Selected Articles from This Issue

Abstract

During the COVID-19 pandemic, many colorectal cancer-related procedures were suspended, with unclear implications for colorectal cancer mortality. In this study, van den Puttelaar and colleagues used observed data and simulation modeling to estimate the impact on colorectal cancer outcomes, clinical resources, and associated tradeoffs, for longer versus shorter recovery periods to catch up procedures. The authors estimate that the disruptions may cause 4,200 to 14,400 excess colorectal cancer deaths in the US in the next 20 years, depending on the assumed extent of disruption, length of recovery period, and resources used. These estimates may help inform strategies to mitigate the broader impact of the COVID-19 pandemic or future crises.Christopher and colleagues used a data-driven approach to identify exercise trajectories over the adult life course and examined how these trajectories were associated with colon cancer risk within the NIH-AARP Diet and Health Study. Adults maintaining moderate-to-high amounts of exercise consistently throughout adulthood had a lower risk of colon cancer. Being inactive early in adulthood but increasing exercise participation by midlife was also suggestive of a lower risk. These findings are aligned with the current physical activity recommendations and add new evidence that promoting physical activity at all stages of the adult life course is needed for population-based colon cancer prevention.Few empirical data are available for older adults on the absolute risk of colorectal cancer and its associated mortality in the context of prior screening. Dalmat and colleagues address this evidence gap with estimates from a large population of screen-eligible adults ages 76 to 85 years who had a negative colonoscopy ten years ago. Estimates of cumulative incidence and mortality were 1.29% (95% CI: 1.02–1.61%) and 0.46% (95% CI: 0.30–0.70%), respectively, in eight years following screening eligibility date, after accounting for competing risk of death from another cause. Patients were approximately 90 times more likely to die from another cause than colorectal cancer, which may be an important context for older adults’ decision making.Nicotine metabolism significantly influences nicotine dependence. The goal of this study, by Perez-Paramo and colleagues, was to examine the impact of genetic variants in nicotine metabolizing enzyme genes on urinary levels of nicotine metabolites. Functional deficiency of cytochrome P450 2A6 caused multiple changes in nicotine metabolites in smokers’ urine. Genetic polymorphisms in multiple functional metabolizing enzyme genes showed a significant impact on urinary levels of many nicotine metabolites. These data suggest that multiple genes in several pathways are involved in the metabolism of nicotine, which may influence nicotine dependence and smoking behavior.