Distance-to-care: Stage at diagnosis for New Mexico (NM) residents with colorectal cancer (CRC).

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 421-421 ◽  
Author(s):  
Meredith C. Mason ◽  
Andrew Bruner ◽  
Angela W. Meisner ◽  
Katherine T. Morris ◽  
Itzhak Nir ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Logistic Regression ◽  
New Mexico ◽  
Late Stage ◽  
Early Stage ◽  
Stage At Diagnosis ◽  
Multiple Logistic Regression ◽  
Place Of Residence ◽  
Distance To Care ◽  
Incident Cases

421 Background: CRC is a leading cause of morbidity and mortality among NM’s American Indians, Hispanics, and non-Hispanic whites. Previous studies have shown that rural residents are more likely than urban dwellers to be diagnosed with late stage disease. Geographically New Mexico is the 5th largest state with a population of 2 million, many of whom reside in rural regions. This study was designed to characterize the association between distance-to-care and stage of disease at diagnosis in NM. Methods: The population-based NM Tumor Registry was used to identify records for all incident cases of CRC between 2001-2008. Latitude and longitude were determined for the place of residence for cancer cases and for the facility where each case was diagnosed. The “Great Circles” algorithm was used to estimate the distance from place of residence to the diagnosing facility. The percentage of cases diagnosed with early stage vs. other stages (i.e., regional, distant, and unknown stages-combined) was assessed by quartile of distance-to-care with the use of the chi-squared test for trend. Multiple logistic regression was used to characterize the association between stage and quartile of distance-to-care while controlling for other factors know to be associated with stage at diagnosis. Results: Analysis was based on 6,291 incident cases of CRC that were diagnosed among NM residents. Latitude and longitude for both place of residence at diagnosis and location of diagnosing facility were available for 4,385 (69.7%) of all incident cases. The percentage of cases diagnosed at early stage was inversely related to the distance between the place of residence at diagnosis and the facility where the cancer was diagnosed, as follows: 41.4% of cases in Quartile 1 (shortest distance-to-care); 39.9% in Quartile 2; 37.8% in Quartile 3; and 35.3% in Quartile 4 (p=0.002).By multiple logistic regression, distance-to-care was a significant predictor of stage at diagnosis after adjustment of sex, age and race/ethnicity. Conclusions: Rural residents of NM who must travel relatively long distances to receive medical care are at increased risk of being diagnosed at late stage colorectal cancer.

Health Insurance Status as a Predictor of Mode of Colon Cancer Detection but Not Stage at Diagnosis: Implications for Early Detection

2021 ◽  
pp. 003335492199917
Author(s):  
Lindsey A. Jones ◽  
Katherine C. Brewer ◽  
Leslie R. Carnahan ◽  
Jennifer A. Parsons ◽  
Blase N. Polite ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Health Insurance ◽  
Early Detection ◽  
Late Stage ◽  
Early Stage ◽  
Insurance Status ◽  
Stage At Diagnosis ◽  
Health Insurance Status ◽  
Percentage Point Increase ◽  
Point Increase

Objective For colon cancer patients, one goal of health insurance is to improve access to screening that leads to early detection, early-stage diagnosis, and polyp removal, all of which results in easier treatment and better outcomes. We examined associations among health insurance status, mode of detection (screen detection vs symptomatic presentation), and stage at diagnosis (early vs late) in a diverse sample of patients recently diagnosed with colon cancer from the Chicago metropolitan area. Methods Data came from the Colon Cancer Patterns of Care in Chicago study of racial and socioeconomic disparities in colon cancer screening, diagnosis, and care. We collected data from the medical records of non-Hispanic Black and non-Hispanic White patients aged ≥50 and diagnosed with colon cancer from October 2010 through January 2014 (N = 348). We used logistic regression with marginal standardization to model associations between health insurance status and study outcomes. Results After adjusting for age, race, sex, and socioeconomic status, being continuously insured 5 years before diagnosis and through diagnosis was associated with a 20 (95% CI, 8-33) percentage-point increase in prevalence of screen detection. Screen detection in turn was associated with a 15 (95% CI, 3-27) percentage-point increase in early-stage diagnosis; however, nearly half (47%; n = 54) of the 114 screen-detected patients were still diagnosed at late stage (stage 3 or 4). Health insurance status was not associated with earlier stage at diagnosis. Conclusions For health insurance to effectively shift stage at diagnosis, stronger associations are needed between health insurance and screening-related detection; between screening-related detection and early stage at diagnosis; or both. Findings also highlight the need to better understand factors contributing to late-stage colon cancer diagnosis despite screen detection.

