Early Detection Of Colon Cancer Research Articles

Why is early detection of colon cancer still not possible in 2023?

Colorectal cancer (CRC) screening is a fundamental tool in the prevention and early detection of one of the most prevalent and lethal cancers. Over the years, screening, particularly in those settings where it is well organized, has succeeded in reducing the incidence of colon and rectal cancer and improving the prognosis related to them. Despite considerable advancements in screening technologies and strategies, the effectiveness of CRC screening programs remains less than optimal. This paper examined the multifaceted reasons behind the persistent lack of effectiveness in CRC screening initiatives. Through a critical analysis of current methodologies, technological limitations, patient-related factors, and systemic challenges, we elucidated the complex interplay that hampers the successful reduction of CRC morbidity and mortality rates. While acknowledging the advancements that have improved aspects of screening, we emphasized the necessity of addressing the identified barriers comprehensively. This study aimed to raise awareness of how important CRC screening is in reducing costs for this disease. Screening and early diagnosis are not only important in improving the prognosis of patients with CRC but can lead to an important reduction in the cost of treating a disease that is often diagnosed at an advanced stage. Spending more sooner can mean saving money later.

The DNA methylation of the interleukin6 as a biomarker for the early detection of colorectal cancer

Objectives: To identify the DNA methylation pattern of the interleukin6 promoter region in colorectal cancer patients and colorectal polys patients that could be a biomarker for early detection of colorectal cancer.
 Methods: For this purpose, we examined the DNA methylation pattern of the promoter region of the IL6 specifically 358 bp (-292 to +67) including 7 CpG sites (-228, -213, -163, -119, +10, +19, +25) in a total of ninety samples with thirty samples each for controls, cancer patients, and colorectal polyps using the bisulfite conversion sequencing method.
 Result: Our results indicate that CpG +25 and CpG -119 can serve as biomarkers for early detection of colon cancer, showing a significant difference in P-values of 0.001 at CpG +25 and 0.004 at CpG-119. The hypomethylation of CpG -119 in cancer groups facilitates the binding of the methyl-sensitive transcription factor Sp1. It enhances the overexpression of IL6 besides hypermethylation of CpG +25 that prevents binding of the methyl-sensitive insulator CTF, unbinding the insulator to the promoter region of the cancer samples makes the promoter region open access to the TFs that enhances overexpression. Furthermore, a remarkable non-recorded SNP at CpG -228 was observed in 98.6% of the enrolled groups.
 Conclusion: In the state of DNA methylation, IL 6 could contribute to the onset of colorectal polyps and colorectal polyps cancer due to a significant level of methylation in CpG +25 and CpG -119.

The Expression of LINC00673 in Colon Cancer and the Melatonin's Effect on Its Expression

Objective: In this study, the cell lines SW620 and DLD-1 which belongs to colon cancer were employed with the aim of observing melatonin's effect on the growth of colon cancer cells and exploring the influence of melatonin about the autophagy of colon cancer. Besides. It uses qRT-PCR to identify LINCRNA00673 (LINC00673) expression in colon cancer and the influence of melatonin on LINC00673 expression.For the purpose of providing a fundamental theory for melatonin in anti-cancer therapy and also presenting as a biomarker for the early detection of colon cancer. Method: 1) Cultivating the colon cancer cell lines SW620 and DLD-1, and subdividing them in accordance with distinct concentrations of melatonin: 0 mM, 1mM, and 2mM, to detect the impact of melatonin for migration and growth of colon cancer cells by Cell Scratch Test and Colony Formation Assay.2) Detecting the expression level of autophagy-related molecules in colon cancer cells in response to melatonin employing Western Blot Assay. 3) Utilizing QT-PCR, extract RNA from two groups of cells and detect the expression of LINC00673 and LINC00673 following melatonin treatment. Result: 1) The Cell Scratch test and Colony Formation Assay indicated that compared with the normal group, the scratch healing of SW620 cells and DLD-1 cells decreased. Furthermore, following melatonin administration, the number of cell colonies decreased. And the results are statistically significant. 2) Western blotting results illustrated that after the interferon of melatonin, the expression level of the autophagy-related molecule Beclin-1 increased significantly, whereas the expression of P62 decreased. 3) QT-PCR results demonstrated that the expression of LINC00673 in colon cancer cells SW620 and DLD-1 was significantly increased. Moreover, melatonin had an inhibiting effect on it. Conclusion: These in vitro experiments managed to prove that melatonin possesses a powerful anti-colon cancer effect and can inhibit the growth and spread of colon cancer. Western blotting indicated that melatonin can inhibit colon cancer through autophagy. Besides which, it is discovered that melatonin may exert its anticancer effect by influencing LINC00673.

