Colorectal Cancer

2018 ◽  
Author(s):  
Cathy Eng
Keyword(s):  
Colorectal Cancer ◽  
Staging System ◽  
Occult Blood ◽  
Cancer Staging ◽  
The United States ◽  
Tnm Staging ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Screening And Surveillance ◽  
Staging Systems

Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States. Although environmental factors, including diet and lifestyle, clearly play a role in the etiology of colorectal cancer, as many as 25% of patients with colorectal cancer have a family history of the disease, which suggests the involvement of a genetic factor. Inherited colon cancers can be divided into two main types: the well-studied but rare familial adenomatous polyposis (FAP) syndrome, and the increasingly well-characterized, more common hereditary nonpolyposis colorectal cancer (HNPCC, a.k.a. Lynch Syndrome). The prevention, screening, diagnosis, and treatment of cancers of the colon and rectum are covered in this chapter. Figures illustrate various forms of adenomatous polyps, the tumor, node, metastasis (TNM) staging system for colorectal cancer, and the five-year survival rate in patients with colorectal carcinoma. Tables describe risk factors; possible chemopreventive agents; evidence supporting the effectiveness of screening tests; features and usage issues with different fecal occult blood tests; recommendations for early detection, screening, and surveillance for patients at different levels of risk; colorectal cancer staging systems; indicators of poor prognosis; and chemotherapeutic and biologic agents in the treatment of colorectal cancer. This chapter contains 197 references.

Colorectal Cancer

2018 ◽  
Author(s):  
Cathy Eng
Keyword(s):  
Colorectal Cancer ◽  
Staging System ◽  
Occult Blood ◽  
Cancer Staging ◽  
The United States ◽  
Tnm Staging ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Screening And Surveillance ◽  
Staging Systems

Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States. Although environmental factors, including diet and lifestyle, clearly play a role in the etiology of colorectal cancer, as many as 25% of patients with colorectal cancer have a family history of the disease, which suggests the involvement of a genetic factor. Inherited colon cancers can be divided into two main types: the well-studied but rare familial adenomatous polyposis (FAP) syndrome, and the increasingly well-characterized, more common hereditary nonpolyposis colorectal cancer (HNPCC, a.k.a. Lynch Syndrome). The prevention, screening, diagnosis, and treatment of cancers of the colon and rectum are covered in this chapter. Figures illustrate various forms of adenomatous polyps, the tumor, node, metastasis (TNM) staging system for colorectal cancer, and the five-year survival rate in patients with colorectal carcinoma. Tables describe risk factors; possible chemopreventive agents; evidence supporting the effectiveness of screening tests; features and usage issues with different fecal occult blood tests; recommendations for early detection, screening, and surveillance for patients at different levels of risk; colorectal cancer staging systems; indicators of poor prognosis; and chemotherapeutic and biologic agents in the treatment of colorectal cancer. This chapter contains 197 references.

Colorectal Cancer

2017 ◽  
Author(s):  
Cathy Eng
Keyword(s):  
Colorectal Cancer ◽  
Staging System ◽  
Occult Blood ◽  
Cancer Staging ◽  
The United States ◽  
Tnm Staging ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Screening And Surveillance ◽  
Staging Systems

Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States. Although environmental factors, including diet and lifestyle, clearly play a role in the etiology of colorectal cancer, as many as 25% of patients with colorectal cancer have a family history of the disease, which suggests the involvement of a genetic factor. Inherited colon cancers can be divided into two main types: the well-studied but rare familial adenomatous polyposis (FAP) syndrome, and the increasingly well-characterized, more common hereditary nonpolyposis colorectal cancer (HNPCC, a.k.a. Lynch Syndrome). The prevention, screening, diagnosis, and treatment of cancers of the colon and rectum are covered in this chapter. Figures illustrate various forms of adenomatous polyps, the tumor, node, metastasis (TNM) staging system for colorectal cancer, and the five-year survival rate in patients with colorectal carcinoma. Tables describe risk factors; possible chemopreventive agents; evidence supporting the effectiveness of screening tests; features and usage issues with different fecal occult blood tests; recommendations for early detection, screening, and surveillance for patients at different levels of risk; colorectal cancer staging systems; indicators of poor prognosis; and chemotherapeutic and biologic agents in the treatment of colorectal cancer. This chapter contains 197 references.