scholarly journals Racial–Ethnic Disparities in Late-Stage Colorectal Cancer Among Hispanics and Non-Hispanic Whites of New Mexico

2017 ◽  
Vol 15 (4) ◽  
pp. 180-188 ◽  
Author(s):  
Melissa Gonzales ◽  
Fares Qeadan ◽  
Shiraz I. Mishra ◽  
Ashwani Rajput ◽  
Richard M. Hoffman
Keyword(s):  
Colorectal Cancer ◽  
New Mexico ◽  
Late Stage ◽  
Ethnic Disparities ◽  
Racial Ethnic

Cancer screening utilization in patients diagnosed with cancer types with and without recommended screening modalities.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10557-10557
Author(s):  
Ariella Cohain ◽  
Christine Hathaway ◽  
Mudit Gupta ◽  
Braxton Lagerman ◽  
Yali Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cancer Screening ◽  
Cancer Patients ◽  
Late Stage ◽  
Screening Methods ◽  
Stage At Diagnosis ◽  
Tumor Registry ◽  
Late Stage Diagnosis ◽  
Screening Adherence ◽  
Cancer Types

10557 Background: Several studies have shown screening methods can detect cancer at earlier stages and improve cancer prognosis; however, only four cancer types (breast, colorectal, cervical, and lung) currently have screening methods recommended by the United States Preventive Services Taskforce (USPSTF). In 2021, these four cancers are expected to make up roughly 40% of new cases and cancer deaths, meaning that the majority of cancer deaths will be associated with cancer types lacking recommended screening. We sought to characterize patients who were diagnosed with cancer types with and without recommended screening modalities to demonstrate the gaps in screening faced by the majority of cancers today. Methods: The Geisinger Health System (GHS) Phenomics Initiative Database (PIDB) provides deidentified data from electronic health, billing, and imaging records, and a tumor registry. PIDB was used to identify patients aged 50 to 76 who had cancers diagnosed between 2008 and 2020 and a record of USPSTF-recommended cancer screenings within GHS prior to diagnosis. Analysis focused on patients who received care at GHS during their screening-eligible intervals. Results: Between 2008 and 2020, 13,347 incident invasive cancers were identified in the GHS tumor registry. Of these, 40% (N = 5,331) were cancer types with a recommended screening modality. 57% of these cases (N = 3,039; 23% of all incident cancers) occurred in patients who underwent screening in the interval preceding diagnosis. Screening adherence was significantly associated with stage at diagnosis; patients who were not screened for their diagnosed cancer were more than twice as likely to have a late-stage diagnosis as compared with patients who received screening (multivariate ordinal logistic regression, OR = 2.16, p < 0.001). Patterns of screening adherence in this population are complex; however, 57% of these patients had received screening for a different cancer type. The majority of incident cancers were of those types with no recommended screening modality (N = 8,016; 60% of all incident cancers). Of these, most (N = 6,252; 78%) had been screened for at least one of breast, lung, colon, or cervical cancer and nearly half (N = 3,607; 45%) were current for all guideline-recommended screenings. Not surprisingly, stage at diagnosis was not associated with adherence to any or all screening modalities (multivariate ordinal logistic regression, p = 0.11 and p = 0.45). Conclusions: The majority (79%) of individuals diagnosed with cancer had a history of adherence to at least one screening recommendation. Out of all cancer patients, only 23% were screened specifically for the cancer with which they were subsequently diagnosed, a group that is associated with a lower odds of a late-stage diagnosis. This suggests that the majority of cancer patients who underwent any cancer screening did not benefit from earlier stage diagnosis.

scholarly journals Nanoparticle-Aided Detection of Colorectal Cancer-Associated Glycoconjugates of Extracellular Vesicles in Human Serum

2021 ◽  
Vol 22 (19) ◽  
pp. 10329
Author(s):  
Rufus Vinod ◽  
Randa Mahran ◽  
Erica Routila ◽  
Janne Leivo ◽  
Kim Pettersson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Human Serum ◽  
Cell Lines ◽  
Extracellular Vesicles ◽  
Late Stage ◽  
Early Stage ◽  
Biological Fluids ◽  
Serum Samples ◽  
Benign Condition ◽  
Hek 293

