Latest & greatest articles for colorectal cancer

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Top results for colorectal cancer

1061. Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. (Abstract)

Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. BACKGROUND & AIMS: We conducted a study to estimate population coverage and detection rate (DR) achievable through different strategies of colorectal cancer (CRC) screening. METHODS: A population-based multicenter randomized trial comparing 3 strategies was used: (1) biennial immunologic fecal occult blood test (FIT), (2) "once only" sigmoidoscopy (FS), and (3) "once only (...) participation rate at TC as at FS, 48 TCs would be necessary to detect 1 additional advanced neoplasm missed by FS. CONCLUSIONS: When participants are offered 1 screening test, participation is lower in a TC than in an FS program. However, DR of advanced neoplasia is higher with TC.

2007 EvidenceUpdates Controlled trial quality: uncertain

1062. Aspirin and the risk of colorectal cancer in relation to the expression of COX-2. (Abstract)

Aspirin and the risk of colorectal cancer in relation to the expression of COX-2. Regular use of aspirin reduces the risk of a colorectal neoplasm, but the mechanism by which aspirin affects carcinogenesis in the colon is not well understood.We estimated cyclooxygenase-2 (COX-2) expression by immunohistochemical assay of sections from paraffin-embedded colorectal-cancer specimens from two large cohorts of participants who provided data on aspirin use from a questionnaire every 2 years. We (...) applied Cox regression to a competing-risks analysis to compare the effects of aspirin use on the relative risk of colorectal cancer in relation to the expression of COX-2 in the tumor.During 2,446,431 person-years of follow-up of 82,911 women and 47,363 men, we found 636 incident colorectal cancers that were accessible for determination of COX-2 expression. Of the tumors, 423 (67%) had moderate or strong COX-2 expression. The effect of aspirin use differed significantly in relation to COX-2

2007 NEJM

1063. Gastrointestinal stromal tumour. (Abstract)

Gastrointestinal stromal tumour. Gastrointestinal stromal tumours are the most common mesenchymal neoplasm of the gastrointestinal tract and are highly resistant to conventional chemotherapy and radiotherapy. Such tumours usually have activating mutations in either KIT (75-80%) or PDGFRA (5-10%), two closely related receptor tyrosine kinases. These mutations lead to ligand-independent activation and signal transduction mediated by constitutively activated KIT or PDGFRA. Targeting (...) these activated proteins with imatinib mesylate, a small-molecule kinase inhibitor, has proven useful in the treatment of recurrent or metastatic gastrointestinal stromal tumours and is now being tested as an adjuvant or neoadjuvant. However, resistance to imatinib is a growing problem and other targeted therapeutics such as sunitinib are available. The important interplay between the molecular genetics of gastrontestinal stromal tumour and responses to targeted therapeutics serves as a model for the study

2007 Lancet

1064. A 68-year-old man with COPD contemplating colon cancer surgery. (Abstract)

A 68-year-old man with COPD contemplating colon cancer surgery. Mr A is a 68-year-old man with a history of melena who was found to have a mass in his colon that was suspicious for possible malignancy. His 75-pack-year smoking history has resulted in a chronic daily cough and the diagnosis of chronic obstructive pulmonary disease. On physical examination, he has wheezes, decreased breath sounds, and a prolonged expiratory phase; his forced expiratory volume in the first second (FEV1) is 1.34 L (...) (47% predicted). Mr A needs surgery for potentially curative treatment for presumed colon cancer, but he is understandably worried about the effect of his lung disease on his surgical risk. In particular, he is worried that he may not be able to be weaned off the ventilator after surgery. This discussion reviews the important patient- and procedure-related risk factors for pulmonary complications after surgery, the role of preoperative testing, and the evidence supporting strategies to reduce

2007 JAMA

1065. Routine aspirin or nonsteroidal anti-inflammatory drugs for the primary prevention of colorectal cancer: U.S. Preventive Services Task Force recommendation statement. (Abstract)

Routine aspirin or nonsteroidal anti-inflammatory drugs for the primary prevention of colorectal cancer: U.S. Preventive Services Task Force recommendation statement. This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendation and supporting scientific evidence on routine use of aspirin or nonsteroidal anti-inflammatory drugs for the primary prevention of colorectal cancer. The complete information on which this statement is based, including evidence tables