Lack of information on colorectal cancer in general public might be the reason for low response rates to screening progam

Introduction: In Croatia, about 3,500 patients are diagnosed with a colorectal carcinoma annually. The National Program for Early Detection of Colon Cancer has been implemented in Croatia since 2007. The program’s primary goal is todetect colon cancer at an early stage of the disease, which should reduce the incidence and mortality from colon cancer. Aim: To determine the interest of the target group in participating in the program, reasons for not responding to the program, and their knowledge about it altogether. Materials and methods: Surveying 50 patients within the program’s target group about their response to and understanding of reasons for screening. Results: Although 84% of the participants know about the program, the response rate was unsatisfactory. Conclusion: Most of the respondents who suffered from a colorectal carcinoma received a call but did not respond due to the absence of symptoms, which correlates with a low level of knowledge on colorectal carcinoma.

Identification of hub genes and pathways in colitis-associated colon cancer by integrated bioinformatic analysis

BackgroundColitis-associated colon cancer (CAC) patients have a younger age of onset, more multiple lesions and invasive tumors than sporadic colon cancer patients. Early detection of CAC using endoscopy is challenging, and the incidence of septal colon cancer remains high. Therefore, identifying biomarkers that can predict the tumorigenesis of CAC is in urgent need.ResultsA total of 275 DEGs were identified in CAC. IGF1, BMP4, SPP1, APOB, CCND1, CD44, PTGS2, CFTR, BMP2, KLF4, and TLR2 were identified as hub DEGs, which were significantly enriched in the PI3K-Akt pathway, stem cell pluripotency regulation, focal adhesion, Hippo signaling, and AMPK signaling pathways. Sankey diagram showed that the genes of both the PI3K-AKT signaling and focal adhesion pathways were upregulated (e.g., SPP1, CD44, TLR2, CCND1, and IGF1), and upregulated genes were predicted to be regulated by the crucial miRNAs: hsa-mir-16-5p, hsa-mir-1-3p, et al. Hub gene-TFs network revealed FOXC1 as a core transcription factor. In ulcerative colitis (UC) patients, KLF4, CFTR, BMP2, TLR2 showed significantly lower expression in UC-associated cancer. BMP4 and IGF1 showed higher expression in UC-Ca compared to nonneoplastic mucosa. Survival analysis showed that the differential expression of SPP1, CFRT, and KLF4 were associated with poor prognosis in colon cancer.ConclusionOur study provides novel insights into the mechanism underlying the development of CAC. The hub genes and signaling pathways may contribute to the prevention, diagnosis and treatment of CAC.

Value of MSCT plus MRI in the Detection of Colon Cancer.

Colon cancer is a common digestive system malignancy with nonspecific early symptoms, which necessitates better early detection methods. The present study was conducted to assess the accuracy and clinical value of multislice spiral CT (MSCT) plus magnetic resonance imaging (MRI) for colon cancer. Between January 2019 and July 2020, 100 patients with pathologically confirmed colon cancer treated in Wuxi People's Hospital were assessed for eligibility and recruited. All eligible patients received MRI and MSCT without any treatment prior to scanning. The accuracy of preoperative diagnosis and staging of colon cancer by MRI, MSCT, and MRI plus MSCT were analyzed using postoperative pathological results as the gold standard, and consistency analysis was performed. The receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) was obtained to analyze the preoperative diagnostic value. The accuracy of MRI, MSCT, and MRI plus MSCT was 98.00%, 96.00%, and 100% with good consistency (Kappa = 0.732, 0.703, and 0.756). The AUC of MRI, MSCT, and MRI plus MSCT was 0.889, 0.861, and 0.903, respectively. The preoperative diagnostic accuracy of MRI for colon cancer at T1, T2, T3, and T4 stages was 76.92%, 82.61%, 73.47%, and 86.67%, respectively, those of MSCT was 53.85%, 69.57%, 63.27%, and 40.00%, respectively, and those of MRI plus MSCT was 100.00%, 95.65%, 95.92%, and 86.67%, respectively. Consistency analysis yielded good consistency for the diagnosis of the T-staging of colon cancer (Kappa = 0.754, 0.731, 0.776). MSCT plus MRI yielded higher accuracy, specificity, and sensitivity in the detection of colon cancer versus the standalone MRI or MSCT, which demonstrated great potential in the early detection of colon cancer with a high clinical value.

