Assessment of Perception, Awareness about Predictors of Colorectal Cancer of Hail Region Saudi Arabia population

Colorectal cancer is one of the major malignancies world-wide, accounting for approximately 20% of incident cases. The incidence and mortality have dramatically increased over the past 10th decades in Saudi Arabia. It has been argued that the change in epidemiological pattern is due to the implementation of a way of life style, characterized by use of junk foods and lack somatic exercise. The pharmacokinetics (PK) and pharmacodyn amics (PD) of various drug are also under study for Colon cancer patients. It is remarkable that a lack of routine exercise or activity is supplementary evident for GIT cancer than any other cancer combined. Obesity has been reported to be associated with increased risk of colorectal cancer, and closely associated with the level of physical activity in this study the effect of sociodemographic factor on biochemical aspects of Cancer is further analyzed. Aim of this study is to determine the awareness and perception of Colorectal cancer in Saudi Arabia and to find out the dietary habits and use of fiber diet among them in order to identify the subpopulation that can be recipients of awareness and screening programs. About 317 subjects was selected after taking written consent on a detailed prescribed questionnaire. Sociodemographic data and information about dietary habits was collected along with biophysical data. All information and the obtained results were analyzed by using SPSS 23. Results: Most of the respondents (51% and 71.9%) knew what is colon and its function. About 11.7%, 62.1% and 22.1% respectively answer high, moderate and low incidence of CRC in Saudi Arabia while 66.9% knew that bowel cancer is 90% curable if detected early. 42% respondent shoed that that there is a an association between IBD and CRC and 75% know the correct time of screening for CRC. Very few respondents know the correct symptoms, risks factors, and screening modalities of Colorectal cancer. Mass media and books are most common method to know about colorectal cancer. Conclusions: Most of the respondent have enough knowledge about CRC although Screening awareness and modalities for screening of CRC need to be further acknowledged. Although they have enough awareness about CRC still most of the study population showed unhealthy life style and few of them use fiber diets and Vegetables and fruits as daily ingredient.

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Are Volatile Organic Compounds Accurate Markers in the Assessment of Colorectal Cancer and Inflammatory Bowel Diseases? A Review

Cancers ◽

10.3390/cancers13102361 ◽

2021 ◽

Vol 13 (10) ◽

pp. 2361

Author(s):

Filippo Vernia ◽

Marco Valvano ◽

Stefano Fabiani ◽

Gianpiero Stefanelli ◽

Salvatore Longo ◽

...

Keyword(s):

Colorectal Cancer ◽

Volatile Organic Compounds ◽

Organic Compounds ◽

Inflammatory Bowel Diseases ◽

Screening Programs ◽

Inflammatory Status ◽

Incidence And Mortality ◽

Volatile Organic ◽

Bowel Diseases ◽

Inflammatory Bowel

Colorectal cancer (CRC) is one of the leading causes of cancer-related death in the Western world. Early detection decreases incidence and mortality. Screening programs based on fecal occult blood testing help identify patients requiring endoscopic examination, but accuracy is far from optimal. Among the alternative strategies, volatile organic compounds (VOCs) represent novel potentially useful biomarkers of colorectal cancer. They also represent a promising tool for the screening of both intestinal inflammation and related CRC. The review is focused on the diagnostic potential of VOCs in sporadic CRC and in inflammatory bowel diseases (IBD), which increase the risk of CRC, analyzing future clinical applications. Despite limitations related to inadequate strength of evidence, differing analytical platforms identify different VOCs, and this unconventional approach for diagnosing colorectal cancer is promising. Some VOC profiles, besides identifying inflammation, seem disease-specific in inflammatory bowel diseases. Thus, breath, urine, and fecal VOCs provide a new and promising clinical approach to differential diagnosis, evaluation of the inflammatory status, and possibly the assessment of treatment efficacy in IBD. Conversely, specific VOC patterns correlating inflammatory bowel disease and cancer risk are still lacking, and studies focused on this issue are strongly encouraged. No prospective studies have assessed the risk of CRC development by using VOCs in samples collected before the onset of disease, both in the general population and in patients with IBD.

