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Latest & greatest articles for colorectal cancer
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Familial colorectalcancer risk in half siblings and siblings: nationwide cohort study. To explore the risk of colorectalcancer in family members of patients with colorectalcancer, with an emphasis on subtypes of second degree relatives, especially half siblings, which were lacking in the literature.Ambidirectional cohort study.Nationwide Swedish Family Cancer Data (record linkage).All people residing in Sweden and born after 1931, with their biological parents, totalling >16 million (...) individuals (follow-up: 1958-2015); of those with clear genealogy, 173 796 developed colorectal cancer.Lifetime (0-79 years) cumulative risk and standardised incidence ratio of colorectalcancer among first degree relatives and second degree relatives.The overall lifetime cumulative risk of colorectalcancer in siblings of patients was 7%, which represents a 1.7-fold (95% confidence interval 1.6 to 1.7; n=2089) increase over the risk in those without any family history of colorectalcancer. A similarly
Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for ColorectalCancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(23):2564-2575. . Centers for Disease Control and Prevention. National Health Interview Survey. Available at: . Published March 1, 2014. Accessed June 21, 2018. .National Cancer Institute. SEER Cancer Statistics Fact sheets: Colon and Rectum Cancer. Available at: .Published September, 2014. Accessed June 21, 2018 (...) will continue to improve, and blood tests for CRC are in development. Research and one blood test, Epi pro Colon, was approved by the FDA in 2016. However, it is not currently recommended by the USPSTF. As this area of research develops, it is important that physicians remain aware of all the currently available USPTSF-approved screening modalities. “One size fits all” may not be the most effective cancer screening approach for all patients. Studies have shown that colonoscopy may be avoided by large
, SMAD4, BMPR1A, MLH1, MSH2, MSH6, PMS2, STK11, GREM1, MUTYH, and EPCAM* [*deletions associated with epigenetic silencing of MSH2]. Generally for the gastrointestinal (GI) cancer predisposition genes, those testing positive require close surveillance with colonoscopy to detect the rapidly growing cancers which occur driven by, for example, the mutator phenotype (accumulating hundreds of mutations in the tumours) typically of Lynch Syndrome. Those who do develop colorectalcancer are usually advised (...) this rearrangement. 3. Summary of consideration and rationale for MSAC’s advice MSAC noted that the proposed purposes and populations are (a) diagnostic testing of patients with either (i) colorectal or endometrial carcinoma and features suggestive of a hereditary basis, or (ii) a colonic polyposis syndrome, plus (b) cascade testing of relatives of those individuals who are diagnosed with the relevant germline gene variants. The diagnostic genetic test is to characterise germline gene variants in three or more
Making Patients Fit for Surgery: Introducing a Four Pillar Multimodal Prehabilitation Program in ColorectalCancer. Considering the relation between preoperative functional capacity and postoperative complications, enhancing patients' functional capacity before surgery with a prehabilitation program may facilitate faster recovery and improve quality of life. However, time before surgery is short, mandating a multimodal and high-intensity training approach. This study investigated feasibility (...) for colorectalcancer patients is feasible, safe, and effective. A randomized controlled trial (NTR5947) was initiated to determine whether prehabilitation may lower morbidity and mortality rates in colorectal surgery.