2007 Annals of Internal Medicine

1066. A quantitative immunochemical fecal occult blood test for colorectal neoplasia. (Abstract)

A quantitative immunochemical fecal occult blood test for colorectal neoplasia. Guaiac-based fecal occult blood tests (FOBTs) for colorectal cancer screening are not specific for human hemoglobin and have low sensitivity. Automated-development, immunochemical FOBT is quality-controlled, is specific for human hemoglobin, and does not require diet restriction.To measure the sensitivity and specificity of quantitative immunochemical fecal hemoglobin measurements for detection of cancer (...) and volunteered to prepare immunochemical FOBTs.The hemoglobin content of 3 bowel movements was measured, and the highest value was compared with colonoscopy findings.Sensitivity, specificity, predictive values, likelihood ratios, and 95% CIs of fecal hemoglobin measurements for clinically significant neoplasia, their relationship to the amount of fecal hemoglobin measured, and the number of immunochemical FOBTs performed.Colonoscopy identified clinically significant neoplasia in 91 patients (cancer in 17

2007 Annals of Internal Medicine

1067. Bevacizumab and cetuximab for the treatment of metastatic colorectal cancer (TA118)

Bevacizumab and cetuximab for the treatment of metastatic colorectal cancer (TA118) Overview | Bevacizumab and cetuximab for the treatment of metastatic colorectal cancer | Guidance | NICE Bevacizumab and cetuximab for the treatment of metastatic colorectal cancer Technology appraisal guidance [TA118] Published date: 24 January 2007 Last updated: 01 January 2012 Share Guidance on bevacizumab (Avastin) and cetuximab (Erbitux) for treating metastatic colorectal cancer in adults. This guidance has

2007 National Institute for Health and Clinical Excellence - Technology Appraisals

1068. Guidelines for the Management of Colorectal Cancer

polyps of the small intestine, colon and rectum, in association with muco- cutaneous pigmentation . The risk of colorectal cancer is 10-20% (Tomlinson et al 1997 III). In 20-63% of cases, inactivating mutations can be identified in the gene STK11(LKB1), but there is evidence for genetic heterogeneity (Boardman et al 2000 IIb). Large bowel surveillance by colonoscopy or flexible sigmoidoscopy with barium enema is recommended 3 yearly from age 18 years. Recommendation grade C Juvenile Polyposis (...) patients with colon or rectal cancer should have pre-operative staging by CT scan to determine the local extent of the disease and the presence of lung or liver metastases. Patients with rectal cancer should also have MRI scans of the pelvis to stage the tumour and assess involvement of adjacent organs. Endorectal ultrasound scanning should be performed to assess T1 rectal cancers when local excision is being considered. (p19) B v) People with a greatly elevated personal risk of gastrointestinal

2007 Association of Coloproctology of Great Britain and Ireland

1069. Sequential versus combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer (CAIRO): a phase III randomised controlled trial. (Abstract)

Sequential versus combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer (CAIRO): a phase III randomised controlled trial. The optimum use of cytotoxic drugs for advanced colorectal cancer has not been defined. Our aim was to investigate whether combination treatment is better than sequential administration of the same drugs in patients with advanced colorectal cancer.We randomly assigned 820 patients with advanced colorectal cancer to receive (...) not differ significantly between the two groups, except for grade 3 hand-foot syndrome, which occurred more often with sequential treatment than with combination treatment (13%vs 7%; p=0.004).Combination treatment does not significantly improve overall survival compared with the sequential use of cytotoxic drugs in advanced colorectal cancer. Thus sequential treatment remains a valid option for patients with advanced colorectal cancer.

