Diagnosis Of Colorectal Cancer Research Articles

Gender and sex differences in colorectal cancer screening, diagnosis and treatment.

Males have a higher incidence and mortality rate from colorectal cancer (CRC) compared with females. This review examines the reasons for these differences, including risk factors, screening participation, interpretation of screening tests, presentation and tumour types, pathophysiology (particularly the impact of sex hormones on tumour-related gene expression, microsatellite instability, micro-RNA expression, and the tumour microenvironment), and the efficacy and toxicity of treatment. Sex differences in hormones and body composition are responsible for some of the sexual dimorphism in CRC incidence and outcomes, particularly the pathophysiology, CRC presentation, the pharmacokinetics of cytotoxic therapies, and the impact of treatment on outcomes. However, gender differences also play a role, affecting risk factors, access to or participation in screening and treatment, and patients' experience of treatment (e.g. adverse events and sequelae). Sex and gender issues warrant further investigation in CRC to optimise treatment outcomes for patients.

The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore

The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore

Fecal Microbiota Strongly Correlates with Tissue Microbiota Composition in Colorectal Cancer but Not in Non-Small Cell Lung Cancer

Microbiota could be of interest in the diagnosis of colorectal and non-small cell lung cancer (CRC and NSCLC). However, how the microbial components of tissues and feces reflect each other remains unknown. In this work, our main objective is to discover the degree of correlation between the composition of the tissue microbiota and that of the feces of patients affected by CRC and NSCLC. Specifically, we investigated tumor and non-tumor tissues from 38 recruited patients with CRC and 19 with NSCLC. DNA from samples was submitted for 16S rDNA metagenomic sequencing, followed by data analysis through the QIIME2 pipeline and further statistical processing with STATA IC16. Tumor and non-tumor tissue selected genera were highly correlated in both CRC and NSCLC (100% and 81.25%). Following this, we established tissue–feces correlations, using selected genera from a LEfSe analysis previously published. In CRC, we found a strong correlation between the taxa detected in feces and those from colorectal tissues. However, our data do not demonstrate this correlation in NSCLC. In conclusion, our findings strongly reinforce the utility of fecal microbiota as a non-invasive biomarker for CRC diagnosis, while highlighting critical distinctions for NSCLC. Furthermore, our data demonstrate that the microbiota components of tumor and non-tumor tissues are similar, with only minor differences being detected.

Gut Microbiome Profiles in Colorectal Cancer Patients in Iraq

Colorectal cancer (CRC) is the third most commonly diagnosed cancer globally, and is a significant contributor to both morbidity and mortality rates. Emerging research has promptly highlighted the potential role of the gut microbiome in the development and progression of CRC. This study aims to investigate the differences in gut microbiota between CRC patients and healthy individuals in Iraq, using 16S rRNA metagenomic sequencing on Illumina NovaSeq (PE250-Seq). A total of 21 stool samples were analyzed: 12 from early-stage CRC patients and nine from healthy controls. Bacterial DNA was extracted, followed by 16S rRNA amplicon sequencing to profile the microbial communities. The results indicated significant differences between the fecal microbiome of the two groups. Remarkably, CRC patients exhibited a marked reduction in Bacteroidota and an increase in Verrucomicrobiota compared to healthy controls. At the genus level, Prevotella, Faecalibacterium, Roseburia, Barnesiella, Eubacterium Lachnospiraceae_UCG_004, and Lachnospira were significantly less abundant in CRC patients compared to the healthy individuals, while Actinomyces, Monoglobus, Desulfovibrio, Akkermansia, and Bacteroides were highly enriched. In addition, diversity analyses further indicated decreased α-diversity and distinct β-diversity patterns in the CRC patients, suggesting significant shifts in the gut microbial composition. These findings underscore the potential of microbiome-based diagnostics and therapeutic strategies, with microbial alterations serving as biomarkers for CRC diagnosis. Further research needs to focus on elucidating the causal relationships and therapeutic potential of these microbiome changes in CRC management.

Expression level of miR-548aa in tissue samples of patients with colorectal cancer.