Association between Charlson-Deyo Score and delay to colonoscopy in veterans subsequently diagnosed with colorectal cancer.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 288-288
Author(s):  
Thi Khuc ◽  
Christian Jackson
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Occult Blood ◽  
The United States ◽  
Fecal Occult Blood ◽  
Study Cohort ◽  
Fecal Occult ◽  
Final Study ◽  
Increased Risk ◽  
History Of

288 Background: Colorectal cancer (CRC) is the second most common cause of cancer deaths in the United States and expected to cause 51,020 deaths in 2019. Early detection with yearly fecal occult blood test (FOBT) has been proven to decrease CRC mortality. A 30-day delay from positive FOBT to colonoscopy is associated with increased risk of CRC. The Veterans Affairs Health System (VAHS) treats approximately 11% of CRCs in the United States. The effects of an aging population, physician shortage, and increased military personnel entering the VAHS may increase demands on VAHS resources. The primary aim of this study was to determine risk factors that caused delay to colonoscopy. Methods: We retrospectively reviewed records of 600 patients referred for colonoscopy from January 1999 to January 2009, who were subsequently diagnosed with CRC. Patients with a prior CRC diagnosis were excluded. The final study cohort consisted of 530 patients. We analyzed the relationship between 10 variables and delay in time from initial consultation to colonoscopy. Variables consisted of age, sex, race, ethnicity, CRC location, marital status, history of mental health diagnosis, tobacco use, substance abuse, Charlson/Deyo (C/D) score and season of referral for colonoscopy. A delay in time was defined as 30 days or greater. Logistic regression analysis adjusted for age, race, CRC location and C/D score. Results: A total of 87.17% of patients experienced a delay in time from initial consultation to colonoscopy. When analyzed with a predictive variable of delay to colonoscopy, C/D score of ≥ 2 versus 0, was associated with higher odds of delay in time to colonoscopy (OR = 2.18, p = 0.02). African American race and Hispanic ethnicity was associated with a higher odds of delay in time to colonoscopy, but was not statistically significant (OR = 1.47, p = 0.47, OR = 1.37, p = 0.48). Conclusions: Patients with a C/D score ≥ 2 were 218% more likely to have delay in time from initial consult to colonoscopy, resulting in a delayed CRC diagnosis. C/D score may be used to determine which patients should have more frequent reminders to schedule their colonoscopy to prevent delays in care. Randomized and prospective studies will need to be performed.

scholarly journals Noninvasive diagnostics for colorectal cancer: molecular genetic fecal DNA analysis

2014 ◽  
Vol 21 (3) ◽  
pp. 8-12
Author(s):  
G. M. Butrovich ◽  
E. D. Mirlina ◽  
I. G. Habarova ◽  
O. A. Vostrukhina
Keyword(s):  
Colorectal Cancer ◽  
Large Scale ◽  
Dna Analysis ◽  
Molecular Genetic ◽  
Occult Blood ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Fecal Dna ◽  
Noninvasive Diagnostics ◽  
Crc Screening

Colorectal cancer (CRC) is still one of the leading causes of cancer-related death all over the world. An early diagnosis is fundamental thing for reducing the CRC-related morbidity and mortality. Nowadays researchers are studying more reliable and effective non-invasive screening tests, using easily available biological samples, such as feces. Such methods have high potential to collect and deliver samples. The comparison of some new variants genomic fecal DNA analysis and traditional fecal occult blood tests are discussed in this review. Sensitivity, specificity of the methods, processability, efficacy and ability of early CRC screening are the criteria for the preference of the using of one of these methods. These factors give the opportunity to carry out the large-scale CRC screening. This technological advance promises to increase the efficiency of the fecal DNA analysis and put the using of new clinical applications.

scholarly journals Developments in Screening Tests and Strategies for Colorectal Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Justin L. Sovich ◽  
Zachary Sartor ◽  
Subhasis Misra
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Cancer Mortality ◽  
The United States ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Common Cause ◽  
Crc Screening ◽  
The Third ◽  
Incidence And Mortality

