Early Detection Of Colorectal Cancer Research Articles

Assessing Awareness of Colorectal Cancer Symptoms among Outpatients: A Cross-Sectional Study at a Hospital in Vietnam

Colorectal cancer (CRC) is a prevalent cancer globally, including in Vietnam where its incidence is rapidly increasing. The aim of this study was to evaluate the awareness of signs, symptoms, and risk factors of colorectal cancer among outpatients at Hoa Hao Medic Company Limited, Ho Chi Minh City, Vietnam. A cross-sectional study was conducted, and a total of 441 people who visited Hoa Hao Medic Company Limited for a general health check-up and voluntarily agreed to participate in this study were recruited through the convenience sampling method. Data were collected through face-to-face structured interviews using the Bowel CAM questionnaire. According to the results, the highest percentage of well-recalled warning signs were “change in bowel habit” (36.7%) followed by abdominal pain (35.4%). Other warning signs such as weight loss and rectal bleeding were reported by 19.0% and 18.1% of participants, respectively. Over 42% of participants stated that they were unaware of any signs or symptoms. The most commonly identified risk factors for CRC were pollution (66.9%), genetics (50.6%), and an unhealthy/poor diet (53.7%) for unprompted questions. The overall awareness score of participants was 3.46/9 (SD ± 2.91) for signs and symptoms of CRC and 5.90/10 (SD ± 1.62) for risk factors. Univariate linear regression identified education level and occupation as predictors of higher CRC awareness. In conclusion, this study highlights that overall awareness of CRC is low among outpatients at Hoa Hao Medic Company Limited. Strategies to increase awareness, knowledge, and education programs are necessary to promote early detection of CRC and reduce its burden in Vietnam.

Association Study of IGF-1 rs35767 and rs6214 Gene Polymorphisms with Cancer Susceptibility and Circulating Levels of IGF-1, IGFBP-2, and IGFBP-3 in Colorectal Cancer Patients.

Early detection of colorectal cancer (CRC) increases the 5-year survival rate by 90%; therefore, non-invasive biomarkers such as measurable circulating proteins for early detection and prognosis are crucial. Insulin-like growth factor-1 (IGF-1) is involved in the regulation of cell proliferation and apoptosis. IGF binding proteins (IGFBPs) bind and inhibit the activity of IGF-1. It was inconsistently reported that high IGF-1 and IGFBP-2 and low IGFBP-3 circulating levels are associated with high cancer risk, poor prognosis, and tumor metastasis in several cancers. A total of 175 patients with CRC and 429 controls were enrolled in this study. We genotyped for IGF-1 rs35767 and rs6214 gene polymorphisms and assessed their association with circulating levels of IGF-1 and/or the risk for CRC. We also determined plasma levels of IGF-1, IGFBP-2, and IGFBP-3. Neither rs35767 nor rs2614 were associated with cancer risk or IGF-1 levels in our study cohort. IGF-1 and IGFBP-3 levels were higher in controls than in patients, whereas IGFBP-2 was higher in patients than in controls. Only IGFBP-2 was associated with increased tumor grade but not stage. Therefore, IGF-1, IGFBP-2, and IGFBP-3 may be useful as early detection and prognostic biomarkers in CRC.

Profiling the metabolic disorder and detection of colorectal cancer based on targeted amino acids metabolomics

BackgroundThe morbidity of cancer keeps growing worldwide, and among that, the colorectal cancer (CRC) has jumped to third. Existing early screening tests for CRC are limited. The aim of this study was to develop a diagnostic strategy for CRC by plasma metabolomics.MethodsA targeted amino acids metabolomics method was developed to quantify 32 plasma amino acids in 130 CRC patients and 216 healthy volunteers, to identify potential biomarkers for CRC, and an independent sample cohort comprising 116 CRC subjects, 33 precancerosiss patients and 195 healthy volunteers was further used to validate the diagnostic model. Amino acids-related genes were retrieved from Gene Expression Omnibus and Molecular Signatures Database and analyzed.ResultsThree were chosen out of the 32 plasma amino acids examined. The tryptophan / sarcosine / glutamic acid -based receiver operating characteristic (ROC) curve showed the area under the curve (AUC) of 0.955 (specificity 83.3% and sensitivity 96.8%) for all participants, and the logistic regression model were used to distinguish between early stage (I and II) of CRC and precancerosiss patients, which showed superiority to the commonly used carcinoembryonic antigen. The GO and KEGG enrichment analysis proved many alterations in amino acids metabolic pathways in tumorigenesis.ConclusionThis altered plasma amino acid profile could effectively distinguish CRC patients from precancerosiss patients and healthy volunteers with high accuracy. Prognostic tests based on the tryptophan/sarcosine/glutamic acid biomarkers in the large population could assess the clinical significance of CRC early detection and intervention.Graphical

