Incidence Of Colon Cancer Research Articles

Risk and survival outcomes of secondary pelvic neoplasm after radiotherapy in female patients with genital neoplasms: A large Population-Based cohort study

Background and purposeTo investigate the impact of radiotherapy (RT) on the risk of secondary pelvic neoplasms (SPN) and the survival outcomes of patients following a diagnosis of female patients with genital neoplasm(FGN). Materials and MethodsUtilizing SEER databases, this study involved 102,895 patients from nine oncology centers, spanning 1990 to 2015. We employed the Fine-Gray competing risks regression methodology to chart the trajectory of SPN development and used the Kaplan–Meier method to calculate the 10-year overall survival rates. ResultsThis study included 25,774 patients in the RT group and 77,121 in the non-radiotherapy (NRT) group. The cumulative incidence rate of SPN was 5.10 % in the RT group and 3.42 % in the NRT group. The RT group showed a significantly higher incidence of bladder cancer (adjusted hazard ratio [HR]: 1.75; 95 % confidence interval [CI]: 1.43–2.14; P < 0.05), colon cancer (adjusted HR: 1.32; 95 % CI: 1.16–1.49; P < 0.05), and rectal cancer (adjusted HR: 1.34; 95 % CI: 1.10–1.65; P < 0.05) compared to the NRT group. After propensity score matching, patients in the RT group who developed bladder cancer had significantly reduced 10-year survival rates compared to patients with primary pelvic tumors (P = 0.01). ConclusionRT is identified as an independent risk factor for the development of SPN in patients with FGN. Patients with FGN who undergo RT demonstrate a significant increase in the risk of developing secondary neoplasms, specifically bladder cancers, and experience a reduction in 10-year survival rates.

Awareness of colon cancer screening among the general population: Community-based study from the Qassim Region of Saudi Arabia

ABSTRACT Introduction: Colorectal cancer (CRC) has surged to prominence as the leading cancer affecting men and the second most common affecting women in Saudi Arabia. The need for preventative screening is underscored by the rising prevalence of precancerous polyps, early-stage colorectal cancer, and the fact that these conditions often manifest without symptoms. Methods: This study utilized a cross-sectional descriptive design and employed data from a sample of 425 residents of Qassim region in Saudi Arabia. The participants guaranteed their confidentiality when completing self-administered online questionnaires. Results: Nearly half, 209 (49.2%), of the participants indicated that there were increasing incidences of colon cancer in Saudi Arabia. A considerable number [122 (28.7%)] of respondents believed that family history was the risk factor for colorectal cancer. A total of 203 (47.8%) knew that CRC could develop without symptoms. Common symptoms of CRC were cited as bleeding per rectum 300 (70.6%) and abdominal pain 259 (60.9%). The majority, 384 (90.4%), of the respondents believed that CRC could be prevented and cured if detected early, 415 (97.6%). The results noted that more females knew that there were increasing incidences of CRC in KSA (P = 0.03). Older participants were more likely to understand the function of the colon and rectum (P &lt; 0.001**), the risk factors (P &lt; 0.001**), and the symptoms of CRC (P &lt; 0.001**), as well as their willingness to choose colonoscopy to conduct colon follow-up screening even without symptoms (P &lt; 0.001**). Married participants had a higher likelihood of knowing the ranking of CRC among the most common tumors in both sexes in KSA (P = 0.027*). Participants with a higher education level were more likely to know the ranking of CRC among the common tumors in the KSA (P = 0.004**), the functions of colon and rectum (0.003**), and the symptoms of CRC (P &lt; 0.001**). Conclusion: The study revealed considerably below-average knowledge about the general public’s screening for CRC in the Qassim region of Saudi Arabia. Although a substantial proportion of participants demonstrated knowledge about the risk factors, symptoms, and prevention of CRC, there is limited knowledge about screening programs in the region. This underscores the need for public awareness campaigns and concerted efforts to eliminate the obstacles preventing more people from getting screened with colonoscopies for early detection and prevention of CRC.

Spatial analysis of risk factors related to colorectal cancer in Iran: An ecological study.