Background.Worldwide, colorectal cancer (CRC) is the third most common cancer in men and second most common in women. It is the fourth most common cause of cancer mortality. In the United States, CRC is the third most common cause of cancer and second most common cause of cancer mortality. Incidence and mortality rates have steadily fallen, primarily due to widespread screening.Methods.We conducted keyword searches on PubMed in four categories of CRC screening: stool, endoscopic, radiologic, and serum, as well as news searches in Medscape and Google News.Results.Colonoscopy is the gold standard for CRC screening and the most common method in the United States. Technological improvements continue to be made, including the promising “third-eye retroscope.” Fecal occult blood remains widely used, particularly outside the United States. The first at-home screen, a fecal DNA screen, has also recently been approved. Radiological methods are effective but seldom used due to cost and other factors. Serum tests are largely experimental, although at least one is moving closer to market.Conclusions.Colonoscopy is likely to remain the most popular screening modality for the immediate future, although its shortcomings will continue to spur innovation in a variety of modalities.

scholarly journals Stool DNA Test Targeting Methylated Syndecan-2 (SDC2) as a Noninvasive Screening Method for Colorectal Cancer

2021 ◽  
Author(s):  
Wei-Chih Su ◽  
Wei-Yu Kao ◽  
Tsung-Kun Chang ◽  
Hsiang-Lin Tsai ◽  
Ching-Wen Huang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Characteristic Curve ◽  
Screening Method ◽  
Occult Blood ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Dna Test ◽  
Crc Screening ◽  
Stool Dna ◽  
Healthy Participants

Despite the steadily increasing worldwide incidence of colorectal cancer (CRC), an effective noninvasive approach for early detection of CRC is still under investigation. The guaiac-based fecal occult blood test (FOBT) and fecal immunochemical test (FIT) have gained popularity as noninvasive CRC screening tests owing to their convenience and relatively low costs. However, the FOBT and FIT have limited sensitivity and specificity. To develop a noninvasive tool for the detection of CRC, we investigated the sensitivity, specificity, and accuracy of a stool DNA test targeting methylated syndecan-2 (SDC2), which is frequently methylated in patients with CRC. This study enrolled 62 patients diagnosed as having stage 0–IV CRC and 76 healthy participants between July 2018 and June 2019 from two institutions. Approximately 4.5g of stool sample was collected from each participant for detection of human methylated SDC2 gene. In total, 48 of 62 (77.4%) patients with CRC showed positive results, whereas 67 out of 76 (88.2%) healthy participants showed negative results. The area under the curve of the receiver operating characteristic curve constructed was 0.872 for discrimination between patients with CRC and healthy individuals. This study highlights the potential of the fecal methylated SDC2 test as a noninvasive detection method for CRC screening with a relatively favorable sensitivity of 77.4%, a specificity of 88.2% and a positive predictive value of 84.2% compared to other available fecal tests. Further multicenter clinical trials comprising subjects of varied ethnicities are required to validate this test for the mass screening of patients with CRC.

Evaluating cancer outcomes of outpatient colonoscopies in elderly patients older than 85 years of age.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15079-e15079
Author(s):  
Joy A Lee ◽  
Xia Bi ◽  
Connie Y Huang ◽  
Walter Coyle
Keyword(s):  
Colorectal Cancer ◽  
Occult Blood ◽  
The United States ◽  
Fecal Occult Blood ◽  
Cancer Outcomes ◽  
Moderate Sedation ◽  
Patient Demographics ◽  
Colon Cancers ◽  
Fecal Occult ◽  
Overall Mortality

