Incidence Of Colorectal Malignancies Research Articles

SP9.1.6 Save the scope - a 3-year analysis of follow-up methods for acute diverticulitis and the incidence of colorectal malignancy

Abstract Aims Previously, guidelines for the management of diverticular disease have recommended endoscopic evaluation following acute diverticulitis to exclude colorectal cancer (CRC). However, 2021 ACPGBI consensus guidelines recognised the sensitivity of modern CT scanning and low incidence of CRC, and suggested no routine re-imaging in CT-proven uncomplicated disease. Methods Patient were identified presenting between 2017–2019 at a single centre. Records were retrospectively reviewed to evaluate the incidence of CRC at a minimum of 18-month follow up in this patient group. Secondary outcomes included the imaging method requested, operative management, and complications following endoscopy. Results Of 486 admissions in 461 patients, 168 (35%) had CT-proven complicated disease, 225 (46%) had uncomplicated, and 93 (19%) had no imaging. 281 (59%) had follow-up investigations requested; 126 CT colonoscopy (CTC) and 150 endoscopic. 133 investigations were performed in patients with uncomplicated diverticulitis. Only 6 patients (1%) were diagnosed with CRC; 2 at endoscopy, and 4 by histology from colorectal resections during emergency admission; all had CT-proven complicated diverticulitis. No malignancy was identified in patients with uncomplicated diverticulitis. Secondary outcomes identified that 26 (24%) flexible sigmoidoscopies were poorly tolerated, necessitating further imaging. Conclusions At our centre, there was little consensus on whether patients had follow-up imaging following acute diverticulitis, and what modality was used. We identified no CRC in patients with CT-proven uncomplicated disease, with 133 potentially unnecessary investigations performed in this group. We recommend use of CTC or endoscopy following acute CT-proven complicated diverticulitis in line with ACPGBI guidelines, avoiding follow-up in uncomplicated disease.

Incidence trend for colorectal cancer in the cohort of workers exposed to ionizing radiation

Colorectal cancer is one of the most common malignant neoplasms. Main causes inducing this type of cancer are factors related to the life style and occupational exposures to chemical agents. Some studies demonstrated an association of colorectal cancer incidence and mortality with ionizing radiation. The aim of the present study was to assess the trend in colorectal cancer incidence in a cohort of nuclear workers employed at the Mayak Production Association who had been exposed to ionizing radiation over prolonged periods. The cohort comprised 22,377 workers (25% of females) employed at one of the main plants (reactors, radiochemical and plutonium production plants) of the Mayak Production Association in 1948-1982 who had been externally exposed to gamma rays (cumulative absorbed colon doses were 0–5.85 Gy with the corresponding median dose of 0.16 Gy) and those who had inhaled aerosols containing plutonium particles had been also internally exposed to alpha radiation (cumulative absorbed colon doses were 0–0.18 Gy with the corresponding median dose of 0.0002 Gy). Over the period of 1948–2018, 239 colon cancers and 186 rectum cancers were diagnosed in the study cohort. The incidence of colorectal malignancies among workers of the study cohort was shown to increase with age above 50. Age-standardized incidence rates were higher in males than in females. The time trend analysis of age-standardized rates of colorectal malignancies among workers of the study cohort was performed using a spline regression. The trend of age-standardized rates of colorectal cancer incidence in the Mayak Production Association workers over the analyzed period was nonmonotonic. In general, the average annual percent change of incidence growth for colon cancer was less than 0.1% (for both sexes), while the corresponding estimates for rectum cancer were 1.1% in males and 30.3% in females. To assess the effect of occupational radiation exposure on the incidence of colorectal malignancies, a radiogenic risk analysis that would take into account non-radiation risk factors should be performed.

Predictors of colonic pathologies in active acromegaly: single tertiary center experience.