Colorectal cancer is the third most common cancer worldwide, accounting for 10% of cancer deaths. Therefore, this study was performed with the aim of spatial analysis of risk factors for colorectal cancer in Iran. This study was conducted ecologically using STEPS information (The WHO Stepwise Approach to NCD Risk Factor Surveillance) in Iran. To analyze the data, the researcher used cluster analysis and Geographically Weighted Regression methods with the help of ArcGIS version 10. The results of OLS analysis showed that there was a significant relationship between tobacco consumption (B = 0.571, p-value = 0.044) and smoking (B = 0.772, p-value = 0.010) and the incidence of colon cancer (CC). There was also a significant relationship between abdominal obesity and the incidence of rectal cancer (RC) (B = 0.061, p-value = 0.027). This study showed that (CC) high-risk areas are located in central and northern parts of Iran, and the significant risk factors related to CC and RC were found to be tobacco use, cigarette smoking, and abdominal obesity. These findings are helpful to inform policymakers to plan screening services to reduce CC and RC, especially in high-risk populations.

S531 Can Google Searches Predict Colon Cancer Incidence and Mortality?

S531 Can Google Searches Predict Colon Cancer Incidence and Mortality?

The Dark Knight: Functional Reprogramming of Neutrophils in the Pathogenesis of Colitis-Associated Cancer.

Neutrophils are the primary myeloid cells that are recruited to inflamed tissues, and they are key players during colitis, being also present within the tumor microenvironment during the initiation and growth of colon cancer. Neutrophils fundamentally serve to protect the host against microorganism invasion, but during cancer development, they can become protumoral and lead to tumor initiation, growth, and eventually, metastasis-hence, playing a dichotomic role for the host. Protumoral neutrophils in cancer patients can be immunosuppressive and serve as markers for disease progression but their characteristics are not fully defined. In this review, we explore the current knowledge on how neutrophils in the gut fluctuate between an inflammatory or immunosuppressive state and how they contribute to tumor development. We describe neutrophils' antitumoral and protumoral effects during inflammatory bowel diseases and highlight their capacity to provoke the advent of inflammation-driven colorectal cancer. We present the functional ambivalence of the neutrophil populations within the colon tumor microenvironment, which can be potentially exploited to establish therapies that will prevent, or even reverse, inflammation-dependent colon cancer incidence in high-risk patients.

Imaging colonic polyps in 2024.

Screening colonoscopy and polypectomy are the cornerstone in decreasing the incidence and mortality of colorectal cancer. Despite the low incidence of colorectal cancer in India, there has been a rising trend in the incidence of colonic polyps and cancer over the last decade. It is, hence, imperative that we are well equipped in themanagement of colonic polyps. Adequate training in thedetection and characterization of polyps to aid in their management is necessary. Detection of polyps can be increased by adhering to the standards of colonoscopy, including good bowel preparation, cecal intubation rate, adequate withdrawal time and use of distal attachment devices. A detected polyp needs optimal characterization to predict histology in real time and decide on the management strategies. Characterization of the polyps requires high-definition-white light endoscopy and/or image-enhanced endoscopy (dye based or digital). Various factors that helpin predicting histology include size, location and morphology of the polyp and the pit pattern, vascular and surface pattern of the polyp. Polyps can be differentiated as neoplastic or non-neoplastic with reasonable accuracy with the above features. Prediction of advanced pathology including high-grade dysplasia and deep sub-mucosal invasion is essential, as it helps indeciding if the lesion is amenable to endotherapy and the technique of endoscopic resection. Adequate training in image-enhanced endoscopy is necessary to assess advanced pathology in polyps. Technology pertaining to image-enhanced endoscopy includes narrow banding imaging and blue laser imaging; newer variations are being introduced every few years making it necessary to be abreast with growing information. The recent advances in gastrointestinal (GI) endoscopy with the advent of endocytoscopy and artificial intelligence seem promising and are predicted to be the future of GI endoscopy.

