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

Gut ◽  
2016 ◽  
Vol 67 (2) ◽  
pp. 291-298 ◽  
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.

251 Screening Colonoscopy and the Risk of Death From Right and Left Colon Cancers

2016 ◽  
Vol 150 (4) ◽  
pp. S61
Author(s):  
Chyke A. Doubeni ◽  
Douglas Corley ◽  
Virginia P. Quinn ◽  
Christopher D. Jensen ◽  
Ann G. Zauber ◽  
...  
Keyword(s):  
Left Colon ◽  
Screening Colonoscopy ◽  
Risk Of Death ◽  
Colon Cancers

scholarly journals Comparison of Cancer Patients to Non-Cancer Patients among COVID-19 Inpatients at a National Level

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1436
Author(s):  
Alain Bernard ◽  
Jonathan Cottenet ◽  
Philippe Bonniaud ◽  
Lionel Piroth ◽  
Patrick Arveux ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Mortality Risk ◽  
Hospital Admissions ◽  
National Level ◽  
Administrative Database ◽  
Hospital Death ◽  
Solid Cancer ◽  
Hematological Cancer ◽  
Risk Of Death

(1) Background: Several smaller studies have shown that COVID-19 patients with cancer are at a significantly higher risk of death. Our objective was to compare patients hospitalized for COVID-19 with cancer to those without cancer using national data and to study the effect of cancer on the risk of hospital death and intensive care unit (ICU) admission. (2) Methods: All patients hospitalized in France for COVID-19 in March–April 2020 were included from the French national administrative database, which contains discharge summaries for all hospital admissions in France. Cancer patients were identified within this population. The effect of cancer was estimated with logistic regression, adjusting for age, sex and comorbidities. (3) Results: Among the 89,530 COVID-19 patients, we identified 6201 cancer patients (6.9%). These patients were older and were more likely to be men and to have complications (acute respiratory and kidney failure, venous thrombosis, atrial fibrillation) than those without cancer. In patients with hematological cancer, admission to ICU was significantly more frequent (24.8%) than patients without cancer (16.4%) (p < 0.01). Solid cancer patients without metastasis had a significantly higher mortality risk than patients without cancer (aOR = 1.4 [1.3–1.5]), and the difference was even more marked for metastatic solid cancer patients (aOR = 3.6 [3.2–4.0]). Compared to patients with colorectal cancer, patients with lung cancer, digestive cancer (excluding colorectal cancer) and hematological cancer had a higher mortality risk (aOR = 2.0 [1.6–2.6], 1.6 [1.3–2.1] and 1.4 [1.1–1.8], respectively). (4) Conclusions: This study shows that, in France, patients with COVID-19 and cancer have a two-fold risk of death when compared to COVID-19 patients without cancer. We suggest the need to reorganize facilities to prevent the contamination of patients being treated for cancer, similar to what is already being done in some countries.

Mortality by colon, lung, esophagus, prostate, cervix and breast cancers in Brazilian capitals, 2000 to 2015: a multilevel analysis

2019 ◽  
Author(s):  
NÁDIA CRISTINA PINHEIRO RODRIGUES ◽  
Gisele O’Dwyer ◽  
Mônica Kramer de Noronha Andrade ◽  
Denise Leite Maia Monteiro ◽  
Inês Reis Nascimento Reis ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Cancer Mortality ◽  
Fixed Effects ◽  
Mortality Rates ◽  
Lung Cancers ◽  
Esophageal Cancers ◽  
Risk Of Death ◽  
Colon Cancers ◽  
Significant Difference ◽  
Risk Of Cancer