The pathogenesis of colorectal cancer (CRC) is influenced by various risk factors, and genetic alterations in progression of colon polyps. The expression patterns of microRNA-548 (miR-548) in colorectal tissues have been sufficiently characterized. The aim of this study is to clarify the role of miR-548aa in tumorigenesis, gene targeting, predictive value and its expression levels in tumoral versus adjacent marginal tissues in CRC patients. This study included 35 CRC patients who underwent surgery to remove their tumor tissue. Tumor samples and adjacent marginal tissue were collected and gene expression was analyzed through real-time PCR. The correlation between miR-548aa expression levels and clinical parameters were investigated. Our findings showed a significant increase in the expression of miR-548aa in tumoral tissues compared to marginal tissues (p < 0.05). The upregulation of miR-548aa was significantly detected in CRC samples, showing an area under the curve of 0.89 (p = 0.002), indicating strong sensitivity and specificity for CRC diagnosis. To prediction of miRNA target genes and construction of regulatory networks of miR-548aa, we used bioinformatics tools including TargetScan and miRDB. Protein-protein interaction (PPI) network was constructed through STRING database and visualized using Cytoscape software. Dysregulation of miR-548aa is closely related to tumorigenesis in colorectal tissues, which affects disease progression and clinical outcomes. The miR-548aa can be introduced as a proposed biomolecule involved in mechanism of tumorigenesis, gene targeting and predictive value for CRC diagnosis and a target for therapeutic intervention.

Characteristics, Treatment and Outcomes of Stage I to III Colorectal Cancer in Patients Aged over 80 Years Old

Background: Colorectal cancer primarily affects older adults and poses treatment challenges due to age-related comorbidities and frailty, which hinder surgical and chemotherapy options for many elderly patients. This study aims to analyze treatment and disease patterns in elderly colorectal cancer patients, aged over 80 years old, to inform personalized therapies that accommodate their unique clinical needs and improve their outcomes. Patients and Methods: The medical records of all patients aged 80 years old and above, and those aged 65 to 75 years old, who were diagnosed with colorectal cancer at a cancer center in Canada over a seven year period, were retrospectively reviewed. Results: No significant differences in the initial presentation, location, grade or stage at colorectal cancer diagnosis were observed between age groups. Patients aged 80 years old and above were less likely to receive neoadjuvant and adjuvant chemotherapy treatments for stage II disease (19.2% versus. 58.6%, p = 0.002; 7.9% versus. 40.0%, p = 0.002). There were also differences in the intensity of chemotherapy received and the frequency of dose reductions (76.0% vs. 10.0%, p = 0.0001), neoadjuvant and adjuvant radiation therapy (34.6% vs. 65.5%, p = 0.02) and surgical management (83.7% vs. 95.3%, p = 0.006). Despite these differences in treatments, recurrence rates were not statistically significant between the two groups. However, overall survival was reduced in the older age group. Conclusions: Treatment plans for patients aged 80 years old and above should be tailored to the patient’s colorectal cancer presentation, comorbidity status and life expectancy, weighing the impact of cancer treatments on the patient’s short- and long-term outcomes.

MSEANet: Multi-Scale Selective Edge Aware Network for Polyp Segmentation

The colonoscopy procedure heavily relies on the operator’s expertise, underscoring the importance of automated polyp segmentation techniques in enhancing the efficiency and accuracy of colorectal cancer diagnosis. Nevertheless, achieving precise segmentation remains a significant challenge due to the high visual similarity between polyps and their backgrounds, blurred boundaries, and complex localization. To address these challenges, a Multi-scale Selective Edge-Aware Network has been proposed to facilitate polyp segmentation. The model consists of three key components: (1) an Edge Feature Extractor (EFE) that captures polyp edge features with precision during the initial encoding phase, (2) the Cross-layer Context Fusion (CCF) block designed to extract and integrate multi-scale contextual information from diverse receptive fields, and (3) the Selective Edge Aware (SEA) module that enhances sensitivity to high-frequency edge details during the decoding phase, thereby improving edge preservation and segmentation accuracy. The effectiveness of our model has been rigorously validated on the Kvasir-SEG, Kvasir-Sessile, and BKAI datasets, achieving mean Dice scores of 91.92%, 82.10%, and 92.24%, respectively, on the test sets.