The effect of resveratrol and quercetin intervention on azoxymethane-induced colon cancer in Rats model

<h2>Summary</h2><h3>Background</h3> Among gastrointestinal cancers, colon cancer is the fourth leading cause of death in the world, accounting for about 8% of all cancer deaths. Early detection of colon cancer can play an important role in survival in recent years. Although chemotherapy drugs prevent cells from proliferating in certain tissues of the body and induce apoptosis in tumor cells, one of the problems is that treatments for advanced stages of colon cancer have detrimental effects on the patient the American Society of Clinical Oncology (ASCO) proposed natural or synthetic substances that can prevent the recurrence of cancer or slow down the progression of cancer as preventative substances with chemical mechanisms. Resveratrol and quercetin are the natural compounds that has biological effects in the prevention and treatment of cancer. Therefore, the purpose of current study was evaluated the effect of quercetin and resveratrol in colon cancer rats. <h3>Materials and methods</h3> Fifty-five male Sprague dawley rats were randomly assigned to healthy group, control group, resveratrol group, quercetin group and combination of resveratrol and quercetin treated group. At the fourth week animals received azoxymethane (AOM) (15 mg/kg) subcutaneous as a carcinogenic agent weekly for two consecutive weeks except for healthy group. The resveratrol (8 mg/kg) and quercetin (10 mg/kg) intervention done from two weeks before carcinogenesis induction until week 19 via oral gavage. The effect of resveratrol and quercetin was investigated on apoptosis by M30 antibody, cell proliferation by AgNOR staining, histopathological and histomorphological examination of AOM-induced colon cancer in rats model. Other findings were measured by using a beta-catenin count under a microscope. <h3>Result</h3> The highest frequency and highest percentage of nuclear polymorphism scores are observed in the control group, resveratrol, quercetin, and resveratrol + quercetin, respectively. In mucosal stratification the highest frequency and severity of low anomalies are related to resveratrol+ quercetin group and the highest frequency and severity of anomalies are related to control group. Also, in loss of nuclear polarity the highest frequency and low severity of anomalies are related to quercetin group and the highest frequency and severity is related to the control group. In goblet cells the highest frequency and lowest severity of anomalies are related to resveratrol + quercetin group and the highest frequency and severity of anomalies are related to control group. The highest frequency and lowest rate of crypt anomalies is related to resveratrol + quercetin group and the highest frequency and rate of crypt anomaly is related to control group. The highest and lowest mean of M30 expression are in healthy and control group, respectively. The highest and lowest mean of AgNOR are related to control and healthy groups, respectively. Beta-catenin proteins expression was lower in the combination of resveratrol and quercetin group in versus to others group. <h3>Conclusion</h3> Intervention of resveratrol and quercetin supplements together can be promising as a therapeutic strategy in future studies for colon cancer.

The Utility of Serum Vasorin Levels as a Novel Potential Biomarker for Early Detection of Colon Cancer.

ObjectiveThe objective of this study was to investigate the utility of vasorin, a newly discovered transmembrane protein, as a novel biomarker in the early detection of colon cancer.MethodsA total of 80 patients aged 55-70 years, diagnosed with colon cancer and followed up in our clinics, and 50 healthy volunteer blood donors were included in the study. Participants' demographics such as age, gender, and vasorin levels were recorded and compared between the patient and control groups. In addition, primary tumor status (pT) values N and T stages of the tumors were studied in the patient group. All patients included in the study were pathologically confirmed by colonoscopy plus biopsy and postoperative histopathologic examination.ResultsThe mean age was found as 64.59±3.70 (min-max: 55-70) years old in the patient group and 63.56±3.07 (min-max: 57-70) years. There was no statistically significant difference between both groups regarding demographics (p>0.05). Serum Vasorin levels were higher in patients with colon cancer than in the control group (p<0.001). Serum Vasorin levels were higher among patients with advanced disease and related to the clinical stage of the locally advanced tumor. ConclusionOur findings revealed that serum vasorin levels are upregulated in patients with colon cancer. Raised vasorin levels may be a non-invasive biomarker beneficial for early detection and prediction of colon cancer prognosis. In addition, vasorin levels further rose as the disease advanced to higher TNM (tumor (T), nodes (N), and metastases (M)) stages. Further comprehensive studies are needed to draw more evident conclusions and generalize our results.