Abstract Background. In Brazil, cancer is the second most common cause of death, and the most incident types of cancer are prostate, breast, lung, colon and rectum. This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals from 2000 to 2015. Methods. Data from 2005-2015 cancer mortality and resident population were collected from Information Technology Department of the Brazilian Unified Health System (DATASUS), the Brazilian Institute of Geography and Statistics (IBGE) and the Brazilian Mortality Information (SIM). State capitals were the study’s analytic units. A multilevel Poisson model was used to estimate the adjusted risk of cancer mortality (prostate, breast, cervix, colon, lung and esophageal cancers). The adjusted models included the following variables as fixed effects: age, Gross Domestic Product, region, year squared and year of death. Results. A statistically significant difference was found between mortality rates by gender for colon, lung and esophageal cancers. The highest mortality rates were observed in the older age group, especially for prostate and lung cancers, which values were higher than 100 deaths per 100,000. Comparing with those aged 40-59 years, men older than 59 years showed 47 times higher mortality risk for prostate cancer, 8-9 times higher for lung or colon cancers and four times higher for esophageal cancer. Compared with those aged 40-59 years, women older than 59 years old showed 5-7 times higher mortality risk for esophageal, lung or colon cancers and 2-3 times higher for breast or cervix cancers. Conclusions. Colon cancer mortality rate increased from 2000 to 2015 for both genders, while breast and lung cancers mortality increased over the period only for women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Northern capitals had a lower risk of death by prostate and breast cancer and a higher risk of death by cervix cancer.

scholarly journals Anxiety and the risk of death in older men and women

2004 ◽  
Vol 185 (5) ◽  
pp. 399-404 ◽  
Author(s):  
Hein P. J. van Hout ◽  
Aartjan T. F. Beekman ◽  
Edwin De Beurs ◽  
Hannie Comijs ◽  
Harm Van Marwijk ◽  
...  
Keyword(s):  
Gender Difference ◽  
Anxiety Disorders ◽  
Mortality Risk ◽  
Older Men ◽  
Community Based ◽  
Men And Women ◽  
Risk Of Death ◽  
Screening Design ◽  
Older Men And Women

BackgroundThere are inconsistent reports as to whether people with anxiety disorders have a higher mortality risk.AimsTo determine whether anxiety disorders predict mortality in older men and women in the community Method Longitudinal data were used from a large, community-based random sample (n=3107) of older men and women (55–85 years) in The Netherlands, with a follow-up period of 7.5 years. Anxiety disorders were assessed according to DSM–III criteria in a two-stage screening design.ResultsIn men, the adjusted mortality risk was 1.78 (95% Cl 1.01–3.13) in cases with diagnosed anxiety disorders at baseline. In women, no significant association was found with mortality.ConclusionsThe study revealed a gender difference in the association between anxiety and mortality. For men, but not for women, an increased mortality risk was found for anxiety disorders.

Value of Mismatch Repair, KRAS, and BRAF Mutations in Predicting Recurrence and Benefits From Chemotherapy in Colorectal Cancer

2011 ◽  
Vol 29 (10) ◽  
pp. 1261-1270 ◽  
Author(s):  
Gordon Hutchins ◽  
Katie Southward ◽  
Kelly Handley ◽  
Laura Magill ◽  
Claire Beaumont ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mismatch Repair ◽  
Mutational Analysis ◽  
Left Colon ◽  
Rectal Tumors ◽  
Wild Type ◽  
Right Colon ◽  
Kras Mutations ◽  
Risk Of Recurrence ◽  
Braf Mutant

Purpose It is uncertain whether modest benefits from adjuvant chemotherapy in stage II colorectal cancer justify the toxicity, cost, and inconvenience. We investigated the usefulness of defective mismatch repair (dMMR), BRAF, and KRAS mutations in predicting tumor recurrence and sensitivity to chemotherapy. Patients and Methods Immunohistochemistry for dMMR and pyrosequencing for KRAS/BRAF were performed for 1,913 patients randomly assigned between fluorouracil and folinic acid chemotherapy and no chemotherapy in the Quick and Simple and Reliable (QUASAR) trial. Results Twenty-six percent of 695 right-sided colon, 3% of 685 left-sided colon, and 1% of 407 rectal tumors were dMMR. Similarly, 17% of right colon, 2% of left colon, and 2% of rectal tumors were BRAF mutant. KRAS mutant tumors were more evenly distributed: 40% right colon, 28% left colon, and 36% rectal tumors. Recurrence rate for dMMR tumors was half that for MMR-proficient tumors (11% [25 of 218] v 26% [438 of 1,695] recurred; risk ratio [RR], 0.53; 95% CI, 0.40 to 0.70; P < .001). Risk of recurrence was also significantly higher for KRAS mutant than KRAS wild-type tumors (28% [150 of 542] v 21% [219 of 1,041]; RR, 1.40; 95% CI, 1.12 to 1.74; P = .002) but did not differ significantly between BRAF mutant and wild-type tumors (P = .36). No marker predicted benefit from chemotherapy with efficacy not differing significantly by MMR, KRAS, or BRAF status. The prognostic value of MMR and KRAS was similar in the presence and absence of chemotherapy. Conclusion MMR assays identify patients with a low risk of recurrence. KRAS mutational analysis provides useful additional risk stratification to guide use of chemotherapy.