Association between colonoscopy and colorectal cancer occurrence and mortality in the older population: a population-based cohort study.

We aimed to evaluate the association between colonoscopy and colorectal cancer (CRC) occurrence and related mortality in an older population.This retrospective, nationwide, population-based cohort study used data of adults aged ≥40 years from the Health Insurance Review and Assessment Service database. After excluding colonoscopy within 6 months of CRC diagnosis during enrollment, CRC occurrence and related mortality were compared between colonoscopy and non-colonoscopy groups using a time-dependent Cox proportional hazard model. Subgroup analysis was conducted among four age groups: young, middle-aged, old, and very old.Among 748986 individuals followed for 9.64 (SD 0.99) years, the colonoscopy group had a 65% lower CRC occurrence (adjusted hazard ratio [HRa] 0.35, 95%CI 0.32-0.38) and 76% lower CRC-related mortality (HRa 0.24, 95%CI 0.18-0.31) after 5 years compared with the non-colonoscopy group. Colonoscopy was associated with the most significant reduction in CRC occurrence in the middle-aged group (HRa 0.32, 95%CI 0.29-0.35) and in CRC-related mortality in the young group (HRa 0.04, 95%CI 0.01-0.33); the very old group had the least reduction in both CRC occurrence and CRC-related mortality (HRa 0.44, 95%CI 0.33-0.59 and HRa 0.28, 95%CI 0.15-0.53, respectively).We found a significant association between colonoscopy and reduction in CRC occurrence and CRC-related mortality in adults aged ≥40 years after 5 years of follow-up; however, these associations were weaker in the very old group. More research is needed on the association between colonoscopy and older age.

Colorectal cancer classification using weakly annotated whole slide images: Multiple instance learning optimization study.

Colorectal cancer (CRC) is considered one of the most deadly cancer types nowadays. It is rapidly increasing due to many factors, such as unhealthy lifestyles, water and food pollution, aging, and medical diagnosis development. Detecting CRC in its early stages can help stop its growth by providing the necessary treatments, thereby saving many people's lives. There are various tests that doctors can perform to diagnose CRC; however, biopsy using histopathological images is considered the "gold standard" for CRC diagnosis. Deep learning techniques can now be leveraged to build computer-aided diagnosis (CAD) systems that can affirm if an input sample shows any symptoms of cancer and determine its stage and location with an acceptable degree of confidence. In this research, we utilize deep learning to study the CRC classification problem using weakly annotated histopathological whole slide images (WSIs). We relax the constraints of the multiple instance learning (MIL) algorithm and primarily propose WSI-label prediction functions to be integrated with MIL, which significantly enhances the performance of WSI-level classification. We also applied efficient preprocessing techniques that output a computationally power-efficient dataset representation and performed multiple experiments to compose the most efficient CAD system. Our study introduces a notable improvement over the results obtained by the baseline research where we achieved an accuracy of 93.05% compared to 84.17%. Furthermore, our results using only the weakly annotated WSIs outperformed the baseline results that are based on performing initial pre-training using a strongly annotated part of the dataset.

Influence of SARS-CoV2 Pandemic on Colorectal Cancer Diagnosis, Presentation, and Surgical Management in a Tertiary Center: A Retrospective Study

Influence of SARS-CoV2 Pandemic on Colorectal Cancer Diagnosis, Presentation, and Surgical Management in a Tertiary Center: A Retrospective Study

DNA Self-Assembly Generated by Aptamer-Triggered Rolling Circle Amplification Cascades for Profiling Colorectal Cancer-Derived Small Extracellular Vesicles.