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Colorectal Cancer in Young and Older Adults in Uruguay: Changes in Recent Incidence and Mortality Trends

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158232 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8232

Author(s):

Carina Musetti ◽

Mariela Garau ◽

Rafael Alonso ◽

Marion Piñeros ◽

Isabelle Soerjomataram ◽

...

Keyword(s):

Colorectal Cancer ◽

Older Adults ◽

Cancer Incidence ◽

Age Groups ◽

Incidence Rates ◽

Mortality Trends ◽

Screening Programs ◽

Lifestyle Risk Factors ◽

Incidence And Mortality ◽

Colorectal Cancer Incidence

Uruguay has the highest colorectal cancer incidence rates in Latin America. Previous studies reported a stable incidence and a slight increase in mortality among males. We aimed to assess colorectal cancer incidence (2002–2017) and mortality trends (1990–2017) by age groups and sex, using data from the National Cancer Registry. Annual percent changes (APCs) were estimated using joinpoint regression models. We included 27,561 colorectal cancer cases and 25,403 deaths. We found an increasing incidence among both males and females aged 40–49, with annual increases of 3.1% (95%CI: 1.21–5.03) and 2.1% (95%CI: 0.49–3.66), respectively, and an increasein the rate in older males (70+) of 0.60% (95%CI: 0.02–1.20) per year between 2002 and 2017. Mortality remained stable among those younger than 50, whereas it decreased for older females aged 50–69 and 70+ (APC: −0.61% (−1.07–0.14) and −0.68% (−1.02–0.34), respectively), and increased for the oldest males (70+; APC: 0.74 (0.47–1.01)). In conclusion, we found rising colorectal cancer incidence accompanied by stable mortality in young adults. Sex disparities were also found among the older adults, with a more favorable pattern for females. Exposures to dietary and lifestyle risk factors, and inequalities in access to and awareness of screening programs, are probably among the main underlying causes and deserve further investigation.

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Molecular Screening for Hereditary Nonpolyposis Colorectal Cancer: A Prospective, Population-Based Study

Journal of Clinical Oncology ◽

10.1200/jco.2001.19.19.3944 ◽

2001 ◽

Vol 19 (19) ◽

pp. 3944-3950 ◽

Cited By ~ 73

Author(s):

Antonio Percesepe ◽

Francesca Borghi ◽

Mirco Menigatti ◽

Lorena Losi ◽

Moira Foroni ◽

...

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Germline Mutation ◽

Hereditary Nonpolyposis Colorectal Cancer ◽

Germline Mutations ◽

Screening Programs ◽

High Incidence ◽

Hereditary Nonpolyposis ◽

Incident Cases ◽

High Incidence Area

PURPOSE: Germline mutations in mismatch repair genes predispose to hereditary nonpolyposis colorectal cancer (HNPCC). To address effective screening programs, the true incidence of the disease must be known. Previous clinical investigations reported estimates ranging between 0.5% and 13% of all the colorectal cancer (CRC) cases, whereas biomolecular studies in Finland found an incidence of 2% to 2.7% of mutation carriers for the disease. The aim of the present report is to establish the frequency of the disease in a high-incidence area for colon cancer. PATIENTS AND METHODS: Through the data of the local CRC registry, we prospectively collected all cases of CRC from January 1, 1996, through December 31, 1997 (N = 391). Three hundred thirty-six CRC cases (85.9% of the incident cases) were screened for microsatellite instability (MSI) with six to 12 mono- and dinucleotide markers. MSI cases were subjected to MSH2 and MLH1 germline mutation analysis and immunohistochemistry; the methylation of the promoter region was studied for MLH1. RESULTS: Twenty-eight cases (8.3% of the total) showed MSI. MSI cases differed significantly from microsatellite-stable (MSS) cases for their proximal location (P < .01), high mucinous component (P < .01), and poor differentiation (P = .002). Of MSI cases studied (n = 12), only one with a family history compatible with HNPCC had a germline mutation (in MSH2). Five other patients with a family history of HNPCC (two with MSI and three with MSS tumors) did not show germline mutations. CONCLUSION: We conclude that the incidence of molecularly confirmed HNPCC (one [0.3%] of 336) in a high-incidence area for CRC is lower than in previous biomolecular and clinical estimates.