EVALUATION OF CLINICAL AND LABORATORY CHARACTERISTICS OF COLON CANCERS

Background: Colon cancer is one of the most common cancers in the world as well as in Vietnam. The clinical symptoms are usually nonspecific and prominent late in colon cancer depending on the tumor location, tumor size and presence of metastasis. It has now become possible to early detection of colon cancer. The aims of this study were to investigate the clinical, laboratory characteristics and the differences between right side and left side of colon cancer. Methods: A prospective study consisted of 30 colon cancers, who had undergone laparoscopic colectomy for colon cancer at Gastrointestinal Surgery Department, Hue University of Medicine and Pharmacy Hospital from October 2017 to January 2021. Results: Mean age of 30 patients was 58.8 ± 14.8 years. Mean age of left colon cancer patients was significantly higher than in right colon cancer (64.7 vs 52.1 years, p = 0.015) The majority of colorectal cancers occur in people aged 50 to 79. Male/female ratio was 2.0. The mean BMI was 21.3 ± 2.1, 10.0% of patients were underweight and 22.3% of patients were overweight or obese. The most common clinical symptoms were abdominal pain (86.7%) and bloody mucus in stool (43.4%). The mean hemoglobin was 117.4 ± 29.1 g/l. The mean hemoglobin of right colon cancer patients was lower than in the left side (109.7 vs 124.1 g/l). However, this difference was no statistically significant (p = 0.183). Elevated CEA levels was found in 38.1% patients. The concentration of CEA increased with the degree of invasion of the tumor (5.3 ng/ml in Tis-1 and 9.9 ng / ml in T3, 4). The most common site of the tumor was sigmoid colon (46.7%). The mean size of tumors on CT Scan was 49.0 mm. Conclusion: Colon cancer was more common in male than in female with the mean age of 58.8 years. The most common clinical symptom was abdominal pain. The mean hemoglobin of right colon cancer patients was lower than in the left side. The CEA level increased with the degree of invasion of the tumor Key words: Colon cancer, left-sided colon cancer, right-sided colon cancer, CEA, Hemoglobin.

A Prospective Cohort Study of Colonic Malignancy in a Tertiary Care Hospital in North Kerala, India

Introduction: Colon cancer is the third most commonly diagnosed cancer in males and the second in females, with more than 1.4 million new cancer cases every year. Colon cancer can take many years to develop and early detection of colon cancer greatly improves the chances of a cure. Aim: To study the different modes of clinical presentation of colonic malignancy and its relation to the site of the lesion as seen at a tertiary care hospital in North Kerala, India. Materials and Methods: This was a prospective cohort study carried out in patients diagnosed with colonic cancer and admitted to the Department of Surgery of a tertiary care hospital in North Kerala, India, during the study period of one year from November 2014 to November 2015. Total of 45 patients were clinically evaluated, investigated, taken up for surgical management and followed-up. The collected data were entered into the study proforma and analysed using Statistical Package for Social Sciences. The Chi-square test for goodness of fit, Chi-square test for association and Student’s t-test were used. Results were considered statistically significant when p-value was less than 0.05. results: Of the 42 cases of carcinoma of colon, 24 (57.1%) were males and 18 (42.9%) were females with a male to female ratio of 1.3:1. The maximum frequency of cases were in between the ages 51 and 60 years (6th decade) followed by the 7th and 8th decades. The mean age of presentation of carcinoma in the left colon (64.43 years) was significantly higher than the right side (55.95 years). The most common symptom/signs were abdominal pain (78.6%), anaemia (54.8%), altered bowel habits (50%), abdominal mass (38.1%) loss of weight/appetite (33.3%), constipation (31%) and blood and mucus per rectum (28.6%). conclusion: Cancer of the colon primarily affected older individuals especially those with left colonic cancers. Common complaints such as abdominal pain, altered bowel habits, constipation and blood and mucous per rectum were seen frequently in the patients having colonic cancer. Certain symptoms like constipation, altered bowel habits and blood and mucous per rectum were more in patients with cancer in the left colon.