Adjuvant Chemotherapy of Locally Advanced ColonCancer: Final Results of a Randomized Trial Comparing 5-Fluorouracil and Folinic Acid with Folfiri. There is still the need to optimize adjuvant treatment of coloncancer (CC). Standard adjuvant chemotherapy using 5-fluorouracil (FU) and folinic acid (FA) was compared with a combination including irinotecan (Folfiri). The aim of the present report was to analyze overall survival (OS) after long-term follow-up, to summarize final recurrence rates (...) in 17 (12.8%) patients treated with FUFA and in 50 (36.8%) patients treated with Folfiri. Recurrences occurred in 46 of 133 (34.6%) and in 47 of 136 (34.6%) patients who received FUFA and Folfiri, respectively. 5-year OS rates were 69.9% (95% confidence interval (CI): 61.2-77.1) for FUFA and 72.7% (95% CI: 63.9-79.8) for Folfiri. OS was associated with tumor grading (1 & 2 vs. 3), tumor sub-stage (II vs. IIIa vs. IIIb vs. IIIc), and tumor location (left vs. right colon).Folfiri cannot be generally
Sequential Versus Combination Therapy of Metastatic ColorectalCancer Using Fluoropyrimidines, Irinotecan, and Bevacizumab: A Randomized, Controlled Study-XELAVIRI (AIO KRK0110) The XELAVIRI trial investigated the optimal treatment strategy for patients with untreated metastatic colorectalcancer. We tested the noninferiority of initial treatment with a fluoropyrimidine plus bevacizumab, followed by the addition of irinotecan at first progression (arm A) versus upfront use of fluoropyrimidine (...) of 421 randomly assigned patients (arm A: n = 212; arm B: n = 209) formed the full analysis set. Median age was 71 and 69 years, respectively. Noninferiority of TFS was not shown (hazard ratio [HR], 0.86; 90% CI, 0.73 to 1.02). In detail, patients with RAS/BRAF wild-type tumors benefitted from combination chemotherapy (HR, 0.61; 90% CI, 0.46 to 0.82; P = .005), whereas patients with RAS mutant tumors (HR, 1.09; 90% CI, 0.81 to 1.46; P = .58) did not (Cox model for interaction of study arm and RAS
Mortality From Postscreening (Interval) ColorectalCancers Is Comparable to That From Cancer in Unscreened Patients-A Randomized Sigmoidoscopy Trial Endoscopic screening for colorectalcancer (CRC) is performed at longer time intervals than the fecal occult blood test or screenings for breast or prostate cancer. This causes concerns about interval cancers, which have been proposed to progress more rapidly. We compared outcomes of patients with interval CRCs after sigmoidoscopy screening vs (...) diagnosed with CRC 30 days or longer after screening (interval cancer group, n = 163) and individuals diagnosed with CRC in the nonscreened group (controls, n = 1740). All CRCs in the control group were identified when they developed symptoms (clinically detected CRCs). Analyses were stratified by cancer site. We used Cox regression to estimate hazard ratio (HRs), adjusted for age and sex.Over the follow-up period, 43 individuals in the interval cancer group died from CRC; among controls, 525 died from
Colon capsule endoscopy (CCE-2) for the detection of colorectal polyps and cancer in adults with signs or symptoms of colorectalcancer or at increased risk of colorectalcancer SHTG Advice Statement | 1 Advice Statement 014-18 November 2018 Advice Statement Colon capsule endoscopy (CCE-2) for the detection of colorectal polyps and cancer in adults with signs or symptoms of colorectalcancer or at increased risk of colorectalcancer Advice for NHSScotland Colon capsule endoscopy (CCE-2 (...) ) is not recommended for routine use in NHSScotland for the detection of colorectal polyps and cancer. The clinical effectiveness evidence is currently limited, no relevant published evidence on the cost effectiveness of the technology was identified, and its place in the patient care pathway has still to be established. CCE-2 may however be considered as an additional testing option in patients who are able to undergo the intensive bowel cleansing needed for CCE-2 and who have contraindications for optical