Role of Primary Healthcare Physicians in Early Detection of Colorectal Cancer in Al-Ahsa, Saudi Arabia

Role of Primary Healthcare Physicians in Early Detection of Colorectal Cancer in Al-Ahsa, Saudi Arabia

The Diagnostic Value of Stool-Based MicroRNA-135b in the Early Detection of Colorectal Cancer and the Potent Neuro Function of MiR-146a

Background: Detecting microRNA (miRNA) in stool is a non-invasive approach for colorectal cancer (CRC) screening. This study aims to assess the diagnostic performance of stool-based microRNA-135b in detection of colorectal cancer and the role of miR-146a. Methods: To identify eligible studies that are well suited for diagnostic value of miR-135b in stool of colorectal cancer patients, we have evaluated 3 papers after systematic literature search of public database. The sensitivity and specificity were used to plot the summary receiver operator characteristic (SROC) curve and calculate the area under the SROC curve (AUC). The between-study heterogeneity was evaluated by Q test and I2 statistics. Importantly, we have also identified microRNA (miRNA) gene expression patterns by expression profiling. Moreover, we execute the pathway analysis to find the function of miR-146a. Results: A total of 3 studies from 19 articles were included for the meta-analysis according to the inclusion criteria. The overall analysis showed that microRNA-135b has a relatively good diagnostic performance in colorectal cancer, with a sensitivity of 0.685, a specificity of 0.813 and a partial AUC of 0.658. In stool samples, level of microRNA-135b was 2.21 fold change higher in subjects with CRC (P < 0.0001). Moreover, our study proved that miR-146a involved in the neuro and immune function. Interpretation: In conclusion, stool-based microRNA-135b shows a moderate level of overall diagnostic accuracy in diagnosis of CRC, which may present as auxiliary means for the diagnosis of colorectal cancer compare with colonoscopy. Further large-scale prospective studies are necessary to validate their potential applicability (miR-135b and miR-146a) combined with FBT methods in human cancer diagnosis.

623P Advances in methylation analysis of liquid biopsy in early cancer detection of colorectal and lung cancer

623P Advances in methylation analysis of liquid biopsy in early cancer detection of colorectal and lung cancer

Analysing the colorectal cancer screening patterns during the COVID-19 pandemic and their effects on patient outcomes.