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Insulin enhances and metformin reduces risk of colorectal carcinoma in type-2 diabetes

QJM ◽

10.1093/qjmed/hcz253 ◽

2019 ◽

Author(s):

C-H Chen ◽

C-L Lin ◽

C-Y Hsu ◽

C-H Kao

Keyword(s):

Colorectal Cancer ◽

Type 2 Diabetes ◽

Cohort Study ◽

Dietary Habits ◽

Occult Blood ◽

Population Based ◽

Study Cohort ◽

Urbanization Level ◽

Increased Risk

Abstract Background Identifying colorectal cancer associated risks is important for conducting a program for the survey and prevention of colorectal cancer. Aim To investigate the association between use of insulin or metformin with colorectal cancer (CRC) in type 2 diabetes (T2DM). Design Population-based cohort study. Methods Through analysis of National Health Insurance (NHI) database between 1998 and 2010 in Taiwan, we identified 66 324 T2DM patients aged ≥ 20 years and selected subjects without diabetes by 1: 1 randomly matching with the study cohort based on age, sex and index date. We followed up the participants until 31 December 2011 or when they withdrew from the NHI program. Results Compared with non-diabetic subjects, the T2DM patients exhibited an increased risk of CRC [adjusted HR (aHR) = 1.56, 95% confidence interval (CI) = 1.39–1.75], after adjustment for age, sex, urbanization level, comorbidities and examinations of colonoscopy, sigmoidoscopy, or stool occult blood test. Among the T2DM patients, insulin usage increased the risk of CRC (aHR = 1.86, 95% CI = 1.58–0–2.19) after adjustment for age, sex, urbanization level, comorbidities, metformin usage and examinations; nevertheless, metformin decreased the risk of CRC (aHR = 0.65, 95% CI = 0.54–0.77) after adjustment for age, sex, urbanization level, comorbidities, insulin usage and examinations. Compared with the non-insulin cohort, the risk of CRC tended to increase with the incremental dosage of insulin exposure. Conclusion Our population-based cohort study demonstrated an association between T2DM and CRC. Among the T2DM patients, insulin use was associated with an increased risk of CRC and metformin use was associated with a decreased risk of CRC. Inability to obtain information on several potential confounding factors, such as lifestyle and dietary habits, is the major limitation of the study.

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Colorectal cancer screening and prevention—pros and cons

memo - Magazine of European Medical Oncology ◽

10.1007/s12254-019-00520-z ◽

2019 ◽

Vol 12 (3) ◽

pp. 239-243 ◽

Cited By ~ 2

Author(s):

Markus Niederreiter ◽

Lukas Niederreiter ◽

Andreas Schmiderer ◽

Herbert Tilg ◽

Angela Djanani

Keyword(s):