Abstract CT113: A novel laser emission microscopy for early detection of colon cancer: Analysis of at-risk human colon from an interventional trial (research in progress)

Abstract Introduction: Accurate identification of neoplastic or pre-neoplastic lesions is traditionally dependent on microscopic identification of nuclear abnormalities. It is both time-consuming and challenging in early-stage lesions and difficult to detect. Laser-emission microscopy (LEM) that uses laser emission (not fluorescence) is an emerging technology that takes advantage of the finding that highly-proliferating cells like those in pre-neoplastic lesions can be distinguished from less proliferative cells by a lower laser emission dot density (LDD) when stained with a nuclear dye. We have successfully used this technique to detect (early) nuclear changes in a high-fat induced colon cancer model. LEM has also been used successfully to differentiate healthy tissue from cancerous tissue in human patients. Methods: This LEM system is capable of rapidly scanning tissue as large as 2 cm×2 cm in ~10 min. Both laser emission and regular fluorescence are imaged simultaneously, thus providing information regarding the lasing spot density and location within the human colon tissues. In this study, we employed colon biopsies from 12 human subjects (at risk for colorectal cancer). These subjects participated in a 90-day intervention, placebo-controlled, randomized trial. 8 subjects ingested known chemopreventives and 4 subjects took a placebo. Colon biopsies were taken from the sigmoid colon at baseline and after 90 days. The formalin-fixed, paraffin-embedded tissues were subjected to LEM microscopic assessment. For this, the tissues were sandwiched between two mirrors to form a laser cavity and laser excitation was applied. By comparing the laser emission spectra, highly proliferative tissue could be differentiated from less proliferative tissue. Post-treatment biopsies were compared to their baseline status. These biopsies were also stained with Ki67 to obtain their proliferation index to compare with the LEM results. Results: On average, there was a 20% increase in the LDD among the 8 subjects on chemopreventives while no change was seen in Ki67 positivity. In placebo group, Ki67 was decreased by 14% and LDD was 12% increased. On individual comparison, LDD and Ki67 data were correlated positively in 6 subjects. Conclusion: The preliminary data suggest that in histologically-normal but “at-risk” human colon LEM may pick early nuclear changes that may not be detected by a proliferation marker. Table.A comparison of lasing dot density (LDD) data to Ki67 positivity (Whole slide analysis*)Mean LDDPercent Positive NucleiChange RatioSubject IDPrePostPrePostLDDKi67Data correlated?Placebo 1491336504.75.40.741.15NoPlacebo 2851078159.28.70.920.95YesPlacebo 3573183558.96.01.460.67NoPlacebo 4659288469.76.71.340.69NoChemopreventive#1 1296733436.513.61.132.10YesChemopreventive#1 2528261406.57.71.161.20YesChemopreventive#1 3468453429.67.01.140.73NoChemopreventive#1 4758173358.25.60.970.68YesChemopreventive#2 1323046255.34.91.430.91NoChemopreventive#2 2508078408.29.11.541.11YesChemopreventive#2 35587400110.46.80.720.66YesChemopreventive#2 4491373226.94.91.490.71NoPlacebo combined1.12±0.340.86±0.23Chemopreventive combined1.20±0.281.01±0.49*Both mucosa and submucosa were involved in the analysis Citation Format: Muhammad N. Aslam, Yun-Lu Sun, Ingrid Bergin, Mohamed Ali H. Jawad-Makki, Karsten Knuver, Danielle (Kim) Turgeon, James Varani, Xudong Fan. A novel laser emission microscopy for early detection of colon cancer: Analysis of at-risk human colon from an interventional trial (research in progress) [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT113.

Effects of Alternative Offers of Screening Sigmoidoscopy and Colonoscopy on Utilization and Yield of Endoscopic Screening for Colorectal Neoplasms: Protocol of the DARIO Randomized Trial.