Extracellular vesicles (EVs) are found in all biological fluids, providing potential for the identification of disease biomarkers such as colorectal cancer (CRC). EVs are heavily glycosylated with specific glycoconjugates such as tetraspanins, integrins, and mucins, reflecting the characteristics of the original cell offering valuable targets for detection of CRC. We report here on europium-nanoparticle (EuNP)-based assay to detect and characterize different surface glycoconjugates of EVs without extensive purification steps from five different CRC and the HEK 293 cell lines. The promising EVs candidates from cell culture were clinically evaluated on small panel of serum samples including early-stage (n = 11) and late-stage (n = 11) CRC patients, benign condition (n = 11), and healthy control (n = 10). The majority of CRC cell lines expressed tetraspanin sub-population and glycovariants of integrins and conventional tumor markers. The subpopulation of CD151 having CD63 expression (CD151CD63) was significantly (p = 0.001) elevated in early-stage CRC (8 out of 11) without detecting any benign and late-stage samples, while conventional CEA detected mostly late-stage CRC (p = 0.045) and with only four early-stage cases. The other glycovariant assays such as CEACon-A, CA125WGA, CA 19.9Ma696, and CA 19.9Con-A further provided some complementation to the CD151CD63 assay. These results indicate the potential application of CD151CD63 assay for early detection of CRC patients in human serum.

Blood-based detection of early-stage colorectal cancer using multiomics and machine learning.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 66-66
Author(s):  
Girish Putcha ◽  
Tzu-Yu Liu ◽  
Eric Ariazi ◽  
Marvin Bertin ◽  
Adam Drake ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Machine Learning ◽  
Sensitivity And Specificity ◽  
Late Stage ◽  
Early Stage ◽  
High Sensitivity ◽  
Average Risk ◽  
Learning Platform ◽  
Pathological Subtypes ◽  
Mean Sensitivity

66 Background: Despite population screening efforts, screening rates for colorectal cancer (CRC) remain suboptimal. A non-invasive, blood-based screening test with high sensitivity and specificity in early-stage disease should improve adherence and ultimately reduce mortality; however, tests based only on tumor-derived biomarkers have limited sensitivity. Here we used a multiomic, machine learning platform to discover, refine, and combine tumor- and immune-derived signals to develop a blood test for the detection of early-stage CRC. Methods: Samples from 591 participants enrolled in a prospective study including average-risk screening and case-control cohorts (NCT03688906) were included in this analysis (CRC: n = 43; colonoscopy-confirmed CRC-negative controls: n = 548). Participants with CRC were 60% male with a mean age of 63, and controls were 55% male with a mean age of 60. Stage distribution was 54% early (I/II) and 34% late (III/IV) with 11% unknown. Plasma was analyzed by whole-genome sequencing, bisulfite sequencing, and protein quantification methods. Computational methods were used to assess and infer the performance of individual and combined assays. Results: For colorectal adenocarcinoma, which represents ~95% of all CRCs, our multiomic test achieved a mean sensitivity of 92% in early stage (n = 17) and 84% in late stage (n = 11) at a specificity of 90%. Across all CRC pathological subtypes, our test achieved a mean sensitivity of 80% in early stage (n = 19) and 83% in late stage (n = 12) at a specificity of 90%; the test detected the single squamous cell carcinoma but missed both neuroendocrine tumors. Individual assays achieved a mean sensitivity of 50% in early stage and 66% in late stage at a specificity of 90%. Conclusions: In a prospective cohort, we demonstrated high sensitivity and specificity for early-stage adenocarcinoma by combining tumor- and immune-derived signals from cfDNA, epigenetic, and protein biomarkers. While most CRCs are adenocarcinomas, detection of all pathological subtypes is required to maximize sensitivity in a screening population. Further analysis of molecular and pathological subtypes, as well as the entire ~3000 patient cohort, is underway. Clinical trial information: NCT03688906.

Does appendectomy increase the risk of colorectal adenocarcinoma?