scholarly journals Early-onset colorectal cancer: more than one side to the story

2020 ◽  
Vol 9 (3) ◽  
pp. CRC28
Author(s):  
Nina N Sanford ◽  
Pooja Dharwadkar ◽  
Caitlin C Murphy
Keyword(s):  
Colorectal Cancer ◽  
Early Onset ◽  
Age Groups ◽  
Younger Adults ◽  
Risk Of Death ◽  
Colon Cancers ◽  
All Cause Mortality ◽  
Colon And Rectum ◽  
The Impact ◽  
Early Onset Colorectal Cancer

Aim: To determine the impact of tumor sidedness on all-cause mortality for early- (age 18–49 years) and older-onset (age ≥50 years) colorectal cancer (CRC). Materials & methods: We conducted a retrospective study of 650,382 patients diagnosed with CRC between 2000 and 2016. We examined the associations of age, tumor sidedness (right colon, left colon and rectum) and all-cause mortality. Results: For early-onset CRC (n = 66,186), mortality was highest in the youngest age group (18–29 years), driven by left-sided colon cancers (vs 50–59 years, hazard ratio: 1.18; 95% CI: 1.03–1.34). 5-year risk of death among 18–29-year-olds with left-sided colon cancer (0.42, 95% CI: 0.38, 0.46) was higher than all other age groups. Conclusion: Left-sided colon cancers are enriched in younger adults and may be disproportionately fatal.

scholarly journals Clinical presentations of colorectal cancer at initial presentation to hospital and its site specific correlation

2018 ◽  
Vol 6 (11) ◽  
pp. 3652
Author(s):  
Rauf Ahmad Bhat ◽  
Shams Ul Bari
Keyword(s):  
Colorectal Cancer ◽  
Hepatic Flexure ◽  
Left Colon ◽  
Age Group ◽  
Right Colon ◽  
Site Specific ◽  
Clinical Presentations ◽  
Number Of Patients ◽  
Bleeding Per Rectum ◽  
Sixth Decade

Background: Colorectal cancer is one of the leading cause of death all over the world. It progresses slowly and may be asymptomatic for as many as 5 years. Aim of this study was to find the incidence and the initial clinical presentations of patients with colorectal cancer and its site specific correlationMethods: This was a prospective hospital-based study conducted over a period of two years from August 2015 to September 2017 in the postgraduate department of surgery, Government medical college, Srinagar. Total of fifty three patients in the age group of 10 years to 80 years were included in the study. Colorectal tumors were divided into right colon growths (caecum, ascending colon and hepatic flexure), left colon growths (splenic flexure, descending colon and sigmoid colon) and rectal growths. Data was collected from their hospital records and analysed using SPSS computer program.Results: In present study incidence of colorectal cancer was 0.2 per 100,000 people. Thirty percent of our patients were found to be in the sixth decade of their life with male preponderance in almost every age group. Mean age of presentation being 46.44 years (males= 48.5years, females= 43.76years). Out of 53 patients, rectal growths constituted 36%, left colonic growths 36% followed by 28% cases of right colonic growths. More than one symptom was present in several patients. Maximum number of patients (43%) presented with anemia (microcytic hypochromic) with Hb of <9gm% followed by constipation 38% and bleeding per rectum 28%. Pain abdomen was present in 23% of patients. Loss of weight and diarrhoea was equally seen in 19% of patients. Diarrhoea was seen in 6 males and 4 females and was statistically significant (p<0.05).Conclusions: Colorectal cancer was found to affect the Kashmiri patients at younger age (38% were 40 years or less) with peak incidence at sixth decade. Males were affected more than females. Anaemia, constipation and bleeding per rectum were the most common predominant clinical features in right colon, left colon and rectal growths respectively.

