scholarly journals Untreated Hypertension and Subsequent Incidence of Colorectal Cancer: Analysis of a Nationwide Epidemiological Database

2021 ◽  
Author(s):  
Hidehiro Kaneko ◽  
Yuichiro Yano ◽  
Hidetaka Itoh ◽  
Kojiro Morita ◽  
Hiroyuki Kiriyama ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Colorectal Polyps ◽  
Claims Database ◽  
Hazard Ratios ◽  
Inflammatory Bowel ◽  
Stage 1 ◽  
Shared Risk ◽  
Untreated Hypertension

Background Studies of the association of hypertension with incident colorectal cancer (CRC) may have been confounded by including individuals taking antihypertensive medication, at high risk for CRC (ie, colorectal polyps and inflammatory bowel disease), or with shared risk factors (eg, obesity and diabetes). We assessed whether adults with untreated hypertension are at higher risk for incident CRC compared with those with normal blood pressure (BP), and whether any association is evident among individuals without obesity or metabolic abnormalities. Methods and Results Analyses were conducted using a nationwide health claims database collected in the JMDC Claims Database between 2005 and 2018 (n=2 220 112; mean age, 44.1±11.0 years; 58.4% men). Participants who were taking antihypertensive medications or had a history of CRC, colorectal polyps, or inflammatory bowel disease were excluded. Each participant was categorized as having normal BP (systolic BP [SBP]<120 mm Hg and diastolic BP [DBP] <80 mm Hg, n=1 164 807), elevated BP (SBP 120–129 mm Hg and DBP <80 mm Hg, n=341 273), stage 1 hypertension (SBP 130–139 mm Hg or DBP 80–89 mm Hg, n=466 298), or stage 2 hypertension (SBP ≥140 mm Hg or DBP ≥90 mm Hg, n=247 734). Over a mean follow‐up of 1112±854 days, 6899 incident CRC diagnoses occurred. After multivariable adjustment, compared with normal BP, hazard ratios for incident CRC were 0.93 (95% CI, 0.85–1.01) for elevated BP, 1.07 (95% CI, 0.99–1.15) for stage 1 hypertension, and 1.17 (95% CI, 1.08–1.28) for stage 2 hypertension. The hazard ratios for incident CRC for each 10‐mm Hg‐higher SBP or DBP were 1.04 (95% CI, 1.02–1.06) and 1.06 (95% CI, 1.03–1.09), respectively. These associations were present among adults who did not have obesity, high waist circumference, diabetes, or dyslipidemia. Conclusions Higher SBP and DBP, and stage 2 hypertension are associated with a higher risk for incident CRC, even among those without shared risk factors for CRC. BP measurement could identify individuals at increased risk for subsequent CRC.

Colorectal cancer prevalence and risk factors among the uninsured of Tampa Bay: A free clinic study.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 61-61
Author(s):  
Ethan Song ◽  
Artish Patel ◽  
Justin Swanson ◽  
Alexandra Aponte ◽  
Madeline MacDonald ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Smoking Status ◽  
Tampa Bay ◽  
Free Clinics ◽  
Uninsured Patients ◽  
Cancer Prevalence ◽  
History Of ◽  
Inflammatory Bowel

61 Background: Uninsured patients with low socioeconomic status are at higher risk for developing colorectal cancer. There is limited quantifiable data regarding risk factors and prevalence of colorectal cancer in this vulnerable population. The purpose of this study is to assess the risk factors for colorectal cancer in the low income and uninsured patient population across nine free clinics around Tampa Bay, Florida. Methods: An IRB-approved manually extracted retrospective query of several medical record systems from nine free clinics in the Tampa Bay area in 2017 revealed 1,836 (36.1%) of 5,076 total patients who are over 50 years old. Patient demographics, weight, smoking status, alcohol use, type 2 diabetes status, inflammatory bowel disease and colorectal cancer prevalence were also extracted and analyzed. Results: Among patients over 50, the majority of patients were female (n = 1073, 58.4%) and of Hispanic ethnicity (n = 752, 41.0%). Of the 1,349 patients who reported their smoking status, 213 (15.8%) were active smokers and 218 (16.2%) were past smokers, with a mean 16.3 (SD = 15.5) pack year history. Of the 1,124 patients who reported their history of alcohol consumption, 217 (19.3%) were current consumers and 40 (3.6%) were past consumers. The average BMI of patients over 50 years was 30.2 (SD = 6.9), with 558 (30.4%) cases of diabetes. Eleven patients (0.6%) had a history of inflammatory bowel disease. The prevalence of documented colorectal cancer in this sample was 0.6% (n = 11) in our sample population. Conclusions: There is a high prevalence of risk factors for colorectal cancer in this sample of uninsured patients but a lower reported prevalence of colorectal cancer compared to the general population. Additionally, many known risk factors for colorectal cancer, such as diet, physical activity, or family history, are not routinely documented by free clinics. As these clinics provide opportune points of primary care, this baseline data should prompt more attention to colorectal screening and risk factor modification in this vulnerable population.