Colorectal Cancer ◽

Short Review ◽

Premalignant Lesions ◽

Screening Programs ◽

Randomized Controlled ◽

Randomized Controlled Studies ◽

Incidence And Mortality ◽

Screening Strategies ◽

Pros And Cons ◽

Screening Procedures

Summary Colorectal cancer (CRC) is one of the most frequent cancer entities worldwide and a leading cause of death. The disease is known to develop from potentially curable, premalignant lesions over several years and therefore is suitable for screening procedures and preventive measures. Several trials have demonstrated reduced incidence and mortality in screening cohorts. A multitude of different screening strategies for CRC have been implemented in different parts of the world. While randomized controlled studies directly comparing screening procedures are still ongoing, colonoscopy remains the gold standard for screening and the only procedure that allows to effectively prevent CRC by treating premalignant lesions. However, population-wide participation rates vary greatly but often only reach approximately 25%. Noninvasive screening strategies are indispensable to increase acceptance rates and for resource-limited regions with limited capacity for colonoscopy. Importantly, while incidence of CRC increases with age, lately we have seen a raise in incidence for CRC in the population below 50 years of age, potentially requiring to include younger adults (e.g., 45 years of age) into established screening programs. It remains important to continue to gather data and evidence regarding effectiveness of various screening strategies, preferably in randomized controlled trials. This short review will outline currently established screening procedures and will discuss the pros and cons for each individual approach.

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Colonoscopy later than 270 days in a fecal immunochemical test-based population screening program is associated with higher prevalence of colorectal cancer

Endoscopy ◽

10.1055/a-1159-0644 ◽

2020 ◽

Vol 52 (10) ◽

pp. 871-876 ◽

Cited By ~ 2

Author(s):

Manuel Zorzi ◽

Cesare Hassan ◽

Giulia Capodaglio ◽

Maddalena Baracco ◽

Giulio Antonelli ◽

...

Keyword(s):

Colorectal Cancer ◽

High Risk ◽

Screening Program ◽

Waiting Times ◽

Multivariable Analysis ◽

Latex Agglutination ◽

Old Patients ◽

Screening Programs ◽

Increased Risk ◽

Immunochemical Test

Background Colorectal cancer (CRC) screening programs based on fecal immunochemical testing (FIT) generate substantial pressure on colonoscopy capacity in Europe. Thus, a relevant proportion of FIT-positive patients undergo colonoscopy after the recommended 30-day interval, which may be associated with an excess CRC risk. Methods In a cohort of 50–69-year-old patients undergoing biennial rounds of FIT (OC-Hemodia latex agglutination test; cutoff 20 µg hemoglobin/g feces) between 2004 and 2017, we assessed the outcome at colonoscopy (low/high risk adenoma/CRC/advanced stage CRC) among FIT-positive patients, according to different time intervals. The association of each outcome with waiting time, and demographic and clinical factors, was analyzed through multivariable analysis. Results 123 138/154 213 FIT-positive patients (79.8 %) underwent post-FIT colonoscopy. Time to colonoscopy was ≤ 30 days, 31–180 days, and ≥ 181 days in 50 406 (40.9 %), 71 724 (58.3 %), and 1008 (0.8 %) patients, respectively. At colonoscopy, CRC, high risk adenoma, and low risk adenoma were diagnosed in 4813 (3.9 %), 30 500 (24.8 %), and 22 986 (18.7 %) patients, respectively. An increased CRC prevalence at colonoscopy was observed for a time to colonoscopy of ≥ 270 days (odds ratio [OR] 1.75, 95 % confidence interval [CI] 1.15–2.67), whereas it was stable for waiting times of < 180 days. The proportion of advanced CRC also increased after 270 days (OR 2.79, 95 %CI 1.03–7.57). No increase for low or high risk adenomas according to time to colonoscopy was observed. Conclusion In a European FIT-based screening program, post-FIT colonoscopy after 9 months was associated with an increased risk of CRC and CRC progression.

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Trends in the incidence and mortality of colorectal cancer in a brazilian city

BMC Research Notes ◽

10.1186/s13104-020-05411-9 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Alex Rodrigues Moura ◽

Adriane Dórea Marques ◽

Mylena Santos Dantas ◽

Érika de Abreu Costa Brito ◽

Mariana do Rosário Souza ◽

...