BackgroundFlexible sigmoidoscopy and colonoscopy are recommended screening options for colorectal cancer (CRC). Despite colonoscopy being offered for CRC screening in Germany, the uptake of this offer has been very limited.ObjectiveThe objective of this study was to assess the potential for increasing use of endoscopic CRC screening and the detection of advanced colorectal neoplasms by offering the choice between use of flexible sigmoidoscopy and colonoscopy.MethodsThe DARIO study includes a cross-sectional study (part I), followed by a prospective 2-arm randomized controlled intervention trial (part II) with an associated biobank study (part III). Participation is possible in part I of the DARIO study only, parts I and II, or all 3 study parts. After obtaining informed consent from the municipalities, 12,000 people, aged 50-54 years, from the Rhine-Neckar region in Germany were randomly selected from residential lists of the responsible population registries and invited to complete a standardized questionnaire to investigate the nature, frequency, timing, and results of previous CRC screening and eventual diagnostic colonoscopies. In study part II participants from study part I with no colonoscopy in the preceding 5 years are randomized into 2 arms: arm A offering screening colonoscopy only, and arm B offering both options, either screening colonoscopy or screening sigmoidoscopy. The primary endpoint is the proportion of participants in whom colorectal neoplasms >0.5 cm are detected and removed at screening endoscopy. The secondary endpoints are the detection rate of any neoplasm and use of any endoscopic screening. Part III of the study will use samples from participants in study part II to construct a liquid and tissue biobank for the evaluation of less invasive methods of early detection of colon cancer and for the more detailed characterization of the detected neoplasms. Blood, urine, stool, and saliva samples are taken before the endoscopy. Tissue samples are obtained from the neoplasms removed during endoscopy.ResultsA total of 10,568 from 12,000 randomly selected women and men aged 50-54 years living in the Rhine-Neckar-Region of Germany have been invited for participation. The remaining 1432 (11.93%) could not be invited because they reached the age of 55 at the time of contact. Of those invited, 2785/10,568 (26.35%) participated in study part I; 53.60% (1493/2785) of these participants were female. Study parts II and III are ongoing.ConclusionsThis study will answer the question if alternative offers of either screening sigmoidoscopy or screening colonoscopy will increase utilization and effectiveness of endoscopic CRC screening compared with an exclusive offer of screening colonoscopy. In addition, alternative noninvasive screening tests will be developed and validated.Trial RegistrationGerman Clinical Trials Register DRKS00018932; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00018932International Registered Report Identifier (IRRID)DERR1-10.2196/17516

Gender- and Race-Based Differences in Barriers and Facilitators to Early Detection of Colon Cancer.

Background: Early detection of colon cancer is essential to successful treatment and survival, yet most patients are diagnosed only after onset of symptoms. Previous studies suggest differences in colon cancer screening and presentation by gender and race, but reasons for this are not understood. The purpose of this study was to identify barriers and facilitators to early detection of colon cancer and to compare by gender and race. Materials and Methods: In the Colon Cancer Patterns of Care in Chicago study, non-Hispanic Black and White (NHB, NHW) patients aged 30-79 newly diagnosed with colon cancer between 2010 and 2014 (n = 249) underwent in-depth semistructured interviews regarding the pathway to colon cancer diagnosis. Mixed qualitative and quantitative methods were used to analyze patient narratives and to compare response patterns by gender and race within prespecified domains: health care access factors, provider-related factors, patient-related factors, and diagnostic workup factors. Results: Women reported more barriers than facilitators to early detection than men (barrier: facilitator ratio of 0.60 vs. 0.48). Thematic differences were seen, with women reporting more barriers related to health care access, scheduling of follow-ups, symptom recognition, and inappropriate or inconclusive diagnostic tests. Fewer women than men reported facilitators related to provider factors such as ease of scheduling follow-ups and receiving referrals for screening or a specialist. NHBs and NHWs reported similar ratios of barriers to facilitators (0.55 vs. 0.53), but more NHBs than NHWs reported barriers related to health care access, scheduling follow-ups, and clinical delays, and fewer NHBs reported facilitators related to health care accessibility (existing relationship with provider, ease of scheduling follow-ups). Conclusions: In this diverse population of patients recently diagnosed with colon cancer, we identified substantive gender- and race-based differences in the types and burden of barriers and facilitators to early detection experienced in the path to diagnosis. These differences should be explored further as they may contribute to disparities in the diagnosis and prognosis of colon cancer.

Knowledge, attitude and practice towards early screening of colorectal cancer in Riyadh.

Background and Aims:Colorectal cancer (CRC) is a common cause of mortality worldwide. It is preventable, treatable when detected early. The aim of this study is to assess knowledge, attitude and practice (KAP) of the participants toward CRC and its early screening, and identify the sources of information on the subjects.Methods:We conducted a cross-sectional study on the people 40y old and above at the primary care clinics at King Saud university medical city (KSUMC) in Riyadh. The estimated sample size was 245 subjects whom we requested to complete a self-administered Arabic questionnaire, which consisted of three parts. These were: 1. Demographic data, 2. KAP toward CRC, its early detection. 3 sources of information of the public about colorectal cancer.Results:A total of 231 subjects participated; (54.5%) were male (mean age = 50.7 ± 9.8). About 47% of the participants heard about cancer screening, and 45% knew that colonoscopy is used for such purposes. Another 24.2% were aware that occult blood in the stool test is a method of early detection of colon cancer. About 40% to 50% of the subjects were knowledgeable about hazardous factors and cautioning symptoms for CRC. Only 6.5% of the subjects did an early screening for CRC, but 82.9% would do it if their doctor advised them to do so.Conclusion:The participant's knowledge and early checkups of CRC are inadequate. They would undergo early screening if their doctors advised them to do so. It is time to develop a national policy for CRC screening involving primary care doctors and utilizing social media to improve people's information.

