scholarly journals Primary and Secondary Prevention of Colorectal Cancer

2014 ◽  
Vol 7 ◽  
pp. CGast.S14039 ◽  
Author(s):  
Pedro J. Tárraga López ◽  
Juan Solera Albero ◽  
José Antonio Rodríguez-Montes
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Early Detection ◽  
Secondary Prevention ◽  
Cause Of Death ◽  
Meta Analysis ◽  
Brown Rice ◽  
Primary And Secondary Prevention ◽  
The Third ◽  
Diet And Lifestyle

Introduction Cancer is a worldwide problem as it will affect one in three men and one in four women during their lifetime. Colorectal cancer (CRC) is the third most frequent cancer in men, after lung and prostate cancer, and is the second most frequent cancer in women after breast cancer. It is also the third cause of death in men and women separately, and is the second most frequent cause of death by cancer if both genders are considered together. CRC represents approximately 10% of deaths by cancer. Modifiable risk factors of CRC include smoking, physical inactivity, being overweight and obesity, eating processed meat, and drinking alcohol excessively. CRC screening programs are possible only in economically developed countries. However, attention should be paid in the future to geographical areas with ageing populations and a western lifestyle. 19 , 20 Sigmoidoscopy screening done with people aged 55-64 years has been demonstrated to reduce the incidence of CRC by 33% and mortality by CRC by 43%. Objective To assess the effect on the incidence and mortality of CRC diet and lifestyle and to determine the effect of secondary prevention through early diagnosis of CRC. Methodology A comprehensive search of Medline and Pubmed articles related to primary and secondary prevention of CRC and subsequently, a meta-analysis of the same blocks are performed. Results 225 articles related to primary or secondary prevention of CRC were retrieved. Of these 145 were considered valid on meta-analysis: 12 on epidemiology, 56 on diet and lifestyle, and over 77 different screenings for early detection of CRC. Cancer is a worldwide problem as it will affect one in three men and one in four women during their lifetime. There is no doubt whatsoever which environmental factors, probably diet, may account for these cancer rates. Excessive alcohol consumption and cholesterol-rich diet are associated with a high risk of colon cancer. A diet poor in folic acid and vitamin B6 is also associated with a higher risk of developing colon cancer with an overexpression of p53. Eating pulses at least three times a week lowers the risk of developing colon cancer by 33%, after eating less meat, while eating brown rice at least once a week cuts the risk of CRC by 40%. These associations suggest a dose–response effect. Frequently eating cooked green vegetables, nuts, dried fruit, pulses, and brown rice has been associated with a lower risk of colorectal polyps. High calcium intake offers a protector effect against distal colon and rectal tumors as compared with the proximal colon. Higher intake of dairy products and calcium reduces the risk of colon cancer. Taking an aspirin (ASA) regularly after being diagnosed with colon cancer is associated with less risk of dying from this cancer, especially among people who have tumors with COX-2 overexpression. 16 Nonetheless, these data do not contradict the data obtained on a possible genetic predisposition, even in sporadic or non-hereditary CRC. CRC is susceptible to screening because it is a serious health problem given its high incidence and its associated high morbidity/mortality. Conclusions (1) Cancer is a worldwide problem. (2) A modification of diet and lifestyle could reduce morbidity and mortality. (3) Early detection through screening improves prognosis and reduces mortality.

Colorectal Cancer

2018 ◽  
Author(s):  
Nana Keum ◽  
Kana Wu ◽  
Edward Giovannucci ◽  
David J. Hunter
Keyword(s):  
Colorectal Cancer ◽  
Secondary Prevention ◽  
Disease Risk ◽  
Dietary Factors ◽  
Colorectal Adenomas ◽  
Precursor Lesions ◽  
Primary And Secondary Prevention ◽  
The Third ◽  
Incidence And Mortality ◽  
Rapid Changes

Colorectal cancer (CRC), typically adenocarcinoma, arises from epithelial cells lining the large bowel or intestine. Colorectal adenomas are well-established precursor lesions for the majority of CRCs. Relatively uncommon prior to 1900, CRC has become the third most commonly diagnosed cancer, as well as the fourth leading cause of malignant death globally. Modifiable causes are demonstrated by the large variation in incidence across countries, rapid changes in incidence within some populations, and the transition in disease risk for immigrants toward that of the host country in migration studies. A number of lifestyle and dietary factors are now established as convincing or probable causes. In addition, the ability to access and remove adenomas can lower cancer incidence through secondary prevention. Thus, a combination of primary and secondary prevention can greatly lower incidence and mortality from CRC.

scholarly journals CTIM-02. TWO OUNCES OF PREVENTION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF VEGF AND IMMUNE CHECK POINT INHIBITION FOR PRIMARY AND SECONDARY PREVENTION OF BRAIN METASTASES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii32-ii33
Author(s):  
Alireza Mansouri ◽  
Alireza Mansouri ◽  
Timothy Brown ◽  
Dawit Aregawi ◽  
Brad Zacharia ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Secondary Prevention ◽  
Brain Metastases ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Treatment Options ◽  
Sensitivity Analyses ◽  
Primary And Secondary Prevention ◽  
Predictors Of Response ◽  
Inverse Variance