The analysis of small extracellular vesicles (sEVs) has shown clinical significance in early cancer diagnostics and considerable potential in prognostic assessment and therapeutic monitoring, offering possibilities for precise clinical intervention. Despite recent diagnostic progress based on blood-derived sEVs, the inability to specifically profile multiple parameters of sEVs proteins has hampered advancement in clinical applications. Herein, we report an approach to profile colorectal cancer (CRC)-derived sEVs by using multiaptamer-triggered rolling circle amplification (RCA) cascades. In practice, in the presence of target sEVs, the complementary strands are released from the duplexes of the structure-switching aptamer. Then, the RCA cascade occurs but only when the specific DNA strand pair is presented. As a result, the noncanonical DNA assemblies are generated whose size reaches micrometers that can be directly analyzed by conventional flow cytometry, thereby facilitating facile clinical diagnostics. In this study, the developed diagnostic method is verified on cell-derived sEVs, followed by achieving modeling based on clinical samples. The final diagnostic results from the clinical cohort indicate promising diagnostic efficacy for CRC-derived sEVs with 92% sensitivity, 86.7% specificity, and 90% overall accuracy, highlighting the substantial potential of sEVs as biomarkers for CRC diagnosis and significantly advancing the development of clinical tools for early disease diagnosis.

Integrated analysis of non‑coding RNAs (HOTAIR and miR‑130a) and their cross‑talk with TGF‑β1, SIRT1 and E‑cadherin as potential biomarkers in colorectal cancer.

Molecular changes have a substantial impact on the onset of colorectal cancer (CRC). Complexes of HOTAIR and miRNAs disrupt several cellular functions during carcinogenesis, primarily by disrupting several carcinogenic signaling pathways. In the present study, the relationships between the serum levels of transforming growth factor-β1 (TGF-β1), sirtuin-1 (SIRT1) and E-cadherin and those of HOX transcript antisense intergenic RNA (HOTAIR) and microRNA-130a (miR-130a) in individuals with CRC were analyzed, including their correlations and diagnostic potential. Patients with colon cancer and healthy volunteers were enrolled in the study. Blood samples were collected from 70 patients with CRC and 30 age-matched healthy control volunteers and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to determine the serum levels of HOTAIR and miR-130a. In addition, the levels of TGF-β1, SIRT1 and E-cadherin were determined utilizing enzyme-linked immunosorbent assays. Patients with CRC were found to have significantly higher TGF-β1, SIRT1, HOTAIR and miR-130a serum levels than those of healthy participants. In addition, patients with high-grade CRC had significantly higher levels of TGF-β1, SIRT1, HOTAIR and miR-130a compared with those of patients with low-grade CRC. A significant reduction in the serum levels of E-cadherin was observed in participants with CRC compared with healthy participants, but no significant difference was detected according to the grade of CRC. Positive correlations were found between HOTAIR and miR-130a, as well as TGF-β1 and SIRT1. By contrast, negative correlations were noted between E-cadherin and HOTAIR, miR-130a, TGF-β1 and SIRT1. Therefore, it may be concluded that the miR-130a/HOTAIR and TGF-β1/SIRT1/E-cadherin axes may serve as novel biomarkers for the early diagnosis of CRC.

Clinical significance of fecal Syndecan-2 gene methylation combined with blood tumor abnormal protein detection in the diagnosis of colorectal cancer and precancerous lesions

Clinical significance of fecal Syndecan-2 gene methylation combined with blood tumor abnormal protein detection in the diagnosis of colorectal cancer and precancerous lesions

The Clinical utility of Interleukin-17A rs2275913 polymorphism with colorectal cancer in Egyptian patients

year throughout the world, according to the World Health Organization 2022. CRC is the third most prevalent disease and the second most common cancer in terms of fatality. People diagnosed with colorectal cancer in the early stages have a five-year survival rate of roughly 95%, but people identified with the disease in the later stages have a survival rate of approximately 12%. There are a number of variables that contribute to the development of CRC, these factors include both hereditary and environmental influences. We aimed to investigate the clinical utility of Interleukin (IL)-17A rs2275913 polymorphism to assess its association with CRC in Egyptian patients and the ability of using it as a non-invasive biomarker to assist in diagnosis of colorectal cancer. This case–control study included 75 subjects. Of these, 35 were CRC cases, 20 inflammatory bowel disease (IBD) patients and 20 normal control persons. Blood was collected and DNA extracted. The rs2275913 of IL-17A was genotyped using the Real-Time polymerase chain reaction (PCR). In CRC patient’s group, (5.71%) had the homozygous AA genotype, (40%) the heterozygous GA genotype and (54.29%) the wild GG genotype. While in IBD group (15%) had the homozygous AA genotype, (40%) the heterozygous GA genotype and (45%) the wild GG genotype. In the normal control group, no one had the homozygous AA genotype, but (45%) had the heterozygous GA genotype and (55%) the wild type of GG genotype. However, there was no statistically significant substantial variation amongst the three groups (p&gt;0.05). In conclusion, our study demonstrated no association of IL-17A rs2275913 with both CRC and IBD in the Egyptian population.