with papillary thyroid cancer that is the cribriform-morular variant, or hepatoblastoma Individuals with a diagnosis of CRC and>10 colorectal adenomas Individuals with a personal history of20 adenomas Individuals with multiple gastrointestinal hamartomatous polyps or serrated polyposis syndrome Individuals from a family with a known hereditary syndrome associated with CRC with or without a known mutation Individuals with a desmoid tumor, multifocal or bilateral CHRPE CHRPE, congenital hypertrophy of retinal (...) of CRC or advanced adenoma warrants more intense screening for CRC. Well-designed prospective studies are needed in order to make de?nitive evidence-based recommendations about the age to commence screening and appropriate interval between screening tests. Keywords: Adenoma; Cancer; Colonoscopy; Colorectal; FOBT; Neoplasms; Polyp; Screening. Executive Summary Colorectalcancer (CRC) is the second leading cause of cancer deaths in Canada and the United States. A positive family history (FH) signi
) in children and adults? Clinical Bottom Line Incidental findings on dental radiographs could serve as screening tools for systemic diseases and syndromes. The attention should be raised when gene mutation, congenitally diseases or familial colorectalcancer are reported by patients during the medical history questionnaire. For patients with risk of FAP, the Dental panoramic radiographic score (DPRS) is inexpensive, and reinforce the referral for the further clinical investigation, gene mapping (...) . Perspective: These studies emphasize the extra-intestinal manifestations of colorectalcancer. The dental anomalies, commonly considered incidental findings, appear around 10 years before the clinical evidence of the intestinal polyps and the dental professional should be aware of these correlations. Since the gene mutation affects families, it is important to early detect, refer and map genetically these patients reducing the morbidity. The colorectalcancer is considered a public health issue, FAP
Efficacy and Tolerability of First-Line Cetuximab Plus Leucovorin, Fluorouracil, and Oxaliplatin (FOLFOX-4) Versus FOLFOX-4 in Patients With RAS Wild-Type Metastatic ColorectalCancer: The Open-Label, Randomized, Phase III TAILOR Trial Cetuximab in combination with chemotherapy is a standard-of-care first-line treatment regimen for patients with RAS wild-type (wt) metastatic colorectalcancer (mCRC); however, the efficacy of cetuximab plus leucovorin, fluorouracil, and oxaliplatin (FOLFOX) has
Bevacizumab (Mvasi) - Metastatic ColorectalCancer (mCRC) or Locally Advanced, Metastatic or Recurrent Non-small Cell Lung Cancer (NSCLC) Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product
–170. 8. Novelli M, Rossi S, Rodriguez-Justo M et al. DOG1 and CD117 are the antibodies of choice in the diagnosis of gastrointestinal stromal tumours. Histopathology 2010; 57: 259–270. 9. Gasparotto D, Rossi S, Polano M et al. Quadruple-negative GIST is a sen- tinel for unrecognized neuro?bromatosis type 1 syndrome. Clin Cancer Res 2017; 23: 273–282. 10. Brierley JD, Gospodarowicz MK, Wittekind C. (eds). TNM Classi?cation of MalignantTumours, 8th edn. Oxford: John Wiley & Sons, Inc. 2016. 11 (...) imatinib for high- risk GI stromal tumor: analysis of a randomized trial. J Clin Oncol 2016; 34: 244–250. 17. Dematteo RP, Ballman KV, Antonescu CR et al. Adjuvant imatinib mesy- late after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial. Lancet 2009; 373: 1097–1104. 18. Gronchi A, Judson I, Nishida T et al. Adjuvant treatment of GIST with imatinib: solid ground or still quicksand? A comment on behalf of the EORTC Soft Tissue
subtype of squamous-cell carcinoma, adenocarcinoma, or adenosquamous carcinoma, we randomly assigned patients to undergo minimally invasive surgery or open surgery. The primary outcome was the rate of disease-free survival at 4.5 years, with noninferiority claimed if the lower boundary of the two-sided 95% confidence interval of the between-group difference (minimally invasive surgery minus open surgery) was greater than -7.2 percentage points (i.e., closer to zero).A total of 319 patients were (...) , body-mass index, stage of disease, lymphovascular invasion, and lymph-node involvement; minimally invasive surgery was also associated with a lower rate of overall survival (3-year rate, 93.8% vs. 99.0%; hazard ratio for death from any cause, 6.00; 95% CI, 1.77 to 20.30).In this trial, minimally invasive radical hysterectomy was associated with lower rates of disease-free survival and overall survival than open abdominal radical hysterectomy among women with early-stage cervical cancer. (Funded