e15079 Background: With increasing life expectancy, the incidence of colorectal cancer increases. Currently, there are few studies on cancer outcomes of outpatient colonoscopy in patients older than 85 years of age. Methods: The database at Scripps was queried for all outpatient colonoscopies performed under moderate sedation between April 1, 2012 to March 31, 2017 on patients aged 85 years and older. Patient demographics, indication for procedure, and endoscopic findings were obtained. Variables including location and stage of tumor, subsequent treatments, and overall mortality were analyzed. Results: 322 outpatient colonoscopies were reviewed. Median age was 86 years. 53% were females. Screening colonoscopies accounted for 2.1% of procedures. 40 (12.4%) colon cancers were detected. 38 (95%) were adenocarcinomas and 2 (5%) were neuroendocrine tumors. 26 (65%) were right sided colon cancers. Among those diagnosed with cancer, anemia was the most common indication followed by positive fecal occult blood test (FOBT). 20 (50%) of these patients had a FOBT within the past year. Of those FOBTs, 18 (90%) were positive. Median age of patients with colon cancer was 88 years. 70% were females. 12 (30%) patients had never had a colonoscopy. 19 (47.5%) were diagnosed at an advanced stage (stage III or IV). 32 (80%) pursued surgery, 10 (25%) received chemotherapy, and 5 (12.5%) received radiation. 3 (7.5%) patients received supportive care only. 1-year mortality was 22.5% and 3-year mortality was 40% from the time of diagnosis. Conclusions: To date, this is the first study in the United States that examines cancer outcomes in an elderly population undergoing an outpatient colonoscopy. Overall, patients over the age of 85 with colorectal cancer have good outcomes that are comparable to that of the general population and colonoscopies should be considered for appropriate candidates.

Cost-effectiveness of screening for colorectal cancer in France using a guaiac test versus an immunochemical test

2010 ◽  
Vol 26 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Catherine Lejeune ◽  
Vincent Dancourt ◽  
Patrick Arveux ◽  
Claire Bonithon-Kopp ◽  
Jean Faivre
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Participation Rate ◽  
Occult Blood ◽  
Sensitivity Analyses ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Fecal Occult ◽  
Immunochemical Test

Objectives: The aim of this study was to compare the cost and the effectiveness of two biennial fecal occult blood screening tests for colorectal cancer: a guaiac nonrehydrated test (G-FOBT) and an immunochemical test (I-FOBT) with the absence of screening.Methods: A Markov model was developed to compare these strategies in a general population of subjects aged 50 to 74 over a 20-year period.Results: Compared with the absence of screening, G-FOBT and I-FOBT were associated with a decrease in colorectal cancer mortality of 17.4 percent and 25.2 percent, respectively. With regard to cost-effectiveness, expressed as cost per life-year gained, I-FOBT was the most effective and most costly alternative. Compared with no screening, G-FOBT and I-FOBT presented similar discounted incremental cost-effectiveness ratios: €2,739 and €2,819 respectively per life-year gained. When compared with G-FOBT, I-FOBT presented an incremental cost-effectiveness ratio of €2,988 per life-year gained. Sensitivity analyses showed the strong influence of the I-FOBT lead time, of the participation rate to screening for I-FOBT, and of the purchase price of the I-FOBT on the discounted incremental cost-effectiveness ratios.Conclusions: Compared with the absence of screening and with G-FOBT, the biennial two-stool immunochemical test can be considered a promising method for mass screening for colorectal cancer.

scholarly journals Colorectal cancer screening and prevention: A brief review of the current guidelines and modalities

2021 ◽  
Vol 7 (2) ◽  
pp. 097-103
Author(s):  
Ashan T Hatharasinghe ◽  
Ike R Ogbu ◽  
Abdul G Gheriani ◽  
George A Trad ◽  
Andre E Manov
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Occult Blood ◽  
Fecal Occult Blood Testing ◽  
The United States ◽  
Alternative Methods ◽  
Fecal Occult Blood ◽  
Fecal Occult ◽  
Preventative Measures ◽  
Screening And Prevention

Colorectal cancer (CRC) remains a frequently addressed topic in primary care. Recent studies have been published detailing modifiable risk factors for CRC, as well as preventative measures. Providers must be up to date on screening recommendations and modalities. Colonoscopy is the preferred method of screening for CRC, and the screening recommendations in the United States were recently updated in 2020. It is also common for the practitioner to encounter patients who refuse colonoscopy but are willing to undergo alternative methods of testing. The COVID pandemic has also placed a burden on hospital resources, and colonoscopy may not be logistically feasible in some healthcare settings. Therefore, awareness of the guidelines for the various alternative modalities, along with their respective guidelines for frequency of screening is critical. This article provides a brief review of the risk factors associated with colon cancer, the screening modalities (including colonoscopy, sigmoidoscopy, CT colonography, fecal immunohistochemical testing (FIT), guaiac-based fecal occult blood testing (gFOBT), multi target stool DNA testing (MTs-DNA), and others) and the most recent screening recommendations for the general population.

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