40 Background: In Canada, colorectal cancer (CRC) ranks as the third most prevalent cancer and second leading cause of cancer mortality (1). The potential to prevent a significant proportion of colorectal cancers and associated mortality through effective screening is widely acknowledged (Han-Mo Chiu, 2021). Notably, fecal immunohistochemistry testing (FIT) has led to improved early detection of CRC (2). However, FIT screening was suspended in Canada in the initial phase of the COVID-19 pandemic response. Specifically, in Ontario, the collection of FIT samples was suspended between March 23rd, 2020 and August 26th, 2020 (3). During this 3-month period, an estimated 540,000 Canadians would have participated in screening, as indicated by OncoSim, a microsimulation model for cancer (4). The primary objective was to evaluate the consequences of screening cessation, through comparison of asymptomatic and symptomatic CRC diagnoses at the Windsor Regional Cancer Centre in Windsor, Ontario. Methods: A retrospective chart review was performed for patients admitted to the Windsor Regional Cancer Centre of Windsor Regional Hospital between December 2016 and June 2021. Demographic data, risk factors for CRC, cancer operability status, and the presence of symptoms at diagnosis of CRC were recorded. Results: 771 patient charts were reviewed and 77 (10%) were excluded due to duplication or insufficient chart data. Of the remaining 694 patients, 545 (79%) were classified as the pre-COVID group (December 2016 to February 2020) and 149 (21%) as the COVID group (March 2020 to June 2021). We found a 2.5% increase in symptomatic diagnoses of CRC in patients diagnosed after March 2020 (pre-COVID group vs. COVID group). However, we did not observe a significant difference in proportion of inoperable CRC cases between groups. Conclusions: The observed trend of symptomatic diagnoses of CRC underscores the importance of FIT screening for early CRC detection and the need for increased catch-up screening to mitigate the potential risks and mortality associated with CRC screening interruptions. For this, it is presumed that a population of patients exists who would have tested positive through FIT screening but instead presented symptomatically at a later stage of the disease. It is also important to note that our study data did not extend beyond June 2021, so we could not capture the complete impact of FIT cessation. (1) Canadian Cancer Statistics, 2021. (2) Zauber, 2015. (3) Ontario Health, 2021. (4) StatCan, 2021.

Impact of Various Risk Factors on the Positive Fecal Immunochemical Test for Colorectal Cancer in the Iranian Population.

Background: Colorectal cancer (CRC) is the most prevalent cancer with high mortality worldwide. We aimed to evaluate the incidence of CRC based on the positive fecal immunochemical test (FIT) result in the Iranian population. Methods: The present study was conducted on the health assessment data recorded in the SINA (Integrated Health Information System) in 2018 and 2019 from individuals who had participated in the national program, including asymptomatic people aged 50-69 years or had risk factors of CRC such as family or past personal history of CRC as well as symptomatic individuals, for the early detection and prevention of CRC in Mashhad, Iran. Results: The study participants included 140,463 eligible individuals, of whom 8258 (5.88%) and 145 (2.21%) were positive for FIT and diagnosed with colon cancer, respectively. Unfortunately, only 654 people had undergone colonoscopy. Our results indicated that age, fast food intake (≥two units per day), family history of CRC in first or second-degree relatives, some gastrointestinal diseases such as inflammatory bowel disease (IBD) and CRC, as well as bleeding per anus, constipation, abdominal cramp, and losing body weight were associated with increased risk of positive FIT. However, some other factors, including having a hard job, physical activity, and Iranian nationality (compared to non-Iranians), were associated with a low risk of positive FIT screening tests for CRC. Conclusion: A high number of high-risk persons in Mashhad were positive for the FIT test in 2018-2019, and many of them were diagnosed with CRC, according to the colonoscopy results. Therefore, screening is highly recommended as the first step in the early detection of CRC.

Breaking Down Barriers to Detection and Care in Early-Age-Onset Colorectal Cancer in Canada.

The second Early-Age-Onset Colorectal Cancer Symposium, convened in October 2022, sought solutions to the barriers to early detection and care for colorectal cancer in Canada. This meeting built on a previous symposium, held in 2021 and reported in this journal. Early-age-onset colorectal cancer (EAOCRC) affects increasing numbers of people under the age of 50 in Canada and throughout the developed world. Two main themes emerged from the meeting: the importance of timely detection, and the need for a tailored approach to the care of EAOCRC. Early detection is crucial, especially in light of the later stage at diagnosis and unique tumour characteristics. Symposium participants were strongly in favour of reducing the age of eligibility for screening from 50 to 45, and promoting the development of non-invasive screening techniques such as testing for circulating tumour DNA and biomarkers. Leading approaches to care were described and discussed, which meet the unique treatment needs of younger CRC patients. Multidisciplinary practices within and outside Canada address such factors as fertility, family roles, education, careers and financial responsibilities. These models can be applied in treatment centres across the country.

Current Status and Emerging Trends in Colorectal Cancer Screening and Diagnostics.