Multilevel intervention for follow-up of abnormal FIT in the safety-net: IMProving Adherence to Colonoscopy through Teams and Technology (IMPACTT).

Fecal immunochemical testing (FIT) is a widely used first step for colorectal cancer (CRC) screening. Abnormal FIT results require a colonoscopy for screening completion and CRC diagnosis, but the rate of timely colonoscopy is low, especially among patients in safety-net settings. Multi-level factors at the clinic- and patient-levels influence colonoscopy completion after an abnormal FIT. Our study aims to implement a multi-level approach consisting of a clinic- and patient-level intervention to improve the completion of diagnostic colonoscopy after an abnormal FIT. We will test a multilevel intervention with one safety-net system across 12 primary care clinics - a clinic-level intervention using a stepped wedge design and a patient-level intervention with patient-level randomization. At the clinic level, we will implement a "best practices bundle" to improve workflow for primary care providers and staff using a stepped-wedge design. At the patient level, we will randomize 2000 patients to receive text messages and call reminders or usual care. For the main analysis, we will use a mixed effects logistic model to assess the impact of the clinic intervention on the primary outcome (completion of colonoscopy within 180 days after abnormal FIT). Secondary outcomes include median days to colonoscopy completion, rate of referral to colonoscopy at 42 days, rate of scheduled colonoscopy at 56 days, and bowel preparation quality at colonoscopy. This study will assess the extent to which a multi-level intervention can improve timely colonoscopy completion in a diverse patient population cared for in a safety-net setting. NCT, NCT06191185. Registered 20 December 2023, https://clinicaltrials.gov/study/NCT06191185.

Evaluation of Epigenetic Markers in the Diagnosis and Prognosis of Colorectal Cancer

Introduction: colorectal cancer (CRC) is one of the leading causes of cancer-related death worldwide. Epigenetic factors play a significant role in its development and are increasingly used as tools for early diagnosis and prognosis of this disease. Method: a literature review was conducted on studies published in the last 10 years, available in databases such as PubMed, Cochrane, and SciELO. The selected studies analyze the effectiveness of epigenetic markers, such as DNA methylation and microRNAs, in CRC detection and prognosis. Results: out of 112 articles reviewed, 45 studies met the inclusion criteria, excluding duplicates and those that did not align with the objectives of this review. The analyzed studies highlight that epigenetic marker, particularly the methylation of genes such as SEPT9, NDRG4, and BMP3, are effective in detecting colorectal cancer (CRC) in its early stages, thus enhancing early intervention opportunities. Key microRNAs, such as miR-21, miR-92a, and miR-29a, were also identified, with their alteration associated with CRC progression and aggression prediction. Conclusions: epigenetic markers provide valuable insights into tumor behavior, metastatic potential, and response to various treatment modalities. Some of the most recent studies suggest that the combined use of epigenetic biomarkers and traditional screening methods, such as colonoscopy, may optimize diagnostic accuracy.

Prognosis of early-onset versus late-onset sporadic colorectal cancer: Systematic review and meta-analysis.