Abstract INTRODUCTION As treatments for cancer outside of the central nervous system improve, brain metastases (BMs) are becoming increasingly frequent. Despite novel treatment options, BMs remain a frequent cause of death for many advanced malignancies, and both the metastases and their treatments are associated with profound cognitive, quality of life, and economic costs. METHODS We conducted exhaustive, PRISMA-compliant systematic reviews of the literature from January 2000 to June 2020 for studies comparing the frequency of new BM in patients treated with chemotherapy regimens including and not including bevacizumab (“primary prevention”), and for studies comparing the frequency of new outside-of-treatment-field metastases in patients treated with stereotactic radiosurgery (SRS) with or without immune checkpoint inhibitors (“secondary prevention”). Pre-specified data was extracted and summary statistics were calculated using the inverse variance method and random effects model. RESULTS Seven studies (n=6,212) reported on BMs in breast, lung, and colon cancer patients treated with chemotherapy with or without bevacizumab. The relative risk (RR) and 95% confidence intervals [95% CI] for the development of new brain metastases was 0.71 [0.55–0.91, p=0.001]. A sensitivity analysis performed on the 3 breast cancer trials (n=2,350) showed a RR of 0.57 [0.34–0.94, p=0.027]. Seven studies (n=609) reported on patients with melanoma BM receiving SRS without or without an ICI. The RR for the development of new out-of-treatment field brain metastases was 0.70 [0.51–0.94, p=0.017]. Results were similar in sensitivity analyses examining only class I and class II trials. CONCLUSION This analysis suggests that the addition of bevacizumab to chemotherapy or ICI SRS+/- chemotherapy can reduce the development of first-ever or new BM by 30% in patients with advanced stage breast, lung, or colon cancer. Prospective trials of primary and secondary prevention in patient groups at high risk of developing BMs, and examining additional predictors of response, are currently underway.

scholarly journals Colorectal cancer screening using a stool DNA-based SDC2 methylation test: a multicenter, prospective trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chang Woo Kim ◽  
Hyunjin Kim ◽  
Hyoung Rae Kim ◽  
Bong-Hyeon Kye ◽  
Hyung Jin Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Early Detection ◽  
Prospective Trial ◽  
Screening Colonoscopy ◽  
Quantitative Detection ◽  
Screening Programs ◽  
Crc Screening ◽  
Stool Dna ◽  
Dna 2

Abstract Background Prevention and early detection of colorectal cancer (CRC) is a global priority, with many countries conducting population-based CRC screening programs. Although colonoscopy is the most accurate diagnostic method for early CRC detection, adherence remains low because of its invasiveness and the need for extensive bowel preparation. Non-invasive fecal occult blood tests or fecal immunochemical tests are available; however, their sensitivity is relatively low. Syndecan-2 (SDC2) is a stool-based DNA methylation marker used for early detection of CRC. Using the EarlyTect™-Colon Cancer test, the sensitivity and specificity of SDC2 methylation in stool DNA for detecting CRC were previously demonstrated to be greater than 90%. Therefore, a larger trial to validate its use for CRC screening in asymptomatic populations is now required. Methods All participants will collect their stool (at least 20 g) before undergoing screening colonoscopy. The samples will be sent to a central laboratory for analysis. Stool DNA will be isolated using a GT Stool DNA Extraction kit, according to the manufacturer’s protocol. Before performing the methylation test, stool DNA (2 µg per reaction) will be treated with bisulfite, according to manufacturer’s instructions. SDC2 and COL2A1 control reactions will be performed in a single tube. The SDC2 methylation test will be performed using an AB 7500 Fast Real-time PCR system. CT values will be calculated using the 7500 software accompanying the instrument. Results from the EarlyTect™-Colon Cancer test will be compared against those obtained from colonoscopy and any corresponding diagnostic histopathology from clinically significant biopsied or subsequently excised lesions. Based on these results, participants will be divided into three groups: CRC, polyp, and negative. The following clinical data will be recorded for the participants: sex, age, colonoscopy results, and clinical stage (for CRC cases). Discussion This trial investigates the clinical performance of a device that allows quantitative detection of a single DNA marker, SDC2 methylation, in human stool DNA in asymptomatic populations. The results of this trial are expected to be beneficial for CRC screening and may help make colonoscopy a selective procedure used only in populations with a high risk of CRC. Trial registration: This trial (NCT04304131) was registered at ClinicalTrials.gov on March 11, 2020 and is available at https://clinicaltrials.gov/ct2/show/NCT04304131?cond=NCT04304131&draw=2&rank=1.

scholarly journals Very-low-dose aspirin and surveillance colonoscopy is cost-effective in secondary prevention of colorectal cancer in individuals with advanced adenomas: network meta-analysis and cost-effectiveness analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajesh K. Veettil ◽  
Siang Tong Kew ◽  
Kean Ghee Lim ◽  
Pochamana Phisalprapa ◽  
Suresh Kumar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Secondary Prevention ◽  
Low Dose ◽  
Meta Analysis ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Surveillance Colonoscopy ◽  
Combination Strategy ◽  
Effectiveness Analysis