scholarly journals DIAGNOSTIC AND MANAGEMENT APPROACH TO POUCHITIS IN INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 57 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Rocío SEDANO ◽  
Paulina NUÑEZ ◽  
Rodrigo QUERA
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Sclerosing Cholangitis ◽  
Biological Therapy ◽  
Response To Therapy ◽  
Management Approach ◽  
Total Proctocolectomy ◽  
Inflammatory Bowel

ABSTRACT In patients with ulcerative colitis refractory to medical therapy, total proctocolectomy and posterior ileal-anal pouch anastomosis is the standard surgical therapy. One of the possible complications is pouchitis. Depending on the duration of the symptoms, it can be classified as acute, recurrent, or chronic. The latter, according to the response to therapy, can be defined as antibiotic-dependent or refractory. The treatment of pouchitis is based on the use of antibiotics and probiotics. Thiopurine and biological therapy have been suggested in patients with refractory pouchitis. Special care should be taken in the endoscopic surveillance of these patients, especially if they present risk factors such as dysplasia or previous colorectal cancer, primary sclerosing cholangitis or ulcerative colitis for more than 10 years.

scholarly journals Risk factors for developing high-output ileostomy: a retrospective study

2021 ◽  
Author(s):  
Xiao Jian'an ◽  
Dongxiao Bai ◽  
Lei Li ◽  
Zhiling Shen ◽  
Tianchen Huang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Total Colectomy ◽  
Neoadjuvant Chemoradiotherapy ◽  
Clear Correlation ◽  
Abdominal Infection ◽  
Inflammatory Bowel

Abstract Background Prophylactic ileostomy and colostomy have been widely used to reduce the risk and complications of anastomotic leakage with high-risk colorectal cancer after operation. However, prophylactic ileostomy itself has some complications, and ileostomy high out-put syndrome is one of them. This study was performed to explore the risk factors of HOS in ileostomy.Methods A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last five years. The clinical and pathological data were analyzed. The relationship between HOS and clinicopathological data was analyzed. Multivariate analysis was performed by logistic regression.Results There was no clear correlation between the occurrence of HOS with sex, age, gross typing, histological grade, location of tumors, lymph node metastasis and TNM stage (p>0.05). Preoperative complications including inflammatory bowel disease, diabetes mellitus and neoadjuvant chemoradiotherapy were risk factors for HOS (p<0.05). Total colectomy and abdominal infection were risk factors for HOS (p<0.05) during operation.Conclusion Inflammatory bowel disease, diabetes mellitus and neoadjuvant radiotherapy and chemotherapy in patients with colorectal cancer are the preoperative risk factors for HOS. Total colectomy and postoperative abdominal infection are the postoperative risk factors for HOS.

Colorectal cancer

2016 ◽  
pp. 444-477
Author(s):  
Alex Boussioutas ◽  
Stephen Fox ◽  
Iris Nagtegaal ◽  
Alexander Heriot ◽  
Jonathan Knowles ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Colon Cancer ◽  
Bowel Disease ◽  
Colonic Cancer ◽  
Early Stage ◽  
Inflammatory Bowel ◽  
Resected Stage ◽  
Stage Ii Colon Cancer

