Screening reduces colorectal cancer death not development risk

SummaryThe case report demonstrates painstaking, one step at a time multitherapy for the third most common cancer and the third cause of cancer death in western countries – colorectal cancer. Multitherapeutic approach at specialized centers for the treatment of colorectal cancer is the cornerstone for reaching favorable treatment results and prognosis.

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A Comparison of Contemporary versus Older Studies of Aspirin for Primary Prevention

10.1101/19004267 ◽

2019 ◽

Author(s):

Frank Moriarty ◽

Mark H. Ebell

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Primary Prevention ◽

Cardiovascular Events ◽

Major Adverse Cardiovascular Events ◽

List Type ◽

Cancer Death ◽

Major Hemorrhage ◽

Before And After ◽

Modern Era

AbstractObjectiveThis study compares the benefits and harms of aspirin for primary prevention before and after widespread use of statins and colorectal cancer screening.MethodsWe compared studies of aspirin for primary prevention that recruited patients from 2005 onward with previous individual patient meta-analyses that recruited patients from 1978 to 2002. Data for contemporary studies were synthesized using random-effects models. We report vascular (major adverse cardiovascular events [MACE], myocardial infarction [MI], stroke), bleeding, cancer, and mortality outcomes.ResultsThe IPD analyses of older studies included 95,456 patients for CV prevention and 25,270 for cancer mortality, while the four newer studies had 61,604 patients. Relative risks for vascular outcomes for older vs newer studies follow: MACE: 0.89 (95% CI 0.83-0.95) vs 0.93 (0.86-0.99); fatal hemorrhagic stroke: 1.73 (1.11-2.72) vs 1.06 (0.66-1.70); any ischemic stroke: 0.86 (0.74-1.00) vs 0.86 (0.75-0.98); any MI: 0.84 (0.77-0.92) vs 0.88 (0.77-1.00); and non-fatal MI: 0.79 (0.71-0.88) vs 0.94 (0.83-1.08). Cancer death was not significantly decreased in newer studies (RR 1.11, 0.92-1.34). Major hemorrhage was significantly increased for both older and newer studies (RR 1.48, 95% CI 1.25-1.76 vs 1.37, 95% CI 1.24-1.53). There was no effect in either group on all-cause mortality, cardiovascular mortality, fatal stroke, or fatal MI.ConclusionsIn the modern era characterized by widespread statin use and cancer screening, aspirin does not reduce the risk of non-fatal MI or cancer death. There are no mortality benefits and a significant risk of major hemorrhage. Aspirin should no longer be recommended for primary prevention.Summary of current evidence and what this study addsWhat is already known about this subject?The cumulative evidence for aspirin suggests a role in the primary prevention of cardiovascular disease, and in reducing cancer incidence and mortality.However most of the trials of aspirin for primary prevention were set in Europe and the United States and recruited patients prior to the year 2000.The benefits and harms of aspirin should be considered separately in studies performed in the eras before and after widespread use of statins and colorectal cancer screening.What does this study add?This study provides the most detailed summary to date of cardiac, stroke, bleeding, mortality and cancer outcomes to date in the literature.In trials of aspirin for primary prevention from 2005 onwards, aspirin reduced major adverse cardiovascular events but significantly increased the risk of bleeding, with no benefit for mortality or,Unlike older studies, there was no reduction in cancer mortality and non-fatal myocardial infarction.How does this impact on clinical practice?Our study suggests aspirin should not be recommended for primary prevention in the modern era.

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A VIEW ON THE PROBLEM OF INADEQUATE SCREENING OF COLORECTAL CANCER IN UKRAINE

Likarska sprava ◽

10.31640/jvd.3.2019(1) ◽

2019 ◽

pp. 3-5

Author(s):

Nelya Melnitchouk ◽

Galyna Shabat

Keyword(s):