Oncogenic mutations in colorectal cancer, indications for anatomical sites, and targeted intervention.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e22037-e22037
Author(s):  
Giovanni Corso ◽  
Valeria Pascale ◽  
Giuseppe Flauti ◽  
Daniele Marrelli ◽  
Franco Roviello
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Microsatellite Instability ◽  
Cancer Patients ◽  
Left Colon ◽  
Targeted Intervention ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Oncogenic Mutations ◽  
Colorectal Cancer Patients

e22037 Background: Oncogenic mutations, such as KRAS, in colorectal cancer patients are considered standard molecular biomarkers that predict the clinical benefit for the targeted intervention with EGFR inhibitors. In addition, these mutations are associated with specific anatomical area in the colon tumor development, as BRAF mutations with the microsatellite instability. Methods: In this translational study we aim to assess the mutation frequencies of the EGFR [hotspot area and polyadenine deletions (A13_del)], KRAS, BRAFV600E, and PIK3CA oncogenes in a series of 280 colorectal cancer patients. Microsatellite instability phenotype is considered in this series. All patients' clinicopathological data were considered for statistical analysis and associations. Results: In this study, we verified multiple associations between oncogenic mutations and specified clinicopathological tumor features. Respectively, we identified the following significant results: 1) EGFR A13_deletions are associated with right colon carcinoma (22.2% vs. 3.3%; p<0.005), mucinous histotype (16% vs. 7.8%; p=0.042), G3 grading (19% vs. 7.3%; p=0.024) and microsatellite instability status (p<0.005); 2) PIK3CA mutations are related mucinous histotype (12% vs. 4.4%; p=0.021) 3) KRASG12 and KRASG13mutations are correlated respectively with the left (91.4% vs. 59.3%) and right (40.7% vs. 8.6%) colon cancer development (p<0.005), and finally 4) microsatellite instability is associated with right colon tumors (28.4% vs. 5.5%; p<0.005). Conclusions: Mostly, we verified a high frequency rate of the KRASG13 and EGFR A13_del oncogene mutations in right colon cancer; whereas KRASG12 codon mutation occurs more frequently in left colon cancers. In particular, we assessed that right colon cancer is associated with specific molecular characteristics, in comparison to left colon tumors. These evidences, in association with specific clinicopathological data, can delineate novel approaches for the colorectal cancer classification and targeted intervention.

The correlation between mismatch repair status and clinicopathological characteristics in Chinese colorectal cancer patients.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 544-544 ◽  
Author(s):  
Zhi-tao Xiao ◽  
Rong-xin Zhang ◽  
Yang Zhao ◽  
Jian-Hong Peng ◽  
Pei-Rong Ding ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Mismatch Repair ◽  
Mucinous Adenocarcinoma ◽  
Clinicopathological Characteristics ◽  
Left Colon ◽  
Stage Ii ◽  
Chinese Patients ◽  
Right Colon ◽  
Significant Difference