Familial adenomatous polyposis: a case report

BackgroundFamilial adenomatous polyposis is characterized by the presence of multiple colorectal adenomatous polyps and caused by germline mutations in the tumor suppressor gene and adenomatous polyposis coli, located on chromosome 5q21–q22. Familial adenomatous polyposis occurs in approximately 1/10,000 to 1/30,000 live births, and accounts for less than 1% of all colorectal cancers in the USA. It affects both sexes equally and has a worldwide distribution. The incidence of colon cancer in low- and middle-income countries is rising. In addition to the increasing incidence, lack of early detection and impeded access to optimal multidisciplinary treatment may worsen survival outcomes. Developing quality diagnostic services in the proper health context is crucial for early diagnosis and successful therapy of patients with colorectal cancer, and applying a resource-sensitive approach to prioritize essential treatments on the basis of effectiveness and cost-effectiveness is key to overcoming barriers in low- and middle-income countries. We report a case of familial adenomatous polyposis presenting as adenocarcinoma with multiple colorectal adenomatous polyps. The diagnosis of familial adenomatous polyposis was made by the presence of numerous colorectal adenomatous polyps and family history of colonic adenocarcinoma. Due to its rarity, we decided to report it.Case presentationA 22-year-old Ethiopian female patient presented to Addis Ababa University College of Health science, Addis Ababa, Ethiopia with rectal bleeding. Abdominopelvic computed tomography scan was done and showed distal rectal asymmetric anterior wall thickening in keeping with rectal tumor. Colonoscopy was done and she was diagnosed to have familial adenomatous polyposis with severe dysplasia. In the meantime, colonoscopy guided biopsy was taken and the diagnosis of adenocarcinoma with familial adenomatous polyposis was rendered. For this, total proctocolectomy was carried out. On laparotomy there was also incidental finding of left ovarian deposition for which left salpingo-oophorectomy was done, and 4 weeks after surgical resection, the patient was started on oxaliplatin, leucovorin, fluorouracil chemotherapy regimen.ConclusionIn the clinical evaluation of a patient with rectal bleeding, familial adenomatous polyposis must be considered as a differential diagnosis in subjects having family history of colonic adenocarcinoma for early diagnostic workup, management, family genetic counseling, and testing.

Disparity in trends and characteristics of early onset colorectal cancer: analysis from the National Inpatient Sample, 2016 to 2021

Introduction Colon cancer is the second most common cause of death in the United States. With an increasing number of patients diagnosed at younger ages, the disease remains a significant burden. However, recent data on early onset patients admitted with colon cancer are still limited. Methods We utilized the 2016 to 2021 National Inpatient Sample to investigate trends and characteristics of colon cancer hospitalizations. Nonelective participants were divided into early onset and normal-age groups, with a cut point of 50 years old. In addition, we also investigated factors associated with the risk of inpatient mortality in the study population. Results There were 26,903 early onset nonelective colon cancer hospitalizations in the population group, amounting to 11.91% of total colon cancer hospitalizations. No significant changes or trends were seen from 2016 to 2021. Compared to the normal-age population group, there was a disproportionate number of Blacks, Hispanics, and Asian Americans, as well as those with obesity and tobacco usage. Conclusion Some demographic factors and comorbidities disproportionately affect early onset colon cancer patients when compared to the normal-age population group. Further investigations are necessary to combat the growing incidence of early onset colon cancer.

Complete Response of an Iraqi Patient with Multiple Liver Metastasis, Colon Cancer and Deep Vein Thrombosis to XELOX/Bevacizumab Treatment

Background: The incidence of colon cancer is rising globally, and several therapeutic techniques, such as surgery, radiation, and systemic therapy, are used to control this illness. Patients with initially treatable metastatic colorectal cancer and unresectable metastases receive preoperative chemotherapy. In patients with rapidly progressing cancer, this strategy aims to shrink the tumor, manage any micro-metastases, and avoid liver surgery. Case presentation: We present a rare case of an Iraqi patient with metastatic colon cancer and an initially unresectable liver metastasis. The patient initially experienced a partial response to chemotherapy with capecitabine, oxaliplatin (XELOX), and Bevacizumab, but after a few days, we observed deep venous thrombosis (DVT). We stopped the oxaliplatin and administered Capecitabine with bevacizumab as a chemotherapy treatment, observing no adverse effects during the therapy period and achieving a complete response with Capecitabine and bevacizumab. Conclusions: The full response in the liver and colon after treatment, which reduced the patients' treatment burden, was the case's unique result. Additionally, this study highlights deep vein thrombosis as a critical problem that can arise with the use of oxaliplatin.