Keyword(s):

Colorectal Cancer ◽

Geographical Distribution ◽

Geographic Distribution ◽

Joinpoint Regression ◽

Annual Percent Change ◽

Northeast Region ◽

Percent Change ◽

Incidence And Mortality ◽

Incident Cases ◽

The City

Abstract Objectives This study was conducted to analyze the trends in colorectal cancer (CRC) incidence and mortality in the city of Aracaju, Sergipe State, Brazil, between 1996 and 2015 with Joinpoint Regression Program 4.7.0.0 and to identify the geographical distribution of CRC in the municipality. Results A total of 1322 cases of CRC and 467 CRC-related deaths during the study period were included. In total, 40% of the incident cases and 43% of the deaths occurred in men, while 60% of the incident cases and 57% of the deaths occurred in women. Males who were 20 to 44 years old had the most significant trend in growth. Among women, those in the group aged 45 to 64 years had the highest observed annual percent change (APC). In both sexes, mortality was stable. Regarding the geographic distribution, there were constant hotspots in the northeast region of the municipality. This study showed a significant increase in incidence, mainly in young men between 20 and 44 years of age, but stable mortality in Aracaju.

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Comparing mortality of colorectal cancer and gastrointestinal bleeding among patients with long-term use of low dose aspirin: A population-based study of 689,209 patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.527 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 527-527

Author(s):

Joseph Sung ◽

Kelvin Kf Tsoi

Keyword(s):

Colorectal Cancer ◽

Gastrointestinal Bleeding ◽

Large Scale ◽

Low Dose ◽

Population Based ◽

Dose Aspirin ◽

Increased Risk ◽

Incidence And Mortality ◽

Low Dose Aspirin

527 Background: Aspirin, commonly used for prevention of cardiovascular and cerebrovascular diseases, is well-known to protect against colorectal cancer (CRC) development but increase risk of gastrointestinal bleeding (GIB). Few large-scale studies have compared the benefit and risk of long-term aspirin usage. This cohort study aims to evaluate the use of low-dose aspirin to prevent CRC and the risk of GIB associated with the aspirin use. Methods: A population-based clinical dataset was used to compare incidence and mortality of CRC and GIB patients receiving low-dose aspirin with sex-and-age matched controls (in 1:2 ratio). Patients with aspirin≤6 months were excluded. Clinical data of 206,243 aspirin users (mean dose 80 mg/day, mean duration 7.7 years) and 482,966 non-users were included. All patients must have at least 10-year follow up on clinical outcome. Results: Among aspirin users 5,776 (2.80%) were diagnosed with CRC; 2,097 (1.02%) died of the malignancy. 16,483 (3.41%) non-users were diagnosed with CRC; 7,963 (1.65%) died of CRC. Using the cox-proportional hazard regression, aspirin usage showed a modest but significant reduction in CRC mortality (HR = 0.65; 95% CI = 0.62 to 0.69). On the other hand, 11,187 (5.42%) aspirin users developed GIB, and 841 (0.41%) died. 15,186 (3.14%) non-users developed GIB, and 1,682 patients (0.35%) died. Aspirin users showed modest but significant increased risk of GIB-related mortality (HR = 1.24; 95% CI = 1.14 to 1.35). Conclusions: The long-term use of low dose aspirin shows preventive effect on CRC, but also increases the associated GIB risk. Considerations of prophylactic use of aspirin should balance the benefit and the risk of this treatment to the target population. [Table: see text]

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A VIEW ON THE PROBLEM OF INADEQUATE SCREENING OF COLORECTAL CANCER IN UKRAINE

Likarska sprava ◽

10.31640/jvd.3.2019(1) ◽

2019 ◽

pp. 3-5

Author(s):

Nelya Melnitchouk ◽

Galyna Shabat

Keyword(s):