Open Medicine ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 315-319 ◽  
Author(s):  
Emre Ergul ◽  
Erdal Gozetlik
Keyword(s):  
Colorectal Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Colorectal Carcinoma ◽  
Logistic Regression Analysis ◽  
Colorectal Adenocarcinoma ◽  
Multiple Logistic Regression Analysis ◽  
Colon Adenocarcinoma ◽  
Multiple Logistic Regression ◽  
Right Colon

AbstractColorectal cancer ranks third as the most common malignancy in the United States and represents the second leading cause of cancer-related mortality. The appendix is thought to have a productive effect against colorectal carcinoma by the immune function based on its association with substantial lymphatic tissue. But, an appendectomy is still the most commonly performed emergency surgical procedure. It is aimed to assess the association between colorectal cancer and appendicectomy. The medical records of 455 patients who received medical and/or surgical treatment with the diagnosis of colorectal carcinoma in two medical centers in a-five-year period were reviewed. The patients were divided into subgroups according to the colonic localization of the tumor, appendectomy status and their body mass indexes (BMI). In order to define independent predictors of colon adeno-cancer, multiple logistic regression analysis was used. Statistically significant variables according to the univariate statistics were selected as candidate variables for multiple logistic regression analysis. A p-value<0.05 was considered statistically significant. Out of 455 colorectal adenocarcinoma patients, 122 (26.81%) were in right colon adenocarcinoma (CA) group, 267 (56.68%) were in left CA group and 66 (14.5%) were in the rectum adenocarcinoma group. Appendectomy was found as the second highest risk factor in rectum and right colon adenocarcinoma. Being appendectomized increases the risk of rectum adenocarcinoma 3.232 times (95%CI: 1.670–6.254), left CA 2.537 times (95%CI: 1.544–4.168) and right CA 3.607 times (95%CI: 2.056–6.330). In the light of our findings, we suggest that being appendectomized might increase the risk of colorectal adenocarcinoma in sporadic cases.

scholarly journals DEAD-box RNA helicase protein DDX21 as a prognosis marker for early stage colorectal cancer with microsatellite instability

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Atsushi Tanaka ◽  
Julia Y. Wang ◽  
Jinru Shia ◽  
Yihua Zhou ◽  
Makiko Ogawa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Protein Expression ◽  
Microsatellite Instability ◽  
Late Stage ◽  
Early Stage ◽  
Disease Free Survival ◽  
Rna Helicase ◽  
Cancer Tissue ◽  
Proteomic Profiling ◽  
Dead Box

AbstractDEAD-box RNA helicase DDX21 (also named nucleolar RNA helicase 2) is a nuclear autoantigen with undefined roles in cancer. To explore possible roles of autoimmune recognition in cancer immunity, we examined DDX21 protein expression in colorectal cancer tissue and its association with patient clinical outcomes. Unbiased deep proteomic profiling of two independent colorectal cancer cohorts using mass spectrometry showed that DDX21 protein was significantly upregulated in cancer relative to benign mucosa. We then examined DDX21 protein expression in a validation group of 710 patients, 619 of whom with early stage and 91 with late stage colorectal cancers. DDX21 was detected mostly in the tumor cell nuclei, with high expression in some mitotic cells. High levels of DDX21 protein were found in 28% of stage I, 21% of stage II, 30% of stage III, and 32% of stage IV colorectal cancer cases. DDX21 expression levels correlated with non-mucinous histology in early stage cancers but not with other clinicopathological features such as patient gender, age, tumor location, tumor grade, or mismatch repair status in any cancer stage. Kaplan–Meier analyses revealed that high DDX21 protein levels was associated with longer survival in patients with early stage colorectal cancer, especially longer disease-free survival in patients with microsatellite instability (MSI) cancers, but no such correlations were found for the microsatellite stable subtype or late stage colorectal cancer. Univariate and multivariate analyses also identified high DDX21 protein expression as an independent favorable prognostic marker for early stage MSI colorectal cancer.

scholarly journals The effect of marital status on stage at diagnosis and survival in Saudis diagnosed with colorectal cancer: cancer registry analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mesnad Alyabsi ◽  
Majed Ramadan ◽  
Mohammed Algarni ◽  
Kanan Alshammari ◽  
Abdul Rahman Jazieh
Keyword(s):  
Colorectal Cancer ◽  
Marital Status ◽  
Cancer Registry ◽  
National Guard ◽  
Early Stage ◽  
Stage At Diagnosis ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Registry Analysis