In the last years, a dramatic increase in colorectal cancer (CRC) diagnoses in early-onset (EO) patients has been observed. The prognosis of EO-CRC compared to late-onset (LO) patients is still unclear. This meta-analysis aims to clarify whether there is any difference in the prognosis between the two groups. A systematic review was conducted on EMBASE-Medline, Pubmed and Cochrane Library in March 2024 to identify studies comparing overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), local recurrence (LR) and distant recurrence (DR) risk outcomes between EO-CRC (<50 years old) and LO-CRC (>50 years old) with at least 50 patients per group and one year of follow-up. The risk of bias was assessed with the ROBINS-E tool. Data from stage prevalence and survival were extracted and meta-analysed. Meta-regression was used to identify impacting effect modifiers. The PROSPERO registration number was CRD42024573264. Twenty-six studies were identified; 1,062,037 patients (13.4% EO-CRC and 86.6% LO-CRC) were included in the stage prevalence and 567,689 in the prognostic meta-analysis. Overall, 60% of the EO-CRC and 49% of the LO-CRC were diagnosed with an advanced stage (III-IV) of disease (RR 1.26, 95%CI 1.19-1.35, I2=87%). EO-CRC had a better OS than LO-CRC (HR 0.89, 95%CI 0.81-0.99, I2=89%) but equal CSS (HR 0.94, 95%CI 0.83-1.06, I2=82%), DFS (HR 1.05 95%CI 0.94-1.16, I2=76%), LR (HR 1.41, 95%CI 0.62-3.18, I2=49%) and DR (HR 1.51, 95%CI 0.79-2.89) risk. Meta-regression analysis identified a worse DFS in the EO-CRC rectal cancer subgroup (HR 1.14, 95%CI 1.00-1.30, I2=0%). Despite the high heterogeneity of existing studies, EO-CRC patients are diagnosed with significantly more advanced stages than LO-CRC, although this is not reflected in any difference in cancer-related survival. There is an urgent need for increased vigilance in the early detection of CRC in young patients.

The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of colorectal cancer, 2024 update.

The 2024 updates of the Chinese Society of Clinical Oncology (CSCO) Clinical Guidelines for the diagnosis and treatment of colorectal cancer emphasize standardizing cancer treatment in China, highlighting the latest advancements in evidence-based medicine, healthcare resource access, and precision medicine in oncology. These updates address disparities in epidemiological trends, clinicopathological characteristics, tumor biology, treatment approaches, and drug selection for colorectal cancer patients across diverse regions and backgrounds. Key revisions include adjustments to evidence levels for intensive treatment strategies, updates to regimens for deficient mismatch repair (dMMR)/ microsatellite instability-high (MSI-H) patients, proficient mismatch repair (pMMR)/ microsatellite stability (MSS) patients who have failed standard therapies, and rectal cancer patients with low recurrence risk. Additionally, recommendations for digital rectal examination and DNA polymerase epsilon (POLE)/ DNA polymerase delta 1 (POLD1) gene mutation testing have been strengthened. The 2024 CSCO Guidelines are based on both Chinese and international clinical research, as well as expert consensus, ensuring their relevance and applicability in clinical practice, while maintaining a commitment to scientific rigor, impartiality, and timely updates.

AI-enhanced interface for colonic polyp segmentation using DeepLabv3+ with comparative backbone analysis

Polyps are one of the early stages of colon cancer. The detection of polyps by segmentation and their removal by surgical intervention is of great importance for making treatment decisions. Although the detection of polyps through colonoscopy images can lead to multiple expert needs and time losses, it can also include human error. Therefore, automatic, fast, and highly accurate segmentation of polyps from colonoscopy images is important. Many methods have been proposed, including deep learning-based approaches. In this study, a method using DeepLabv3+ with encoder-decoder structure and ResNet architecture as backbone network is proposed for the segmentation of colonic polyps. The Kvasir-SEG polyp dataset was used to train and test the proposed method. After images were preprocessed, the training of the proposed network was performed. The trained network was then tested and performance metrics were calculated, and additionally, a GUI (Graphical User Interface) was designed to enable the segmentation of colonoscopy images for polyp segmentation. The experimental results showed that the ResNet-50 based DeepLabv3+ model had high performance metrics such as DSC: 0.9609, mIoU: 0.9246, demonstrating its effectiveness in the segmentation of colonic polyps. In conclusion, our method utilizing DeepLabv3+ with a ResNet-50 backbone achieves highly accurate colonic polyp segmentation. The obtained results demonstrate its potential to significantly enhance colorectal cancer diagnosis and planning for polypectomy surgery through automated image analysis.&#xD.

Current Status and Future Perspectives on Early Detection and Diagnosis of Colorectal Cancer in China

Current Status and Future Perspectives on Early Detection and Diagnosis of Colorectal Cancer in China