This chapter covers colorectal cancer, and includes information on epidemiology, risk factors (chronic inflammation/inflammatory bowel disease, radiation, diet and lifestyle, post cholecystectomy, diabetes, obesity and insulin resistance, cigarette smoking, alcohol, ureterocolic anastamosis, and genetic risk factors, screening, and chemoprevention (aspirin, and NSAIDS), the molecular biology and pathology of colorectal cancer, colorectal carcinoma (location, pathologic prognostic markers, and predictive markers), surgical management (colonic cancer and inflammatory bowel disease, hereditary non-polyposis colonic cancer or HNPCC, presenting as an emergency, treatment of polyp or early cancers, liver and lung metastasis, peritoneal disease, results of surgery and treatment for colon cancer, medical management of early stage disease, adjuvant chemotherapy for stage III disease (T1-4, N1-2M0), adjuvant therapy of patients with resected stage II colon cancer, radiotherapy, multidisciplinary care and special groups, the role of allied teams, and surveillance and follow-up.

scholarly journals S0774 Risk Factors for Colorectal Cancer in Inflammatory Bowel Disease: Observations From a Single Center

2020 ◽  
Vol 115 (1) ◽  
pp. S395-S395
Author(s):  
Subash Ghimire ◽  
Amlish Gondal ◽  
Swapna Talluri ◽  
Rasmita Budhathoki ◽  
Sachit Sharma ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Single Center ◽  
Inflammatory Bowel

scholarly journals Risk factors for developing high-output ileostomy: a retrospective study

2020 ◽  
Author(s):  
Xiao Jian'an ◽  
Dongxiao Bai ◽  
Lei Li ◽  
Zhiling Shen ◽  
Tianchen Huang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Total Colectomy ◽  
Neoadjuvant Chemoradiotherapy ◽  
Clear Correlation ◽  
Abdominal Infection ◽  
Inflammatory Bowel

Abstract Background: Prophylactic ileostomy and colostomy have been widely used to reduce the risk and complications of anastomotic leakage with high-risk colorectal cancer after operation. However, prophylactic ileostomy itself has some complications, and ileostomy high out-put syndrome is one of them. This study was performed to explore the risk factors of HOS in ileostomy.Methods: A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last five years. The clinical and pathological data were analyzed. The relationship between HOS and clinicopathological data was analyzed. Multivariate analysis was performed by logistic regression.Results: There was no clear correlation between the occurrence of HOS with sex, age, gross typing, histological grade, location of tumors, lymph node metastasis and TNM stage (p > 0.05). Preoperative complications including inflammatory bowel disease, diabetes mellitus and neoadjuvant chemoradiotherapy were risk factors for HOS (p < 0.05). Total colectomy and abdominal infection were risk factors for HOS (p < 0.05) during operation.Conclusion: Inflammatory bowel disease, diabetes mellitus and neoadjuvant radiotherapy and chemotherapy in patients with colorectal cancer are the preoperative risk factors for HOS. Total colectomy and postoperative abdominal infection are the postoperative risk factors for HOS.

Colorectal cancer

2016 ◽  
pp. 444-477
Author(s):  
Alex Boussioutas ◽  
Stephen Fox ◽  
Iris Nagtegaal ◽  
Alexander Heriot ◽  
Jonathan Knowles ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Colon Cancer ◽  
Bowel Disease ◽  
Colonic Cancer ◽  
Early Stage ◽  
Inflammatory Bowel ◽  
Resected Stage ◽  
Stage Ii Colon Cancer

This chapter covers colorectal cancer, and includes information on epidemiology, risk factors (chronic inflammation/inflammatory bowel disease, radiation, diet and lifestyle, post cholecystectomy, diabetes, obesity and insulin resistance, cigarette smoking, alcohol, ureterocolic anastamosis, and genetic risk factors, screening, and chemoprevention (aspirin, and NSAIDS), the molecular biology and pathology of colorectal cancer, colorectal carcinoma (location, pathologic prognostic markers, and predictive markers), surgical management (colonic cancer and inflammatory bowel disease, hereditary non-polyposis colonic cancer or HNPCC, presenting as an emergency, treatment of polyp or early cancers, liver and lung metastasis, peritoneal disease, results of surgery and treatment for colon cancer, medical management of early stage disease, adjuvant chemotherapy for stage III disease (T1-4, N1-2M0), adjuvant therapy of patients with resected stage II colon cancer, radiotherapy, multidisciplinary care and special groups, the role of allied teams, and surveillance and follow-up.

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