Different Metabolic Associations of Hepatitis C With Colon and Rectal Cancers: A 9-Year Nationwide Population-Based Cohort Study

BackgroundWhether HCV infection is associated with colorectal cancer (CRC) development remains inconclusive. MethodsA nationwide population-based cohort study of the Taiwan National Health Insurance Research Database was conducted. ResultsFrom 2003 to 2012, 1:2:2 propensity score-matched HCV-treated [interferon-based therapy ≥ 6 months, surveys for CRC (n = 9017), colon cancer (CC) (n = 9,022) and rectal cancer (RC) (n = 9,033), HCV-untreated and HCV-uninfected cohorts CRC (n = 18034), CC (n = 18,044) and RC (n = 18,066) were enrolled. The HCV-uninfected cohort had the lowest cumulative incidence of CRC (0.117%; 95% CI: 0.062%-0.207%), whereas the HCV-treated (0.966%; 0.375-2.122%) and HCV-untreated (0.807%; 0.485%-1.280%) cohorts had similar incidences (P = .0662); HCV infection [reference: HCV-untreated cohort, HCV-treated: hazard ratio (HR): 0.598; 95% CI HR: 0.337-1.059; HCV-uninfected: 0.250; 0.138-0.456] and age ≥ 49 years (3.128;1.751-5.59) were associated with CRC development. The HCV-untreated cohort had the highest cumulative incidence of CC (0.883%; 0.371-1.839%), while HCV-treated (0.478%; 0.110-1.518%) and HCV-uninfected cohorts (0.147%; 0.071-0.284%) had similar incidences (P = .4853); HCV infection (HCV-treated: 0.474; 0.232-0.971; HCV-uninfected: 0.338; 0.184-0.62), male sex (2.18; 1.301-3.654), age≥ 49 years (4.818; 2.123-10.936) and diabetes (1.983; 1.205-3.262) were associated with CC development. A higher RC cumulative incidence was noted in the HCV-untreated cohort (0.332%; 0.151-0.664%) than in the HCV-uninfected cohort (0.116%; 0.054-0.232%) (P = .0352); HCV infection (HCV-treated: 0.691; 0.295-1.617; HCV-uninfected: 0.424; 0.207-0.867), age ≥ 49 years (3.745, 1.576-8.898) and stroke (3.162; 1.366-7.322) were associated with RC development. ConclusionsThe baseline associations were HCV infection and age ≥ 49 years with CRC; male sex and diabetes with CC; and stroke with RC. Anti-HCV therapy might reverse the risk of HCV-related CC but not RC.

Risk-stratified screening and colorectal cancer incidence and mortality: A retrospective study from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

ObjectiveTo determine whether risk stratification can optimize the benefits of flexible sigmoidoscopy (FSG) screening. MethodsThe Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial was conducted from 1993 to 2001 in the United States. A colorectal cancer (CRC) risk stratification tool was developed in the control arm (n = 64,207) from the PLCO cohort and validated in the UK Biobank (n = 270,726). PLCO participants (n = 130,021) were classified into low-, medium-, and high-risk groups. Cumulative incidence and mortality were estimated using the Kaplan-Meier method. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between screening and CRC incidence and mortality. ResultsThe CRC risk stratification tool was based on age, gender, body mass index, smoking status, family history of CRC, diabetes, regular use of aspirin, and CRC screening history. Compared with the control arm, FSG screening was significantly associated with a reduction in mortality in both the medium-risk (HR = 0.76, 95% CI = 0.63–0.92) and high-risk groups (0.58, 0.46–0.73), but not in the low-risk group (0.85, 0.61–1.19). FSG screening also reduced distal CRC incidence and mortality in the medium-risk and high-risk groups. Furthermore, it was associated with a reduction in incidence (0.74, 0.59–0.92) and mortality (0.59, 0.40–0.87) of proximal colon cancer in the high-risk group. ConclusionsFSG screening yielded more benefits for the high-risk group than for the low-risk and medium-risk groups, supporting the development of a risk-stratified CRC screening strategy.