Colorectal Cancer ◽

Clinical Symptoms ◽

Screening Program ◽

Early Stage ◽

Cancer Death ◽

Common Cause ◽

Screening Programs ◽

Incidence And Mortality ◽

National Organizations

The incidence of colorectal cancer (CRC) is increasing worldwide and it is the second most common cause of cancer death. There is a lot of investigations and improvement to rise quality of early diagnosis, successful treatment and effective preventions of colorectal cancer. Nowadays available few guidelines of international and national organizations what support effectiveness of screening programs. Colorectal cancer screening is effective way to decrease incidence and mortality with strong evidence confirmed by a lot of investigations of different scientific groups. Currently, Ukraine doesn’t have an established colorectal cancer program, what need to be changed as soon as possible. A lot of patients in Ukraine wait at home till the beginning of clinical symptoms, what often is the representation of later stage of diseases; and of course treatment of patients with later stage of diseases need more costs for treatment and show worst results of morbidity and mortality rate compare with patients treated at the early stage of diseases. We created a simulation Markov model and demonstrated that the implementation of the national screening program for colorectal cancer in Ukraine will be cost saving and will decrease the mortality from colorectal cancer significantly.

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Fecal Hemoglobin Concentrations and Personalized Screening for Colorectal Cancer

Journal of Global Oncology ◽

10.1200/jgo.18.85600 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 212s-212s

Author(s):

S.L.-S. Chen

Keyword(s):

Colorectal Cancer ◽

Risk Group ◽

Average Risk ◽

Hemoglobin F ◽

Screening Programs ◽

Crc Screening ◽

Screening Interval ◽

Pathologic Stage ◽

Increased Risk ◽

Hb Concentration

Background: Although cancer screening programs have been established in some Asian countries, resources are still insufficient to maintain high participation rates. The aim of this study was to assess whether any observed relationship persisted after adjusting for the pathologic stage of CRC to assess whether the increasing fecal hemoglobin (f-Hb) concentration on the risk of CRC death is partially explained by its intermediate influence on the pathologic stage of CRC and to propose the risk stratification by using f-Hb concentration for developing individual-tailored CRC screening. Methods: Over 1 million Taiwanese residents (n = 1,160,895) aged between 50 and 69 years participated in a biennial nationwide fecal immunochemical test (FIT) screening program between 2004 and 2009. The cohort was followed up over time to ascertain colorectal neoplasia and the causes of death until 2012. Cox regression model was operated to validate the definition of the surrogate end point such as tumor stage for the effect of f-Hb on CRC mortality and test the relationships between f-Hb in groups with increasing f-Hb and CRC mortality. The individual risk profiles based on f-Hb are proposed starting from average risk group to low risk and high risk group with biennial interscreening interval for risk prediction in advance colorectal cancer. Results: An incremental increase in both of baseline and updated f-Hb on the risk of advanced CRC cancer and CRC mortality were noted. A significant relationship was found between f-Hb and the risk for CRC mortality, increasing from a slightly increased risk for the category of f-Hb of 6 to 9 μg Hb/g (adjusted hazard ratio [HR] = 1.88; 95% CI, 1.41-2.50) to 33.04 (95% CI, 24.87-43.91) for the group with f-Hb ≥ 450 μg Hb/g as compared with the group with f-Hb of 1 to 5 ng Hb/mL (trend test, P < 0.001) at baseline after adjusting for age, gender. Taking 10-14 μg Hb/g (similar CRC mortality as general population) as standard, subjects with higher f-Hb at first screen should have a shorter interscreening interval with FIT. The screening interval could be altered to 1.5 year and 1 year for subjects with f-Hb of 15-19 μg Hb/g and f-Hb of 20-49 μg Hb/g, respectively. On the other hand, the interval between repeated FIT screens could be extended to avoid false positive cases for those with a lower f-Hb. The screening interval could be lengthened as 3 year for subjects with f-Hb of 6-9 μg Hb/g. Conclusion: We confirmed the direct relationship between f-Hb and colorectal cancer mortality, which is explained by the role of f-Hb as a surrogate for advanced CRC. Different interscreenings by different f-Hb concentrations are recommended. Individualized interscreening intervals by different f-Hb level or together with other factors could be further considered for personalized CRC screening.

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