Colorectal Cancer ◽

Clinical Symptoms ◽

Screening Program ◽

Early Stage ◽

Cancer Death ◽

Common Cause ◽

Screening Programs ◽

Incidence And Mortality ◽

National Organizations

The incidence of colorectal cancer (CRC) is increasing worldwide and it is the second most common cause of cancer death. There is a lot of investigations and improvement to rise quality of early diagnosis, successful treatment and effective preventions of colorectal cancer. Nowadays available few guidelines of international and national organizations what support effectiveness of screening programs. Colorectal cancer screening is effective way to decrease incidence and mortality with strong evidence confirmed by a lot of investigations of different scientific groups. Currently, Ukraine doesn’t have an established colorectal cancer program, what need to be changed as soon as possible. A lot of patients in Ukraine wait at home till the beginning of clinical symptoms, what often is the representation of later stage of diseases; and of course treatment of patients with later stage of diseases need more costs for treatment and show worst results of morbidity and mortality rate compare with patients treated at the early stage of diseases. We created a simulation Markov model and demonstrated that the implementation of the national screening program for colorectal cancer in Ukraine will be cost saving and will decrease the mortality from colorectal cancer significantly.

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Demographic, medical, and behavioral factors associated with colorectal cancer screening and diagnostic colonoscopy in Israel.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.557 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 557-557

Author(s):

Miriam Gofine ◽

Ora Paltiel ◽

Orly Manor ◽

Arnon Cohen ◽

Einat Elran ◽

...

Keyword(s):

Colorectal Cancer ◽

Occult Blood ◽

Patient Characteristics ◽

Fecal Occult Blood Testing ◽

Fecal Occult Blood ◽

Cancer Death ◽

Fecal Occult ◽

Israeli Population ◽

Asymptomatic Individuals ◽

Behavior Characteristics

557 Background: Colorectal cancer (CRC) is the third leading cause of cancer death worldwide and second leading cause of cancer death in Israel. Israel's universal health care system funds CRC screening (CRCS) (fecal occult blood testing or colonoscopy) for all adults aged 50-74. CRCS adherence is influenced by numerous factors including patient characteristics. In addition to screening asymptomatic individuals, those with anemia may have undiagnosed CRC and require aggressive case finding. This study’s goals were: 1) To compare the socio-demographic, health status, and health behavior characteristics of the eligible Israeli population who underwent any versus no CRCS (2009-2012); 2) To examine the relationship between anemia severity and CRCS likelihood; 3) To determine whether anemia status predicts time-to-CRCS. Methods: National retrospective cohort study of Israeli adults aged 51-71 on 1.1.2009 using electronic medical records from all 4 Israeli HMOs (n=1,009,898) over a 4-year period. Results: Differences in CRCS adherence were observed by patient characteristics. For example, ever-smokers comprised 17.9% of the screened population and 24.9% of the non-screened population (p<0.001). Increasing anemia severity was positively associated with any CRCS performance, especially colonoscopy. For example, severely anemic individuals (hemoglobin <10 g/dL for men, <8 g/dL for women) were significantly more likely to receive colonoscopy than those who were not anemic (OR = 3.23; 95% CI, 2.58-4.27). Anemia somewhat expedites CRCS. For example, 8.9% of those with anemia and 7.6% of those without anemia performed any CRCS within 30 days of hemoglobin level recording (p<0.001). Conclusions: Full CRCS adherence is not yet optimized in Israel. Particular attention directed at those at-risk for CRCS non-adherence may decrease CRC mortality. Although lower hemoglobin somewhat expedites colonoscopy performance, few individuals with anemia actually undergo colonoscopy. Further analysis accounting for confounding and effect modification is crucial for a more complete understanding of these relationships.

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Influence of the microbiota on epigenetics in colorectal cancer

National Science Review ◽

10.1093/nsr/nwy160 ◽

2018 ◽

Vol 6 (6) ◽

pp. 1138-1148 ◽

Cited By ~ 1

Author(s):

Danfeng Sun ◽

Yingxuan Chen ◽

Jing-Yuan Fang

Keyword(s):