MiR-21: a promising biomarker for the early detection of colon cancer.

PurposeThe aim of this study was to compare the expression of miR-21 gene in stages II-IV of formalin-fixed paraffin-embedded (FFPE) tissue in patients with colon cancer and introduce miR-21 as a potential molecular marker for detection of colon cancer in the early stages.IntroductionCurrently, identification of key molecules involved in the pathogenesis of cancer is one of the areas under consideration. miRNAs, are small RNAs which have been identified in many cancers. In this study, we investigated the expression of miR-21 in three pathologic stages in patients with colon cancer in the north of Iran.Patients and methodsA total of 40 FFPE samples were obtained from patients with stages II, III, and IV from hospitals in Mazandaran and Golestan provinces. After extraction of RNA, treatment with DNase I and cDNA synthesis was performed and miR-21 expression was assessed by qPCR. Then, the data were analyzed using statistical software R (3.4.3).ResultsThe expression of miR-21 in stage II was significantly different from stage IV. However, no significant difference was observed between the other stages. In stage II, the level of miR-21 expression was higher in men than women. Moreover, in the second pathological stage, miR-21 expression was reduced in patients with adjacent lymphoid tissue engagement. In addition, the expression of miR-21 in grade I was significantly higher than grade II.ConclusionThe results of this study suggest that miR-21 can be a diagnostic marker for early stages of colon cancer, especially in men. It can also be considered as a good candidate for targeted treatment of colon cancer in the early stages of the disease. Furthermore, for the first time, we suggested that miR-21 can be a good molecular marker for classification of the stages of colon cancer.

Urgent surgery in colon cancer has no impact on survival.

Despite advances in early detection of colon cancer, a minority of patients still require urgent surgery. Whether such urgent conditions result in poor outcome remains a topic of debate. Using a prospectively maintained database, patients suffering exclusively from colon cancer and receiving either elective or emergent resection between 2001 and 2014 were analyzed with respect to overall, disease-specific, and relative survival using Cox regression and propensity score analyses. From a total of 877 patients analyzed, 2.7% (24) presented with complications requiring urgent surgery. Propensity-scoring identified strongly biased patient characteristics (0.097 ± 0.069 vs 0.028 ± 0.043; P < 0.001). An unadjusted Cox proportional hazards regression analysis revealed urgent surgery as a statistically significant prognostic factor with an approximately 207% increased risk of mortality (hazard ratio [HR] = 3.07; 95% confidence interval [CI]: 1.62-5.81; P = 0.003). After adjusting the data according to the propensity score analysis, urgent surgery was not associated with a decreased overall (HR = 1.67; 95%CI; 0.84-3.36; P = 0.174), disease-specific (HR = 1.62; 95% CI; 0.81-3.24; P = 0.201) or relative survival (HR = 1.86; 95% CI: 0.92-3.79; P = 0.086). After risk-adjustment, using multivariable Cox regression and propensity score analyses, no significant disadvantage could be noted with regard to overall, disease-specific, or relative survival in patients with exclusively colon cancer who received emergent oncological resection.

Colon Cancer Early Detection by some Serum's Antigenic, Enzymatic and Free- serum's DNA indicators

This research include (104) patient's blood serum diagnosed with colon cancer proved by colonoscopy and histopathology. Blood samples had been selected consecutively over the period March 2013 to April 2014 from patients treated in Oncology and Nuclear Medicine hospital, Al- Jumhory hospital/Mosul and azadi Teaching Hospital/Kirkuk. All cases and controls were aged (21- 85–years). One hundred normal blood donor individuals had been used as controls. Antigenic tumor markers which include carcino-embryonic antigen (CEA) and Carbohydrate antigen 19-9 (CA 19-9) had been measured in blood's serum from 104 patients with colon cancer. Results indicate a significant elevation (p<0.05) in levels of CEA and C19-9 only in patients with advanced stage C and metastatic stage D compared with control. Beside biochemical enzymatic tumor markers that included Cyclooxygenase, Arginase showed significantly increase (p<0.05) of enzymatic activity for colon cancer patients with early stage (A) compared with controls. While the serum alkaline sphingomyelinase level was significantly decreased (p<0.05) in colon cancer patients in stage A compared with controls and this decrease was independent of Dukes’ stage, thus strengthening the hypothesized validity of these assays to be used as serum test for the early detection of colonic neoplasia. The results of this research also revealed a significant increase (p<0.05) in the serum's free DNA in all stages of colon cancer patient's compared with control grope for this it was considered as a good indicator of early detection of colon cancer.