Abstract Background Individuals with advanced colorectal adenomas (ACAs) are at high risk for colorectal cancer (CRC), and it is unclear which chemopreventive agent (CPA) is safe and cost-effective for secondary prevention. We aimed to determine, firstly, the most suitable CPA using network meta-analysis (NMA) and secondly, cost-effectiveness of CPA with or without surveillance colonoscopy (SC). Methods Systematic review and NMA of randomised controlled trials were performed, and the most suitable CPA was chosen based on efficacy and the most favourable risk–benefit profile. The economic benefits of CPA alone, 3 yearly SC alone, and a combination of CPA and SC were determined using the cost-effectiveness analysis (CEA) in the Malaysian health-care perspective. Outcomes were reported as incremental cost-effectiveness ratios (ICERs) in 2018 US Dollars ($) per quality-adjusted life-year (QALY), and life-years (LYs) gained. Results According to NMA, the risk–benefit profile favours the use of aspirin at very-low-dose (ASAVLD, ≤ 100 mg/day) for secondary prevention in individuals with previous ACAs. Celecoxib is the most effective CPA but the cardiovascular adverse events are of concern. According to CEA, the combination strategy (ASAVLD with 3-yearly SC) was cost-saving and dominates its competitors as the best buy option. The probability of being cost-effective for ASAVLD alone, 3-yearly SC alone, and combination strategy were 22%, 26%, and 53%, respectively. Extending the SC interval to five years in combination strategy was more cost-effective when compared to 3-yearly SC alone (ICER of $484/LY gain and $1875/QALY). However, extending to ten years in combination strategy was not cost-effective. Conclusion ASAVLD combined with 3-yearly SC in individuals with ACAs may be a cost-effective strategy for CRC prevention. An extension of SC intervals to five years can be considered in resource-limited countries.

S-1 and Capecitabine for the Treatment of Colorectal Cancer: A Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 1144-1152
Author(s):  
Ping Huang ◽  
Zhenfen Wang ◽  
Qian Liu ◽  
Guohao Cai
Keyword(s):  
Colorectal Cancer ◽  
Web Of Science ◽  
Advanced Colorectal Cancer ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Therapeutic Effects ◽  
Chemotherapeutic Drugs ◽  
The Third ◽  
Hand Foot Syndrome ◽  
The Cochrane Library

Colorectal cancers common tumors that develop in the large intestines. The incidence of colorectal cancer is second only to gastric and esophageal cancers. Both S-1 and capecitabine are the third-generation fluorouracil-based chemotherapeutic drugs. We hope to summarize the therapeutic effects of tecotae and capecitabine in patients with colorectal cancer through this Meta-analysis. We performed a meta-analysis of the findings in the current literature. We performed a systematic review of outcomes associated with S-1 and capecitabine used to treat advanced colorectal cancer based on findings from both English and Chinese publications listed in PubMed, Embase, CNKI, Wanfang, EBSCO, Web of Science and the Cochrane Library. End-points included ORR, DCR, OS, and PFS; adverse events (grades 1–2 and 3–4) were also evaluated. Statistical analysis was performed using RevMan 5.3. A total of 12 studies were eventually included, involving a total of 3,375 patients. Of this group, 1,683 and 1,692 patients underwent treatment with S-1 or capecitabine, respectively. There were no greatly differences with respect to ORR, DCR, or OS; however, PFS was bettered in the group of S-1 compared to those treated with capecitabine. The incidence of leukopenia, diarrhea and anorexia were all higher among those in S-1 group compared to the capecitabine group, but a higher incidence of hand-foot syndrome was linked with use of capecitabine. Use of S-1 for the treatment of colorectal cancer may result in superior outcomes when compared to use of capecitabine.

scholarly journals Adenosquamous Carcinoma of the Colon

2018 ◽  
Vol 11 (3) ◽  
pp. 791-796 ◽  
Author(s):  
Tagore Sunkara ◽  
Megan E Caughey ◽  
Priyanka Makkar ◽  
Febin John ◽  
Vinaya Gaduputi
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Adenosquamous Carcinoma ◽  
Colorectal Cancers ◽  
Men And Women ◽  
Carcinoma Of The Colon ◽  
The Third

Overall, colorectal cancer is the third most commonly diagnosed cancer in both men and women, meaning that it is one of the more widely recognized preventable cancers. Instances of colorectal malignancies though are overwhelmingly attributable to adenocarcinoma. Colorectal cancers with components of squamous cell carcinoma represent a statistical anomaly. Here, we present the case of a 50-year-old male, who complained of abdominal pain and weight loss over a 3-month period of time. Biopsies from a colonoscopy ultimately revealed that this patient’s colon cancer consisted of both adenocarcinoma and squamous cell carcinoma, representing a truly exceptional pathology finding in a patient diagnosed with a colorectal cancer.

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