Gene Expression ◽

Colorectal Cancer ◽

Fatty Acids ◽

Gene Sequence ◽

Short Chain Fatty Acids ◽

Epigenetic Modifications ◽

Host Cells ◽

Cancer Development ◽

Cancer Death ◽

Clear Link

Abstract Colorectal cancer is one of the most common malignancies and is the second leading cause of cancer death worldwide. Generally, there are three categories of colorectal cancer development mechanism—genetic, epigenetic and aberrant immunological signaling pathways—all of which may be initiated by an imbalanced gut microbiota. Epigenetic modifications enable host cells to change gene expression without modifying the gene sequence. The microbiota can interact with the host genome dynamically through the interface presented by epigenetic modifications. In particular, bacterially derived short-chain fatty acids have been identified as one clear link in the interaction of the microbiota with host epigenetic pathways. This review discusses recent findings relating to the cross talk between the microbiota and epigenetic modifications in colorectal cancer.

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Colorectal cancer is a leading cause of cancer incidence and mortality among adults younger than 50 years in the USA: a SEER-based analysis with comparison to other young-onset cancers

Journal of Investigative Medicine ◽

10.1136/jim-2016-000229 ◽

2016 ◽

Vol 65 (2) ◽

pp. 311-315 ◽

Cited By ~ 70

Author(s):

Abhishek Bhandari ◽

Melissa Woodhouse ◽

Samir Gupta

Keyword(s):

Colorectal Cancer ◽

Young Adults ◽

Cancer Incidence ◽

Cancer Site ◽

Cancer Death ◽

Young Onset ◽

Incident Cancer ◽

Incidence And Mortality ◽

The Usa ◽

Incident Rates

Colorectal cancer (CRC) incidence and mortality are rising among young adults. Our aim was to contrast the relative incidence and mortality of CRC to other common cancers among young adults in the USA. We used Surveillance, Epidemiology, and End Results registry data to compare cancer site-specific and age-specific mortality and incident rates for adults younger than age 50. We summarized extracted data, both overall, and stratified by sex. We found CRC was the third leading cause of cancer death among adults younger than age 50, after breast and lung cancer (1.67 cases per 100,000). Among young women, CRC was the fourth leading cause of cancer death (1.51 per 100,000). Among young men, CRC was the second leading cause of cancer death (1.82 cases per 100,000). CRC was the second most incident cancer among young adults for men and women combined. Among men, CRC was the second most incident cancer after age 30, with 4.9, 9.0, 16.4, and 30.8 cases per 100,000 for ages 30–34, 35–39, 40–44, and 45–49 years, respectively. Among women, CRC incidence was similar with 4.2, 7.6, 15.3, and 25.9 cases per 100,000 for ages 30–34, 35–39, 40–44, and 45–49 years, respectively. These results show that CRC is a leading cause of cancer incidence and mortality among young adults in the USA, relative to other cancers. Given trends toward increasing rates of CRC among young adults, strategies for identifying individuals at risk for young-onset CRC who might benefit from early age of screening initiation merit investigation.

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Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study

Gut ◽

10.1136/gutjnl-2016-312712 ◽

2016 ◽

Vol 67 (2) ◽

pp. 291-298 ◽

Cited By ~ 89

Author(s):

Chyke A Doubeni ◽

Douglas A Corley ◽

Virginia P Quinn ◽

Christopher D Jensen ◽

Ann G Zauber ◽

...

Keyword(s):