Colorectal cancer (CRC) is a prevalent and potentially fatal disease categorized based on its high incidences and mortality rates, which raised the need for effective diagnostic strategies for the early detection and management of CRC. While there are several conventional cancer diagnostics available, they have certain limitations that hinder their effectiveness. Significant research efforts are currently being dedicated to elucidating novel methodologies that aim at comprehending the intricate molecular mechanism that underlies CRC. Recently, microfluidic diagnostics have emerged as a pivotal solution, offering non-invasive approaches to real-time monitoring of disease progression and treatment response. Microfluidic devices enable the integration of multiple sample preparation steps into a single platform, which speeds up processing and improves sensitivity. Such advancements in diagnostic technologies hold immense promise for revolutionizing the field of CRC diagnosis and enabling efficient detection and monitoring strategies. This article elucidates several of the latest developments in microfluidic technology for CRC diagnostics. In addition to the advancements in microfluidic technology for CRC diagnostics, the integration of artificial intelligence (AI) holds great promise for further enhancing diagnostic capabilities. Advancements in microfluidic systems and AI-driven approaches can revolutionize colorectal cancer diagnostics, offering accurate, efficient, and personalized strategies to improve patient outcomes and transform cancer management.

Orthogonal Surface‐Enhanced Raman Scattering/Field‐Effect Transistor Detection of Breast and Colorectal Cancer‐Derived Exosomes using Graphene as a Tag‐Free Diagnostic Template

Cancer is one of the leading causes of high mortality worldwide, affecting most of the body organs including the breast and colon. Triple‐negative breast (TNBC) and colorectal cancers (CRC) usually present the poorest clinical outcomes and lowest disease‐free survival rates among the different cancer types. Novel biomarkers for early detection of TNBC and CRC have been proposed throughout the years, although the rate of success remains limited. Herein, a dual method for detection of cancer‐derived exosomes based on the measurement of the Raman spectra in graphene field‐effect transistors (GFETs) is proposed, thereby obtaining electrical signal metrics related to the variation of the Dirac point in graphene and optical features corresponding to representative bio‐molecular cancer structures in an orthogonal way. This pioneering method and classification routine can potentially be extended to other types of cancer, thus creating a unique and universal tag‐free diagnostic template for early cancer diagnostics.

An innovative PCR-free approach for DNA methylation measure: An application for early colorectal cancer detection by means of an organic biosensor

Colorectal cancer (CRC) is one of the most treatable cancers, but high mortality levels have been reported as a result of its asymptomatic nature in the very early stages of the disease. This justifies the importance of mass screening programs to fight colorectal cancer, and thus the interest in the development of minimally invasive, cost-effective tests. In this paper, a novel approach for the detection of CRC biomarkers in DNA stool samples is reported. The strategy is based on the detection of DNA methylation alterations as highly sensitive and selective epigenetic biomarkers by means of an organic transistor-based sensor, particularly suited for the integration in portable, low-cost and easy-to-use sensing system. A clear demonstration of the detection strategy effectiveness is provided using a standard CRC biomarker, namely SEPT9 (encoding for septin9), and further deepened using an innovative biomarker, GRIA4 (encoding for glutamate ionotropic receptor AMPA type subunit 4), in several samples coming from CRC patients. The correct detection of biomarkers, as confirmed by independent optical analysis, is demonstrated both on amplicons and unamplified genomic DNA derived from stool samples, thus making the proposed approach particularly attractive for the future development of non-invasive, PCR-free and low-cost mass screening tests.

Serum methylation of GALNT9, UPF3A, WARS, and LDB2 as noninvasive biomarkers for the early detection of colorectal cancer and advanced adenomas