AbstractColorectal cancer (CRC) is the most common cancer in males and third in females in Saudi Arabia, with the majority (66%) diagnosed at a late stage. We evaluated the effect of marital status on stage at diagnosis and CRC survival. We hypothesized that married patients would be more likely to present at an early stage and have higher survival than unmarried patients. The Ministry of National Guard-Health Affairs (MNG-HA) cancer registry was used to identify patients diagnosed with CRC from 2009 to 2017. A competing risk analysis was performed to assess the 5-year CRC-specific survival, adjusting for potential confounders. The Kaplan–Meier method and the Cox regressions were used to assess survival. Two-thirds (76.50%) of the 936 CRC patients were married, 11.64% were unmarried, and 11.86% had an unknown marital status. With multiple imputation-based analysis, the multivariate analysis indicated that unmarried patients were 52% more likely to present at an advanced stage [adjusted odds ratio (aOR) 1.52; 95% CI 1.33–1.73], and had a 30% higher risk of death due to CRC compared to the married patients (aHR 1.30; CI 1.17, 1.44). Future CRC screening and survivorship programs should assess the needs of the vulnerable unmarried population. Interventions supporting the early detection of CRC in this population may be beneficial in the long term and lead to improved cancer outcomes.

scholarly journals The Association between Fatalistic Beliefs and Late Stage at Diagnosis of Lung and Colorectal Cancer

2015 ◽  
Vol 24 (4) ◽  
pp. 720-726 ◽  
Author(s):  
Georgios Lyratzopoulos ◽  
Michael Pang-Hsiang Liu ◽  
Gary A. Abel ◽  
Jane Wardle ◽  
Nancy L. Keating
Keyword(s):  
Colorectal Cancer ◽  
Late Stage ◽  
Stage At Diagnosis

scholarly journals N-Cadherin as An Important Marker in Colorectal Cancer: An investigation of b-Catenin and Cadherin Expressions of SW-480 and HCT-116 Cell Lines

2021 ◽  
Vol 13 (3) ◽  
pp. 289-94
Author(s):  
Winarko Luminturahardjo ◽  
Djoko Wahono Soeatmadji ◽  
Karyono Mintaroem ◽  
Pudji Rahajoe ◽  
Ferry Sandra
Keyword(s):  
Colorectal Cancer ◽  
Cell Lines ◽  
Late Stage ◽  
Early Stage ◽  
Clinical Samples ◽  
Hct 116 ◽  
Metastatic Process ◽  
Hct 116 Cells ◽  
The One ◽  
E Cadherin

BACKGROUND: The absence of potential biomarkers to detect the metastatic process at an early stage will consequently delay colorectal cancer (CRC) treatment. Some biomarkers including β-Catenin, E-Cadherin and N-Cadherin have been suggested as potential markers. However, there were opposite reports regarding expressions of these markers. Therefore, current study was conducted using CRC cell lines for early stage (SW-480 cells) and late stage (HCT-116 cells) of CRC.METHODS: SW-480 and HCT-116 cells were cultured and seeded on coverslip glasses for immunofluorescence staining to detect β-Catenin, E-cadherin, and N-cadherin. Expressions of β-Catenin, E-cadherin, and N-cadherin were observed and documented under a fluorescent microscope and analyzed with Image J software. Measured results were then statistically analyzed. RESULTS: All β-catenin, E-Cadherin and N-Cadherin expressions were observed in SW-480 and HCT-116 cells. β-catenin MFI averages of SW-480 (47.157±3.479) and HCT-116 (47.240±4.107) cells were similar. E-Cadherin MFI average of SW-480 cells (45.104±4.107) was higher than the one of HCT-116 cells (40.191±3.702). N-Cadherin MFI average of HCT-116 cells (43.702±8.219) was significantly higher (p=0.009) than the one of SW-480 cells (72.506±5.297).CONCLUSION: Taken together, N-Cadherin could be suggested as an important metastasis marker in CRC since the N-Cadherin expression was significantly higher in HCT-116 cells as the late-stage CRC model than SW-480 as the early-stage of CRC model. Further research is still needed by comparing several biomarkers from various clinical samples at all clinical stages of CRC.KEYWORDS: CRC, β-Catenin, E-Cadherin, N-Cadherin, Metastasis, Biomarker

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