Colorectal Cancer ◽

Mortality Risk ◽

Left Colon ◽

Screening Colonoscopy ◽

Cancer Death ◽

Right Colon ◽

Community Based ◽

Risk Of Death ◽

Colon Cancers ◽

Rectal Cancers

ObjectiveScreening colonoscopy's effectiveness in reducing colorectal cancer mortality risk in community populations is unclear, particularly for right-colon cancers, leading to recommendations against its use for screening in some countries. This study aimed to determine whether, among average-risk people, receipt of screening colonoscopy reduces the risk of dying from both right-colon and left-colon/rectal cancers.DesignWe conducted a nested case–control study with incidence-density matching in screening-eligible Kaiser Permanente members. Patients who were 55–90 years old on their colorectal cancer death date during 2006–2012 were matched on diagnosis (reference) date to controls on age, sex, health plan enrolment duration and geographical region. We excluded patients at increased colorectal cancer risk, or with prior colorectal cancer diagnosis or colectomy. The association between screening colonoscopy receipt in the 10-year period before the reference date and colorectal cancer death risk was evaluated while accounting for other screening exposures.ResultsWe analysed 1747 patients who died from colorectal cancer and 3460 colorectal cancer-free controls. Compared with no endoscopic screening, receipt of a screening colonoscopy was associated with a 67% reduction in the risk of death from any colorectal cancer (adjusted OR (aOR)=0.33, 95% CI 0.21 to 0.52). By cancer location, screening colonoscopy was associated with a 65% reduction in risk of death for right-colon cancers (aOR=0.35, CI 0.18 to 0.65) and a 75% reduction for left-colon/rectal cancers (aOR=0.25, CI 0.12 to 0.53).ConclusionsScreening colonoscopy was associated with a substantial and comparably decreased mortality risk for both right-sided and left-sided cancers within a large community-based population.

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Oxaliplatin resistance in colorectal cancer enhances TRAIL sensitivity via death receptor 4 upregulation and lipid raft localization

eLife ◽

10.7554/elife.67750 ◽

2021 ◽

Vol 10 ◽

Author(s):

Joshua D Greenlee ◽

Maria Lopez-Cavestany ◽

Nerymar Ortiz-Otero ◽

Kevin Liu ◽

Tejas Subramanian ◽

...

Keyword(s):

Colorectal Cancer ◽

Lipid Rafts ◽

Lipid Raft ◽

Death Receptor ◽

Cancer Death ◽

Blood Samples ◽

Death Receptor 4 ◽

Trail Sensitivity ◽

Resistant Cells

Colorectal cancer (CRC) remains a leading cause of cancer death, and its mortality is associated with metastasis and chemoresistance. We demonstrate that oxaliplatin-resistant CRC cells are sensitized to TRAIL-mediated apoptosis. Oxaliplatin-resistant cells exhibited transcriptional downregulation of caspase-10, but this had minimal effects on TRAIL sensitivity following CRISPR-Cas9 deletion of caspase-10 in parental cells. Sensitization effects in oxaliplatin-resistant cells were found to be a result of increased DR4, as well as significantly enhanced DR4 palmitoylation and translocation into lipid rafts. Raft perturbation via nystatin and resveratrol significantly altered DR4/raft colocalization and TRAIL sensitivity. Blood samples from metastatic CRC patients were treated with TRAIL liposomes, and a 57% reduction of viable circulating tumor cells (CTCs) was observed. Increased DR4/lipid raft colocalization in CTCs was found to correspond with increased oxaliplatin resistance and increased efficacy of TRAIL liposomes. To our knowledge, this is the first study to investigate the role of lipid rafts in primary CTCs.

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The impact of preoperative preparation on postoperative complications in patients with colorectal cancer

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2016.4.4 ◽

2016 ◽

Vol 11 (4) ◽

pp. 311-316

Author(s):

Octavia Cristina RUSU ◽

◽

Radu Virgil COSTEA ◽

Cristian Constantin POPA ◽

Ştefan Ilie NEAGU ◽

...

Keyword(s):

Colorectal Cancer ◽

Postoperative Complications ◽

Bowel Preparation ◽

Nutritional Support ◽

Mechanical Bowel Preparation ◽

Antimicrobial Treatment ◽

Cancer Death ◽

Preoperative Preparation ◽

Meta Analyses ◽

The Impact

Colorectal cancer is a frequently encountered disease. In most countries, it represents the second leading cause of cancer death. The treatment with radical intent of this condition is surgical. Objective: Through this study, we want to update some data regarding the impact of nutrition and the preoperative mechanical bowel preparation on postoperative complications, in patients who need surgical treatment for colorectal cancer. Material and Method: Relevant articles in the field, contained in international databases were analysed, with no language exclusion, including clinical trials and meta-analyses performed between 1994 and 2015. Conclusions: Preoperative preparation is particularly important in the postoperative evolution of the patients with colorectal cancer and it is based on several main principles: nutritional support, antimicrobial treatment and mechanical bowel preparation.

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