2007 Lancet Controlled trial quality: predicted high

1070. Different strategies of sequential and combination chemotherapy for patients with poor prognosis advanced colorectal cancer (MRC FOCUS): a randomised controlled trial. (Abstract)

Different strategies of sequential and combination chemotherapy for patients with poor prognosis advanced colorectal cancer (MRC FOCUS): a randomised controlled trial. In the non-curative setting, the sequence in which anticancer agents are used, singly or in combination, may be important if patients are to receive the maximum period of disease control with the minimum of adverse effects. We compared sequential and combination chemotherapy strategies in patients with unpretreated advanced (...) or metastatic colorectal cancer, who were regarded as not potentially curable irrespective of response.We studied patients with advanced colorectal cancer, starting treatment with non-curative intent. 2135 unpretreated patients were randomly assigned to three treatment strategies in the ratio 1:1:1. Strategy A (control group) was single-agent fluorouracil (given with levofolinate over 48 h every 2 weeks) until failure, then single-agent irinotecan. Strategy B was fluorouracil until failure, then combination

2007 Lancet Controlled trial quality: uncertain

1071. Rofecoxib and cardiovascular adverse events in adjuvant treatment of colorectal cancer. Full Text available with Trip Pro

Rofecoxib and cardiovascular adverse events in adjuvant treatment of colorectal cancer. Selective cyclooxygenase inhibitors may retard the progression of cancer, but they have enhanced thrombotic potential. We report on cardiovascular adverse events in patients receiving rofecoxib to reduce rates of recurrence of colorectal cancer.All serious adverse events that were cardiovascular thrombotic events were reviewed in 2434 patients with stage II or III colorectal cancer participating (...) in a randomized, placebo-controlled trial of rofecoxib, 25 mg daily, started after potentially curative tumor resection and chemotherapy or radiotherapy as indicated. The trial was terminated prematurely owing to worldwide withdrawal of rofecoxib. To examine possible persistent risks, we examined cardiovascular thrombotic events reported up to 24 months after the trial was closed.The median duration of active treatment was 7.4 months. The 1167 patients receiving rofecoxib and the 1160 patients receiving

2007 NEJM Controlled trial quality: predicted high

1072. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. (Abstract)

Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. The aim of the QUASAR trial was to determine the size and duration of any survival benefit from adjuvant chemotherapy for patients with colorectal cancer at low risk of recurrence, for whom the indication for such treatment is unclear.After apparently curative resections of colon or rectal cancer, 3239 patients (2963 [91%] with stage II [node negative] disease, 2291 [71%] with colon cancer, median (...) significantly by tumour site, stage, sex, age, or chemotherapy schedule. Eight (0.5%) patients in the chemotherapy group and four (0.25%) in the observation group died from non-colorectal cancer causes within 30 weeks of randomisation; only one of these deaths was deemed to be possibly chemotherapy related.Chemotherapy with fluorouracil and folinic acid could improve survival of patients with stage II colorectal cancer, although the absolute improvements are small: assuming 5-year mortality without

2007 Lancet Controlled trial quality: predicted high

1073. Cost-effectiveness analysis of oxaliplatin compared with 5-fluorouracil/leucovorin in adjuvant treatment of stage III colon cancer in the US

Cost-effectiveness analysis of oxaliplatin compared with 5-fluorouracil/leucovorin in adjuvant treatment of stage III colon cancer in the US Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2007 NHS Economic Evaluation Database.

1074. An economic evaluation of oxaliplatin for the adjuvant treatment of colon cancer in the United Kingdom (UK)

An economic evaluation of oxaliplatin for the adjuvant treatment of colon cancer in the United Kingdom (UK) Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2007 NHS Economic Evaluation Database.

1075. The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force

interest Rostom A, Dube C, Lewin G, Tsertsvadze A, Barrowman N, Code C. et al. Use of aspirin and NSAIDs to prevent colorectal cancer. Evidence Synthesis. Rockville (MD): Agency for Healthcare Research and Quality; 2007. Report No.: 45. Indexing Status Subject indexing assigned by NLM MeSH Adenoma /prevention & Adult; Anti-Inflammatory Agents, Non-Steroidal /adverse effects /therapeutic use; Aspirin /adverse effects /therapeutic use; Cardiovascular Diseases /chemically induced; Colonic Polyps (...) /prevention & Colorectal Neoplasms /epidemiology /mortality /prevention & Female; Gastrointestinal Diseases /chemically induced; Humans; Incidence; Male; Primary Prevention; United States /epidemiology; control; control; control AccessionNumber 12007008089 Date bibliographic record published 30/09/2007 Date abstract record published 30/09/2007 Record Status This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary

2007 DARE.

1076. Nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force

Paper URL Other publications of related interest Rostom A, Dube C, Lewin G, Tsertsvadze A, Barrowman N, Code C, et al. Use of aspirin and NSAIDs to prevent colorectal cancer. Evidence Synthesis. Rockville (MD): Agency for Healthcare Research and Quality; 2007. Report No.: 45. Indexing Status Subject indexing assigned by NLM MeSH Adenoma /prevention & Adult; Anti-Inflammatory Agents, Non-Steroidal /adverse effects /therapeutic use; Cardiovascular Diseases /chemically induced; Colonic Polyps (...) /prevention & Colorectal Neoplasms /epidemiology /mortality /prevention & Cyclooxygenase 2 Inhibitors /adverse effects /therapeutic use; Female; Gastrointestinal Diseases /chemically induced; Humans; Incidence; Male; Primary Prevention; United States /epidemiology; control; control; control AccessionNumber 12007008088 Date bibliographic record published 31/10/2007 Date abstract record published 31/10/2007 Record Status This is a critical abstract of a systematic review that meets the criteria

2007 DARE.

1077. Hereditary nonpolyposis colorectal cancer: diagnostic strategies and their implications

Proteins /genetics; Colorectal Neoplasms, Hereditary Nonpolyposis /diagnosis /genetics; DNA Mismatch Repair; DNA Mutational Analysis; DNA-Binding Proteins /genetics; Gene Expression Regulation, Neoplastic; Genetic Predisposition to Disease; Genetic Screening; Germ-Line Mutation; Immunohistochemistry; MutS Homolog 2 Protein; Neoplasm Proteins /genetics; Nuclear Proteins; Proto-Oncogene Proteins /genetics; Risk Factors AccessionNumber 12007008450 Date bibliographic record published 13/12/2007 Date (...) selection Studies of analytical or clinical validity were required to assess biological material from patients with colorectal cancer at risk for HNPCC and to provide data suitable for extraction into 2×2 tables. Studies were required to report one of the following: proportion of tumours that were high microsatellite instability (MSI-H) with National Cancer Institute (NCI) markers versus other markers; the sensitivity or specificity of MSI-H using NCI markers compared with a reference standard

2007 DARE.

1078. Comparison of colonic stenting and open surgery for malignant large bowel obstruction

Comparison of colonic stenting and open surgery for malignant large bowel obstruction Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2007 DARE.

1079. Systematic evaluation of surgical strategies for acute malignant left-sided colonic obstruction

strategies for acute malignant left-sided colonic obstruction. British Journal of Surgery 2007; 94(12): 1451-1460 PubMedID DOI Indexing Status Subject indexing assigned by NLM MeSH Colectomy /methods /mortality; Colonic Neoplasms /mortality /surgery; Decompression, Surgical /methods /mortality; Humans; Intestinal Obstruction /mortality /surgery; Randomized Controlled Trials as Topic; Stents AccessionNumber 12008103239 Date bibliographic record published 01/09/2008 Date abstract record published 02/03 (...) Systematic evaluation of surgical strategies for acute malignant left-sided colonic obstruction Systematic evaluation of surgical strategies for acute malignant left-sided colonic obstruction Systematic evaluation of surgical strategies for acute malignant left-sided colonic obstruction Breitenstein S, Rickenbacher A, Berdajs D, Puhan M, Clavien P A, Demartines N CRD summary This review aimed to provide guidance on the treatment options for acute left-sided colorectal obstruction. The authors

2007 DARE.

1080. Laparoscopic surgery for colon cancer: a systematic review

Laparoscopic surgery for colon cancer: a systematic review Laparoscopic surgery for colon cancer: a systematic review Laparoscopic surgery for colon cancer: a systematic review Kahnamoui K, Cadeddu M, Farrokhyar F, Anvari M CRD summary This review aimed to show that laparoscopic-assisted colorectal resection for cancer is not inferior to open resection in terms of cancer survival and peri-operative outcomes. The authors concluded that laparoscopic resection appears equally safe and effective (...) in the review Studies that compared laparoscopic-assisted colorectal resection with open or conventional resection were eligible. The interventions in the included studies were right and left hemicolectomy, sigmoid resection, anterior resection and abdominoperineal resection. Participants included in the review Studies of adults aged over 16 years with documented colorectal cancer were eligible for inclusion. The participants in the included studies had colon cancer and/or rectal cancer. The mean age

2007 DARE.