Predictors of patient uptake of colorectal cancer gene environment risk assessment

Abstract Background Colorectal cancer (CRC) is the second most prevalent cancer, as it accounts for approximately 10% of all annually diagnosed cancers. Studies have indicated that DNA methylation is involved in cancer genesis. The purpose of this study was to investigate the relationships among DNA methylation, gene expression and the tumor-immune microenvironment of CRC, and finally, to identify potential key genes related to immune cell infiltration in CRC. Methods In the present study, we used the ChAMP and DESeq2 packages, correlation analyses, and Cox regression analyses to identify immune-related differentially expressed genes (IR-DEGs) that were correlated with aberrant methylation and to construct a risk assessment model. Results Finally, we found that HSPA1A expression and CCRL2 expression were positively and negatively associated with the risk score of CRC, respectively. Patients in the high-risk group were more positively correlated with some types of tumor-infiltrating immune cells, whereas they were negatively correlated with other tumor-infiltrating immune cells. After the patients were regrouped according to the median risk score, we could more effectively distinguish them based on survival outcome, clinicopathological characteristics, specific tumor-immune infiltration status and highly expressed immune-related biomarkers. Conclusion This study suggested that the risk assessment model constructed by pairing immune-related differentially expressed genes correlated with aberrant DNA methylation could predict the outcome of CRC patients and might help to identify those patients who could benefit from antitumor immunotherapy.

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Framework for Colorectal Cancer Health Needs Assessment in North and Central Asian Countries

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i09/1202 ◽

2021 ◽

Vol 6 (09) ◽

pp. 569-575

Author(s):

Rebecca Pratiti

Keyword(s):

Colorectal Cancer ◽

Risk Assessment ◽

Disease Risk ◽

Population Attributable Risk ◽

National Income ◽

Risk Indicators ◽

Asian Countries ◽

Central Asian ◽

Central Asian Countries ◽

Per Capita

Colorectal cancer (CRC) is the third leading cause for cancer worldwide. Prevalence of CRC is increasing in North and Central Asian Countries (NCAC). European guidelines encourage member countries to allocate resources for primary prevention of CRC through screening. Though, cost-effective screening is becoming a priority. A framework for health priority determination to prioritize CRC screening was developed. Public health websites were accessed to abstract epidemiologic data. The framework included prioritization by absolute risk (incidence, prevalence), relative risk (CRC ranking for national cancer deaths) and population attributable risk for the disease. Risk indicators were identified for the NCAC. Further detailed risk assessment scoring was completed to assess the CRC disease burden. Statistical analysis was performed for correlation. Variables included in risk assessment were population, life expectancy, gross national income per capita, percent GDP spent on health expenditure, total expenditure on health per capita, age standardized mortality to incidence ratio, cancer ranking by incidence and smoking prevalence. Risk assessment showed Kyrgyzstan, Georgia, Belarus and Armenia have more than expected CRC burden. Tajikistan, Turkmenistan and Latvia have lower than expected CRC burden. Conclusion: Identifying high CRC burden countries to prioritize screening is important. Uniform and comparable CRC risk indicators for the region is needed. Health need assessment and priority setting is important for better distribution of resources. Countries with lower risk score may implement preventive policy to reduce CRC risk factors and countries with higher risk could adapt mitigating policy for early diagnosis of CRC.

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