Electrochemical Determination of the KRAS Genetic Marker for Colon Cancer with Modified Graphete and Graphene Paste Electrodes

ABSTRACTThe determination of KRAS was performed using electrochemical sensing devices based on graphite and graphene pastes, modified with a phthalocyanine-boron dipyrromethene (BODIPY) and azulenes dyes. The limits of quantification for KRAS were 1.54 × 10−4 µg/mL using the sensor based on the phthalocyanine-BODIPY dye and graphite, 2.64 × 10−7 µg/mL using the sensor based on 2,6-bis((E)-2-(furan-2-yl)vinyl)-4-(4,6,8-trimethylazulen-1-yl)pyridine/TiO2Pt/reduced graphene oxide, and 3.84 × 10−3 µg/mL using the sensor based on 2,6-bis((E)-2-(thiophen-3-yl)vinyl)-4-(4,6,8-trimethylazulen-1-yl)pyridine/TiO2Pt/reduced graphene oxide. Recovery measurements demonstrated the suitable analytical performance of these sensors for the early detection of colon cancer by the analysis of whole blood samples.

Circulating PIWI-Interacting RNAs piR-5937 and piR-28876 Are Promising Diagnostic Biomarkers of Colon Cancer.

Background: The early detection of colon cancer is one of the main prerequisites for successful treatment and mortality reduction. Circulating PIWI-interacting RNAs (piRNA) were recently identified as novel promising biomarkers. The purpose of the study was to assess the profiles of piRNAs in blood serum of colon cancer patients with the aim to identify those with high diagnostic potential.Methods: Blood serum samples from 403 colon cancer patients and 276 healthy donors were included in this 3-phase biomarker study. Large-scale piRNA expression profiling was performed using Illumina small RNA sequencing. The diagnostic potential of selected piRNAs was further validated on independent training and validation sets of samples using RT-qPCR.Results: In total, 31 piRNAs were found to be significantly deregulated in serum of cancer patients compared with healthy donors. Based on the levels of piR-5937 and piR-28876, it was possible to differentiate between cancer patients and healthy donors with high sensitivity and specificity. Moreover, both piRNAs exhibited satisfactory diagnostic performance also in patients with stage I disease and enabled detection of colon cancer with higher sensitivity than currently used biomarkers CEA and CA19-9. Finally, the expression of analyzed piRNAs in blood restored significantly 1 month after the surgical resection.Conclusions: Based on our findings, piRNAs are abundant in human blood serum. Furthermore, their levels in colon cancer have been observed to be significantly deregulated. However, their involvement in carcinogenesis must be further established.Impact: piRNAs could serve as promising noninvasive biomarkers for early detection of colon cancer. Cancer Epidemiol Biomarkers Prev; 27(9); 1019-28. ©2018 AACR.

MicroRNA-423-5p inhibits colon cancer growth by promoting caspase-dependent apoptosis.

Plasma microRNA (miR)-423-5p is a potential biomarker for the detection of colon cancer. However, the expression and biological role of miR-423-5p in colon tumorigenesis remains unclear. In the current study, reverse transcription-quantitative polymerase chain reaction was used to determine miR-423-5p expression in malignant colon tissues and plasma from patients with colon cancer. Cell viability, colony formation and apoptosis assays, as well as western blotting, were performed to investigate the biological role and regulatory mechanisms of miR-423-5p in colon cancer. The results demonstrated that miR-423-5p expression was downregulated in tumor tissues and plasma from patients with colon cancer, as well as in colon cancer cell lines. Furthermore, overexpression of miR-423-5p promoted colon cancer cell apoptosis and resulted in the inhibition of cell proliferation and colony formation. Mechanistically, miR-423-5p induced the expression of caspases 3, 8 and 9, as well as p53 in colon cancer. The effect of z-VAD treatment indicated that the miR-423-5p-mediated colon cancer cell apoptosis is caspase-dependent. These results suggest that miR-423-5p is a tumor suppressor in colon cancer and a potential diagnostic target to enable the early detection of colon cancer.