BackgroundEarly detection has proven to be the most effective strategy to reduce the incidence and mortality of colorectal cancer (CRC). Nevertheless, most current screening programs suffer from low participation rates. A blood test may improve both the adherence to screening and the selection to colonoscopy. In this study, we conducted a serum-based discovery and validation of cfDNA methylation biomarkers for CRC screening in a multicenter cohort of 433 serum samples including healthy controls, benign pathologies, advanced adenomas (AA), and CRC.ResultsFirst, we performed an epigenome-wide methylation analysis with the MethylationEPIC array using a sample pooling approach, followed by a robust prioritization of candidate biomarkers for the detection of advanced neoplasia (AN: AA and CRC). Then, candidate biomarkers were validated by pyrosequencing in independent individual cfDNA samples. We report GALNT9, UPF3A, WARS, and LDB2 as new noninvasive biomarkers for the early detection of AN. The combination of GALNT9/UPF3A by logistic regression discriminated AN with 78.8% sensitivity and 100% specificity, outperforming the commonly used fecal immunochemical test and the methylated SEPT9 blood test.ConclusionsOverall, this study highlights the utility of cfDNA methylation for CRC screening. Our results suggest that the combination methylated GALNT9/UPF3A has the potential to serve as a highly specific and sensitive blood-based test for screening and early detection of CRC.

S380 The Economic Impact of a Blood-Based Glycoproteomic Test for Early Detection of Colorectal Cancer

S380 The Economic Impact of a Blood-Based Glycoproteomic Test for Early Detection of Colorectal Cancer

583P A rapid blood test for the earlier detection of colorectal cancer

583P A rapid blood test for the earlier detection of colorectal cancer

S355 Targeting the Sugar Code: Serum Glycoproteome Profiling for Early Detection of Advanced Adenoma and Colorectal Cancer

S355 Targeting the Sugar Code: Serum Glycoproteome Profiling for Early Detection of Advanced Adenoma and Colorectal Cancer

MicroRNAs and colorectal cancer: clinical potential and regulatory networks.

Colorectal cancer (CRC) is a serious global health concern, with a high incidence and mortality rate. Although there have been advancements in the early detection and treatment of CRC, therapy resistance is common. MicroRNAs (miRNAs), a type of small non-coding RNA that regulates gene expression, are key players in the initiation and progression of CRC. Recently, there has been growing attention to the complex interplay of miRNAs in cancer development. miRNAs are powerful RNA molecules that regulate gene expression and have been implicated in various physiological and pathological processes, including carcinogenesis. By identifying current challenges and limitations of treatment strategies and suggesting future research directions, this review aims to contribute to ongoing efforts to enhance CRC diagnosis and treatment. It also provides a comprehensive overview of the role miRNAs play in CRC carcinogenesis and explores the potential of miRNA-based therapies as a treatment option. Importantly, this review highlights the exciting potential of targeted modulation of miRNA function as a therapeutic approach for CRC.

Comparative detection of syndecan-2 methylation in preoperative and postoperative stool DNA in patients with colorectal cancer.

Early detection of colorectal cancer (CRC) is essential to reduce cancer-related morbidity and mortality. Stool DNA (sDNA) testing is an emerging method for early CRC detection. Syndecan-2 (SDC2) methylation is a potential biomarker for the sDNA testing. Aberrant DNA methylation is an early epigenetic event during tumorigenesis and can occur in the normal colonic mucosa during aging, which can compromise the sDNA test results. To determine whether methylated SDC2 in sDNA normalizes after surgical resection of CRC. In this prospective study, we enrolled 151 patients with CRC who underwent curative surgical resection between September 2016 and May 2020. Preoperative stool samples were collected from 123 patients and postoperative samples were collected from 122 patients. A total of 104 samples were collected from both preoperative and postoperative patients. Aberrant promoter methylation of SDC2 in sDNA was assessed using linear target enrichment quantitative methylation-specific real-time polymerase chain reaction. Clinicopathological parameters were analyzed using the results of SDC2 methylation. Detection rates of SDC2 methylation in the preoperative and postoperative stool samples were 88.6% and 19.7%, respectively. Large tumor size (3 cm, P = 0.019) and advanced T stage (T3-T4, P = 0.033) were positively associated with the detection rate of SDC2 methylation before surgery. Female sex was associated with false positives after surgery (P = 0.030). Cycle threshold (CT) values were significantly decreased postoperatively compared with preoperative values (P < 0.001). The postoperative negative conversion rate for preoperatively methylated SDC2 was 79.3% (73/92). Our results suggested that the SDC2 methylation test for sDNA has acceptable sensitivity and specificity. However, small size and early T stage tumors are associated with a low detection rate of SDC2 methylation. As the cycle threshold values significantly decreased after surgery, SDC2 methylation test for sDNA might have a diagnostic value for CRC.