A potential association between recent increased incidence of breast and uterine body cancers in Japanese women and changes in dietary saturated fat and folate intake: A meta-analysis

Recent increases in breast and uterine body cancers among Japanese women suggest the involvement of some modifiable factors in cancer development, including drinking and smoking habits, which are generally associated with Westernized lifestyles. Using national data on annual cancer incidence, this study examines the associations between recent changes in cancer incident rates and dietary habits. Data on age-specific incidence and mortality rates of breast, uterine body, colon, and lung cancers from 2004 to 2019, as well as annual changes in the intake of animal protein, plant protein, saturated fatty acids, and folate from 2001 to 2019 among Japanese women, were obtained from e-Stat, a portal site of Japanese Government Statistics. The analysis indicates that the incidence rates of breast and uterine body cancers among Japanese women increased from 2004 to 2019, displaying distinct distribution patterns with two peaks for breast cancer and one peak for uterine body cancer. The rising incidence rates of both cancers were positively correlated with annual changes in animal protein and saturated fat intake and inversely correlated with changes in plant protein and folate intake. Health-care professionals should be aware of the notable and characteristic increase in breast and uterine body cancer incidence among Japanese women and emphasize the importance of lifestyle modifications to counteract Westernized dietary habits.

Can vitamin D deficiency be considered a risk factor be considered a risk factor in luminal breast cancer?

e24122 Background: The relationship of vitamin D (VD) with cancer is controversial. Its antiproliferative function by inhibiting the cell cycle has been described, as well as its characteristics as an inhibitor of angiogenesis, inducer of apoptosis and its ability to reduce inflammation, invasion and metastasis. Deficiency of this vitamin is very prevalent, affecting 40% of the population under 65 years of age, and there are some studies that relate it to the increase in the incidence of breast cancer (BC), colon or prostate cancer. VD deficiency is defined as a serum level of 25-hydroxy VD &lt; 20 ng/mL. We analyzed whether VD deficiency can be considered a risk factor for BC, given that it is the most frequent tumor in the world. Methods: A single-center, retrospective, descriptive and analytical study of female patients diagnosed with localized luminal BC (stage I-II and III) in the year 2023 and a control group of healthy women. Baseline VD levels were determined in both groups. Statistical analysis (IBM SPSS Statistics 22) of demographic and clinical characteristics and multivariate analysis using a logistic regression model for the study of VD deficiency, according to the variables age, menopausal status and previous chemotherapy. Results: We analyzed 231 patients (p) with luminal BC and a control group of 324 healthy women. In the BC group the median age was 62 years (range 34 - 88 years), 72% (168 p) in postmenopausal stage. 52% (121 p) had stage I, 37% (86 p) stage II, and 11% stage III. 59.7 % (138 p) had luminal A phenotype and 40.2 % luminal B phenotype. 27.7 % (64 p) had received chemotherapy. In the control group the median age was 65 years (range 45 - 78 years), 90% (287 women) in postmenopausal state. VD deficiency was present in 50.6 % of the BC group with a mean VD value of 21 ng / ml. In the control group the deficit was 33 % with a mean VD value of 24 ng / ml. Therefore, this deficit is significantly higher in breast cancer patients than in healthy patients, with OR of 2.08 with 95% CI (1.4 - 2.7). In the overall multivariate analysis postmenopausal women have 5.1 more risk of presenting VD deficit, with p = 0.04. The variable age did not reach statistical significance. Logistic regression was performed to determine the effects of age, menopausal status, and having received previous chemotherapy, on the probability of BC patients presenting a VD deficit, without reaching statistical significance. Conclusions: VD deficiency is more prevalent in women with BC than the normal population, which is consistent with previous studies. Further well-designed studies are needed to assess the effect of VD supplementation in the female population as prevention of BC.

Antibiotic exposure and colon carcinogenesis: In-depth profiling of a 492-patient cohort, with a focus on antibiotic classifications and subtypes.