544 Background: Our study aimed to explore the relationship between mismatch repair (MMR) status and clinicopathological characteristics in Chinese patients with colorectal cancer (CRC). Methods: A total of 2684 patients with histologically confirmed adenocarcinoma of CRC were consecutively recruited between May 2011 and May 2015 at Sun Yat-sen University cancer center. The exclusion criteria included multiple primary tumors, synchronous and metachronous CRC, and familial adenomatous polyposis. The CRC was defined as left colon with the tumor located below the splenic flexure or rectum, otherwise grouped as right colon. Correlations of MMR status and patient’s demographics, tumor characteristics and TNM staging (exclude 315 CRC patients receiving neoadjuvant therapy) were investigated. Results: We found that deficient MMR (dMMR) status was more likely detected in younger CRC patients compared to the the elderly (12.7% vs 7.5%, P < 0.001). The dMMR rate in right colon cancer was significantly higher than that in left colon cancer and rectal cancer (22.7% vs 7.2% vs 5.2%, P < 0.001).With respect to tumor differentiation, we found that the mucinous adenocarcinoma had the highest rate of dMMR(24.4%), followed by poorly differentiated adenocarcinoma(18.5%), signet-ring cell carcinoma(17.6%), well differentiated adenocarcinoma(9.5%), moderately differentiated adenocarcinoma(8.9%), and neuroendocrine carcinoma (0%) ( P < 0.001). In addition, the proportions in stage I, stage II, stage III and stage IV CRC were 9.7%, 16.5% , 8.5% and 3.9%, respectively ( P < 0.001). There was no significant difference in gender (P = 0.114). Conclusions: At the first time, our study demonstrated that dMMR status was most likely detected at younger age (less than 59 years) and stage II right colon mucinous adenocarcinoma in large volume Chinese patients, which was similar to the results in western countries.

Microsatellite instability in colorectal cancer: An analysis of the National Cancer Database.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 134-134
Author(s):  
Kamelah Abushalha ◽  
Sawsan Abulaimoun ◽  
Sarah J Aurit ◽  
Erin Jenkins ◽  
Peter T. Silberstein
Keyword(s):  
Colorectal Cancer ◽  
Regression Model ◽  
Microsatellite Instability ◽  
Mucinous Adenocarcinoma ◽  
Medullary Carcinoma ◽  
Left Colon ◽  
Right Colon ◽  
White Race ◽  
Factors Associated ◽  
Colon And Rectum

134 Background: High-frequency microsatellite instability (MSI-H) accounts for roughly 15% of all cases of colorectal cancer (CRC). Studies suggest a significant non-adherence to routine MSI testing in patients diagnosed with CRC despite universal guidelines. Methods: We used the NCDB to identify adults with MSI-H status CRC from 2010-2015 with the following histologic subtypes: mucinous and not otherwise specified adenocarcinoma, and medullary carcinoma. The primary site was localized to the right colon, left colon, and rectum; demographic factors, clinicopathologic features, and treatments were identified. Patients were stratified by site and discrete and continuous variable comparisons were made using the chi-square and Mann-Whitney test, respectively. Survival was examined with the Kaplan-Meier method and a Cox proportional hazards regression model. A logistic regression model was used to examine MSI status. All analyses were conducted with SAS version 9.4. Results: A total of 5364 patients were identified and stratified by site into 3 groups: right colon (n = 4004, 74.6%), left colon (n = 890, 16.59%) and rectum (n = 470, 8.76%). Compared to the left colon and rectum, right colon patients were more likely to be older females with larger tumors and less likely to receive chemoradiation. After adjusting for all else, we found statistical evidence that female vs. male gender (OR = 1.47; 95% CI: 1.24 to 1.73), Black vs. White race (OR = 0.61; 0.45 to 0.83), left vs. right colon (OR = 0.33, 0.27 to 0.41), rectum vs. right colon (OR = 0.08, 0.05 to 0.13), mucinous adenocarcinoma vs. adenocarcinoma (OR = 2.37, 1.92 to 2.93), medullary carcinoma vs. adenocarcinoma (OR = 8.86, 4.56 to 17.22), positive vs. negative k-RAS mutation (OR = 0.49, 0.41 to 0.59), and positive vs. negative CEA status (OR = 0.79, 0.66 to 0.94) were factors associated with MSI-H status. Improved survival was associated were Hispanic white race, stage 1, and free surgical margins within a multivariable context. Factors associated with poor survival: increased Charlson/Deyo score, advanced stage, lymphovascular invasion, and positive CEA status. Conclusions: In settings where resources are scarce and universal testing is not possible, there is a benefit from MSI testing in female patients, those with right-sided colon cancer, mucinous adenocarcinoma, and medullary carcinoma.

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