Updated 5-year survival and exploratory T x N subset analyses of ACTS-CC trial: a randomised controlled trial of S-1 versus tegafur-uracil/leucovorin as adjuvant chemotherapy for stage III coloncancer Adjuvant Chemotherapy Trial of TS-1 for ColonCancer (ACTS-CC), a randomised phase III trial, demonstrated that adjuvant therapy with S-1 for stage III coloncancer was non-inferior in 3-year disease-free survival (DFS) to that of tegafur-uracil plus leucovorin (UFT/LV). We updated DFS (...) and overall survival (OS) and performed T x N subset analysis.A total of 1518 patients with curatively resected stage III coloncancer were randomly assigned to receive S-1 (80-120 mg/day on days 1-28 every 42 days, four courses) or UFT/LV (UFT: 300-600 mg/day and LV: 75 mg/day on days 1-28 every 35 days, five courses).The 5-year DFS rates of the S-1 and UFT/LV group were 70.2 % and 66.9 %, respectively (HR 0.88; 95% CI 0.74 to 1.06; p=0.177), and non-inferiority of DFS was reconfirmed with a median
Can nut consumption improve coloncancer survival? 30363796 2018 11 14 2415-1289 3 2018 Translational gastroenterology and hepatology Transl Gastroenterol Hepatol Can nut consumption improve coloncancer survival? 73 10.21037/tgh.2018.09.14 Aune Dagfinn D Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. Department of Nutrition, Bjørknes University College, Oslo, Norway. Department of Endocrinology, Morbid Obesity and Preventive Medicine
Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal tumours in the digestive tract. The duodenal GIST (dGIST) is the rarest subtype, representing only 4-5% of all GIST, but up to 21% of the resected ones. The diagnostic and therapeutic management of dGIST may be difficult due to the rarity of this tumor, its anatomical location, and the clinical behavior that often mimic a variety (...) patients with dGIST: twenty-seven patients were treated with pancreatoduodenectomy and ninety-six with only local resection (segmental/wedge resections); in four hundred twenty-six patients it is not possible identify the type of treatment performed (pancreatoduodenectomy or segmental/wedge resections).dGISTs are a very rare subset of GISTs. They may be asymptomatic or may involve symptoms of upper GI bleeding and abdominal pain at presentation. Because of the misleading clinical presentation
Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on ColorectalCancer Detection: A Community-Based Cohort Study. The fecal immunochemical test (FIT) is commonly used for colorectalcancer (CRC) screening. Despite demographic variations in stool hemoglobin concentrations, few data exist regarding optimal positivity thresholds by age and sex.To identify programmatic (multitest) FIT performance characteristics and optimal FIT quantitative hemoglobin positivity (...) thresholds in a large, population-based, screening program.Retrospective cohort study.Kaiser Permanente Northern and Southern California.Adults aged 50 to 75 years who were eligible for screening and had baseline quantitative FIT results (2013 to 2014) and 2 years of follow-up. Nearly two thirds (411 241) had FIT screening in the previous 2 years.FIT programmatic sensitivity for CRC and number of positive test results per cancer case detected, overall and by age and sex.Of 640 859 persons who completed
Recent advances in colorectalcancer screening 30276360 2018 11 14 2589-0514 4 3 2018 Sep Chronic diseases and translational medicine Chronic Dis Transl Med Recent advances in colorectalcancer screening. 139-147 10.1016/j.cdtm.2018.08.004 Li Dan D Department of Gastroenterology, Kaiser Permanente Medical Center, Santa Clara, CA 95051, USA. Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA. eng Editorial 2018 09 17 China Chronic Dis Transl Med 101679934 2095 (...) -882X Colonoscopy Colorectalcancer Screening 2018 06 26 2018 10 3 6 0 2018 10 3 6 0 2018 10 3 6 1 epublish 30276360 10.1016/j.cdtm.2018.08.004 S2095-882X(18)30060-4 PMC6160607 Lancet. 2013 Apr 6;381(9873):1185-93 23414648 Am J Surg Pathol. 2004 Nov;28(11):1452-9 15489648 Gastroenterology. 2016 Nov;151(5):870-878.e3 27443823 CA Cancer J Clin. 2017 May 6;67(3):177-193 28248415 Gastroenterology. 2015 Sep;149(3):777-82; quiz e16-7 26226577 Am J Gastroenterol. 2012 Sep;107(9):1315-29; quiz 1314, 1330