e15643 Background: To investigate whether the use of specific antibiotics is associated with an increased risk of colon cancer incidence. Methods: We conducted a retrospective cohort study comprising 492 patients diagnosed with colon cancer between 2012 and 2022, with no prior malignancies and a minimum 5-year follow-up period. We collected demographic data, medical histories, and records of antibiotic exposure, categorizing antibiotics systematically based on the Anatomical Therapeutic Chemical (ATC) classification system. Patient antibiotic histories, including drug names, dosages, durations, and therapeutic indications, were included. Antibiotics were classified as broad-spectrum, narrow-spectrum, or extended-course. We performed univariate and multivariate logistic regression models and used propensity score matching to control for potential confounding variables, such as age, gender, co-morbidities, and concurrent medications. Subgroup analyses were conducted to identify specific antibiotic classes associated with an increased risk of colon cancer. Results: The mean age of the cohort was 65.7 years (SD ± 8.3), with an equal gender distribution. Adenocarcinoma was the predominant histological subtype (429 cases, 87%), with rare subtypes accounting for the remaining cases. Common co-morbidities included hypertension (226 cases, 46%), diabetes mellitus (108 cases, 22%), and hyperlipidemia (88 cases, 18%). The most frequently prescribed antibiotics were fluoroquinolones (158 cases, 32%), followed by cephalosporins (108 cases, 22%), and macrolides (88 cases, 18%). Extended-course antibiotics were administered in 138 cases (28%). Preliminary analysis revealed a statistically significant correlation between the use of extended-course antibiotics and the risk of colon cancer (Odds Ratio = 1.89, 95% Confidence Interval: 1.32-2.71, p &lt; 0.05). No substantial association was observed with broad-spectrum or narrow-spectrum antibiotics. Subgroup analysis identified specific agents within the extended-course antibiotics, such as fluoroquinolones and clindamycin, with an elevated risk profile. Conclusions: This study suggests a potential association between the use of extended-course antibiotics and the development of colon cancer. Further validation through larger-scale, prospective studies is strongly recommended to confirm these findings. Further in-depth mechanistic inquiries, particularly in cellular signaling pathways and microbial interactions within the gut microbiome, are warranted to elucidate the underlying biological mechanisms driving this association.

#883 P-cresyl sulphate and Indoxyl sulphate: two uremic toxins stimulating colon cancer progression in patients with chronic renal failure

Abstract Background and Aims Chronic kidney disease (CKD) leads to the accumulation and production of uremic toxins, such as Indoxyl Sulphate (IS) and P-cresyl sulphate (p-CS). These toxins have been found to activate various processes that promote tumor growth. The literature has reported a two-fold increase in the incidence of colon cancer (CRC) and a worse prognosis in CKD patients, although the specific mechanisms underlying this association have not been fully elucidated. Given the pro-oncogenic activities of p-CS and IS at both the systemic and intestinal levels, it is plausible that these toxins contribute to the heightened aggressiveness of CRC in CKD patients. Method In order to assess the impact of toxins detected in uremic patients, we conducted experiments using three different colorectal cancer (CRC) cell lines (HT29, Hct116, LoVo). We tested various concentrations of IS and p-CS and measured their effects on tumor cell proliferation through a colorimetric assay called WST-8. For further analysis of cell survival, we performed a clonogenic assay. To investigate the migratory abilities of tumor cells after toxins treatment, we conducted a wound healing assay. Additionally, we assessed the invasive capacities of the three CRC cell lines post treatment with IS and p-CS using an invasion assay. In order to identify the specific pathways affected by toxins exposure, we conducted Real Time PCR and Western blot analysis to evaluate the inflammatory pathway and the epithelial-mesenchymal transition (EMT), respectively. Results The results of this study are remarkable, as we observed a notable increase in cell growth after exposure of cultured cells to various concentrations of toxins, as compared to the control group. Furthermore, the concentrations of IS and p-CS induced a substantial enhancement in cell migration and invasion. In the case of HCT116 cells treated with uremic toxins, there was an up-regulation of Vimentin protein expression, while E-cadherin expression was down-regulated compared to the control group. These proteins are crucial in the process of Epithelial-Mesenchymal Transition (EMT). Additionally, we evaluated the expression of genes associated with the inflammatory process (TNF-alpha, INOS, and IL-6) in the HT-29 and LoVo cell lines. Interestingly, we observed an up-regulation of these genes. Of particular importance, in the LoVo cell line, IL-6 exhibited the most significant increase in expression. Conclusion Based on these preliminary results, it appears that IS and p-CS play a key role in the progression of CRC in patients with CKD.

