ◽

The Elderly ◽

Roc Curve Analysis ◽

Convenience Sample ◽

Colonoscopy Screening ◽

History Of ◽

D Values

Background and Aims: Colorectal cancer (CRC) is the third most frequent form of cancer worldwide, and approximately one third of cases have a positive family history of CRC or associated cancers. Colonoscopy is one of the most effective methods of screening for CRC. Uptake of colonoscopy is suboptimal, and many countries lack a national screening programme. Our study aims at exploring and ranking several factual and psychological variables according to their accuracy in discriminating between screeners and non-screeners for CRC in a convenience sample of people over 50 years of age. Methods: The study included 103 individuals aged over 50 years, recruited from day centres for the elderly. We explored socio-demographic variables, frequency of colonoscopy, previous recommendations for screening, health literacy and family history of cancer. Receiver operating characteristic (ROC) analysis was used to establish the discriminative value for each variable between the positive and negative decision for colonoscopy screening. Areas under the curve (AUC) and their equivalent Cohen‘s d values were calculated. Results: Almost a quarter (25.75%) of participants reported previous colonoscopy screening. ROC curve analysis shows that colonoscopy uptake is best discriminated by perceived benefits of screening (AUC=0.71, d=0.78, p<0.001), previous recommendations for screening (AUC=0.68, d=0.69, p<0.001) and previous recommendations for preventive measures (AUC=0.67, d=0.64, p<0.001). Conclusions: Recommendations from healthcare professionals lead to improved colonoscopy uptake when emphasising the benefits of screening. Results can further inform psychosocial interventions by bringing empirical evidence to emphasize screening benefits and explicit recommendations for individuals at risk for CRC cancer.

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