B-382 Accurate and Early Detection of Colorectal Cancer Using a Multilocus DNA Methylation Markers-based Testing in Peripheral Blood Mononuclear Cells

Abstract Background An effective blood-based method for the diagnosis of colorectal cancer (CRC) has not yet been developed. Molecular alterations of immune cells occur early in tumorigenesis, providing the theoretical underpinning for early cancer diagnosis. Therefore, we aimed to develop an effective multi-molecular simultaneous detection method based on peripheral blood mononuclear cells (PBMCs) to improve the diagnosis of early-stage CRC. Methods Candidate DNA methylation markers were first identified from PBMCs using the Infinium MethylationEPIC array in the discovery phase (Shandong cohort I, n = 100) and further validated via pyrosequencing and targeted bisulfite sequencing in validation phase (Shandong cohort II, n = 202). Then, a single-tube multiplex methylation-specific quantitative PCR assay (multi-msqPCR) for simultaneous detection of five markers was established in a pilot study. After that, a CRC prediction model (CPM) based on DNA methylation and multi-msqPCR method was construct and its diagnostic performance were evaluated using the area under the receiver operating characteristic curve (AUROC) in our multicenter cohort (n = 595). Results Five discriminative DNA methylation markers identified by Illumina 850K microarray were successfully validated to diagnose early-stage CRC. Multi-msqPCR showed a better discriminative performance and 10-time lower detection limit than single-molecule detection in early-stage CRC. The cross-validated AUROC for CPM for early-stage CRC was 0.91 (sensitivity = 81.18%; specificity = 89.39%), significantly higher than CEA (AUROC = 0.62). CPM assay also yielded a high degree of discrimination for advanced adenoma (AA) cases (AUROC = 0.85; sensitivity = 63.04%; specificity = 89.39%). Besides, detecting CPM in multiple cancer types implied a CRC-specific diagnostic value. Our follow-up data also demonstrated that CPM could detect early-stage CRC up to 2 years before current traditional diagnostic methods. Conclusions CPM, in combination with epigenetic biomarkers and the multi-msqPCR method, was promising, cost-effective, and easily implementable for routine clinical diagnosis of early-stage CRC.

Lubiprostone plus polyethylene glycol electrolyte lavage solution (PEG-ELS) versus PEG-ELS for bowel preparation in chronic constipation: a randomized controlled trial

Colonoscopy is considered the standard procedure for early detection and prevention of colorectal cancer. Adequate bowel cleansing is an important determinant of the efficacy of colonoscopy screening. Currently, there is no standard method of bowel preparation for patients with chronic constipation. The aim was to access the rate of adequate bowel cleansing achieved using split-dose polyethylene glycol electrolyte lavage solution (PEG-ELS) plus lubiprostone in comparison with split-dose PEG-ELS alone. A single-centre, endoscopist-blinded, randomized controlled trial was conducted. Seventy-eight constipated patients aged 18–75 years who were indicated for colonoscopy in the gastroenterology unit of Srinagarind Hospital, Khon Kaen University, between February 2020 and February 2021 were randomly allocated to receive either split-dose PEG-ELS in combination with lubiprostone (N = 39) or split-dose PEG-ELS alone (N = 39) before colonoscopy. Adequate bowel cleansing was defined as an Ottawa bowel preparation score ≤ 7. The rate of adequate bowel cleansing was comparable between the PEG-ELS plus lubiprostone group and the PEG-ELS alone group (50% vs. 52.9%, p value = 0.81) with a relative risk of 1.13 (95% CI = 0.43–2.91). There were no significant differences in adenoma detection rate (41.2% vs. 35.3%, p value = 0.62), adverse events, acceptance, compliance, or patient satisfaction between the 2 groups. No additional benefit to successful bowel preparation was achieved by the combination of lubiprostone and PEG-ELS in chronic constipation patients undergoing colonoscopy.