Budget Impact Analysis of Circulating Tumor DNA Testing for Colon Cancer in Commercial Health and Medicare Advantage Plans

In a randomized clinical trial, treatment guided by tumor-informed circulating tumor (ct)DNA testing reduced adjuvant chemotherapy use without compromising recurrence-free survival in patients with stage II colon cancer. The potential effects of adopting ctDNA testing into routine patient care is unknown. To compare the total cost of patient care scenarios with and without the adoption of ctDNA testing. This budget impact analysis was conducted from the perspectives of US commercial health and Medicare Advantage payers. A decision-analytical model was populated with age-specific incidence of colon cancer, use of adjuvant chemotherapy, and use of single-agent or multiagent regimens. Total cost was estimated with the costs of ctDNA testing, drug acquisition, administration, surveillance, and adverse events. The analysis was conducted from September 2023 to January 2024. The adoption of ctDNA testing. The incremental cost in the first year following the adoption of ctDNA testing, where testing will affect patient treatment and costs. In hypothetical plans with 1 million individuals covered, 35 commercial health plan members and 102 Medicare Advantage members aged 75 years and younger were eligible for ctDNA testing. In the base case with a 50% adoption rate, total cost savings were $221 684 (equivalent to $0.02 per member per month [PMPM]) for a commercial payer and $116 720 (equivalent to $0.01 PMPM) for a Medicare Advantage payer. Cost savings were robust to variations in assumptions of all parameters in the commercial population but sensitive to variations in assumptions of adjuvant chemotherapy use rates in the Medicare Advantage population. The number needed to test to avoid 1 patient receiving adjuvant chemotherapy was 4 in the commercial population and 10 in the Medicare Advantage population. The budget-neutral cost for ctDNA testing was $16 202 for a commercial payer and $5793 for a Medicare Advantage payer. Use of tumor-informed ctDNA testing to guide adjuvant chemotherapy in postsurgery patients with stage II colon cancer was projected to result in cost savings for both commercial and Medicare Advantage payers. Adoption of ctDNA testing is therefore advantageous from a budgetary perspective.

Incidence of Colon Cancer Among Medicaid Beneficiaries With or Without Human Immunodeficiency Virus Under Comparable Colorectal Cancer Screening Patterns.

People with human immunodeficiency virus (HIV; PWH) in the United States have a lower incidence of colon cancer than the general population. The lower incidence may be explained by differences in receipt of screening. Thus, we sought to estimate colon cancer incidence under scenarios in which Medicaid beneficiaries, with or without HIV, followed the same screening protocols. We used data from 1.5 million Medicaid beneficiaries who were enrolled in 14 US states in 2001-2015 and aged 50-64 years; 72 747 beneficiaries had HIV. We estimated risks of colon cancer and death by age, censoring beneficiaries when they deviated from 3 screening protocols, which were based on Medicaid's coverage policy for endoscopies during the time period, with endoscopy once every 2, 4, or 10 years. We used inverse probability weights to control for baseline and time-varying confounding and informative loss to follow-up. Analyses were performed overall, by sex, and by race/ethnicity. PWH had a lower incidence of colon cancer than beneficiaries without HIV. Compared with beneficiaries without HIV, the risk difference at age 65 years was -1.6% lower (95% confidence interval, -2.3% to -.7%) among PWH with the 2-year protocol and -0.8% lower (-1.3% to -.3%) with the 10-year protocol. Results were consistent across subgroup and sensitivity analyses. Our findings suggest that the lower risk of colon cancer that has been observed among PWH aged 50-64 years compared with those without HIV is not due to differences in receipt of lower endoscopy. Keywords: colon cancer, colorectal cancer screening, endoscopy, Medicaid, human immunodeficiency virus.

Oral anaerobe bacteria-a common risk for cardiovascular disease and mortality and some forms of cancer?

This review explores the results of research on oral health concerning cardiovascular diseases and some forms of cancer and is based on results from published systematic reviews and some studies. The research results will have a strong focus on exploring the relationship between different aspects of oral infections. The relationship between oral health parameters, cardiovascular diseases (CVD), and certain cancers was examined from different angles, including prospective analyses, in a population-based health study in Oslo from the year 2000 (Oslo II study). A major finding was that low levels of antibodies to the oral anaerobe Tannerella forsythia predict both CVD mortality in men with a history of myocardial infarction and incidence of bladder cancer in a random sample of men in the study. Low levels of antibodies to Treponea denticola predict the incidence of bladder and colon cancer in a random sample of men in the study. Both anaerobe bacteria are part of the so-called red complex of bacteria in chronic periodontitis together with Pophyromonas gingivalis. These three bacteria have different properties and are causal in chronic periodontitis. They migrate into the local tissues by adhering to the oral epithelium, break down soft and hard tissues, and spread via the circulation to organs distant from the mouth. This paper will give an overview of which oral health measures have been explored and associated with different CVD and cancer diagnoses and what scientific literature supports or contravenes our hypothesis. The oral microbiome is described with the most relevant bacteria related to microbiology, serum, autopsies, and associated causes such as alcohol. There will be a mention of the possibilities and limitations of different study designs. There seems to be a causal relationship between oral anaerobe bacteria and systemic diseases regulated by the immune system. This is seen alongside other well-known risk factors, especially for CVD. The prospective finding of a relation to the incidence of certain cancers and CVD is particularly intriguing. However, further research is needed to determine the biological mechanisms underpinning these associations.

Elevated Colon Cancer Rates Linked to Prior Appendicitis: A Retrospective Cohort Study Based on Data from German General Practices.

Background/Objective: The association between appendicitis and colon cancer is not yet fully understood. Previous studies have shown contradictory results. Currently, no population-based data from Germany are available with regard to the incidence of colon cancer following appendicitis. This study investigated the association between appendicitis and the incidence of colon cancer in Germany. Methods: In this retrospective cohort study, the incidence of colon cancer was compared for patients with appendicitis and patients without appendicitis, matched for age, sex, index year, average annual consultation frequency, and comorbidity. The aim of the study was to explore the relationship between appendicitis and the incidence of colon cancer. The evaluation was carried out using logistic regression analyses. Results: The study included 49,790 people with and without appendicitis, with a median age of 41 years. During a follow-up period of up to 15 years, 1.04% of cases with appendicitis and 0.60% of cases without appendicitis were newly diagnosed with colon cancer, with some 36.4% of colon cancer cases diagnosed within the first six months after appendicitis. Regression analyses revealed a significant association between appendicitis and colon cancer, particularly in men and in the age groups 41-50 (HR: 10.30; 95% CI: 1.03-43.82) and 18-30 years (HR: 8.17; 95% CI: 1.03-64.58). Conclusions: The present retrospective cohort study suggests an association between appendicitis and the incidence of colon cancer in Germany. Based on our results, we recommend offering a colonoscopy or at least a stool test within 12 months after appendicitis, especially for 18-50-year-olds and >60-year-olds in good general health.

Volatile N-nitrosamines in processed meat products: An approach for monitoring dietary exposure, assessing human risk, and evaluating variable correlations by principal component analysis and heat map

Several epidemiological studies have reported a positive association between the consumption of processed meats containing N-nitrosamines (NAs) and the incidence of hepatocellular and colon cancer. The health risk assessment in this investigation was based on the concentration of six volatile N-nitrosamines (VNAs) (N-nitrosodimethylamine, N-nitrosodiethylamine, N-nitrosomethylethylamine, N-nitrosopiperidine, N-nitrosodibutylamine, and N-nitrosodi-n-propylamine) found in processed meat products (sausage and kielbasa) in the Iranian market. Direct supported liquid membrane two-phase hollow fiber electromembrane extraction coupled to gas chromatography/mass spectrometry was used to analyse six VNAs. The mean concentration of the six VNAs in sausages and kielbasa was 38.677 ± 27.56 and 48.383 ± 35.76 μg/kg, respectively. The 95th percentile for the chronic daily intake of total VNAs for children (3–14 years) and adults (15–70 years) were calculated to be 5.06 × 10−4 and 1.09 × 10−4 mg/kg bw/day, respectively. The cancer risk assessment showed that the risk associated with NDEA was the highest among the other VNAs studied in Iranian processed meat, with a 95th percentile for the child and adult groups. Based on an incremental lifetime cancer risk (ILCR) value of ≤10−4 for the carcinogenic effects of exposure to a total of six VNAs, it indicates low concern for all age groups.