Regarding the incidence of colorectal malignancy and polyps in patients with acromegaly, studies reported different results in different populations. For this reason, the aim of this study was to determine the frequency of possible colonic pathologies, such as diverticula, polyps, and malignancies in Turkish patients with active acromegaly and factors affecting them. Atotal of 134patients with acromegaly and 134patients with irritable bowel syndrome/dyspeptic symptoms as acontrol group were included in the study. None of these patients had aprevious or family history ofcolonicneoplasms. Colonoscopies of patients with acromegaly were performed before definitive surgeryin asingle center by experienced endoscopists. The acromegaly and control groups were similar in terms of age and sex. The incidence of all colonic polyps was significantly higher in the acromegaly group (p = 0.012). The frequency of hyperplastic polyps was also increased in the acromegaly group (p = 0.004); however, the frequencies of adenomatous polyps and colonic diverticula were similar in both groups. In the comparison of patients with acromegaly for the presence of polyps, those with polyps were older, had higher levels of insulin-like growth factor (IGF-1), were of male sex, and skin tags were more common (p = 0.016, p = 0.034, p = 0.006 and p = 0.001, respectively). There were no colorectal malignancies in the patients with active acromegaly. The frequency of hyperplastic polyps was increased, whereas colonic malignancy was not observed in Turkish patients with active acromegaly.

The Role of Deleted in Colorectal Cancer (Dcc) and P53 Mrna Expression In Young Colorectal Cancer Patients

Background : The incidence of colorectal malignancies at a young age, and the absence of sufficient data to explain about it, including in terms of gene mutations that play a role. The research will be done here is to determine whether changes in mRNA expression of genes DCC ( deleted in colorectal cancer ) and p53 play a role in colorectal malignancy is less than 40 years of age. Researchers also will perform immunohistochemistry to look at protein expression of the gene and protein expression was evaluated whether these correlated with mRNA expression.
 Methods : This study is an observational analytic cross sectional design, carried out in the Laboratory of Biomedical Faculty of Medicine Sebelas Maret University from June 2013 to March 2014. Subjects were 30 patients with stage III colorectal adenocarcinoma, with details of the 15 subjects for each group. Subjects taken by consecutive sampling. Immunohistochemical examination of paraffin block preparation and reverse transcriptase - polymerase chain reaction (RT - PCR) of tumor tissue samples for evaluation of the presence of the protein and mRNA expression of DCC and p53 genes .Statistical analysis using the chi-square test and Phi correlation. 
 Results : the 4 subjects in the age group ≤ 40 years was not accompanied by DCC protein expression while in the age group > 40 years of protein expression obtained in all preparations. Expression of p53 protein more available in the age group > 40 years ( 3 subjects ), in the age group ≤ 40 years is only found in 1 subject. Examination results of RT-PCR to assess the mRNA expression results are consistent with the results of immunohistochemistry. Eleven subjects from the age group ≤ 40 years obtained DCC mRNA expression, whereas p53 mRNA expression was found in 12 subjects. From statistical analysis using the chi-square test and Phi correlation, we found significant association between protein and mRNA expression of DCC with colorectal cancer aged ≤ 40 years. Correlation of test results, obtained significant correlation between mRNA expression of DCC with colorectal cancer aged ≤ 40 years and the results of protein expression were significantly correlated with mRNA expression of DCC and p53 genes. 
 Conclusion : the expression of p53 protein and mRNA did not play a role in colorectal cancer ≤ 40 years of age. Protein expression was positively correlated with mRNA expression .

Nature and outcomes of the increased incidence of colorectal malignancy after liver transplantation in Australasia

To examine whether incidence of colorectal malignancy is increased in Australasian liver transplant recipients compared with the general population of Australia, and to assess the characteristics and outcomes of colorectal malignancy in this patient group. Data on patients who underwent orthotopic liver transplantation (OLTx) and had a diagnosis of de-novo colorectal malignancy after transplantation during the period 1985-2011 were obtained from the Australia and New Zealand Liver Transplant Registry, and these data were compared with colorectal malignancy data from the Australian Institute of Health and Welfare. Time from OLTx to diagnosis of colorectal malignancy, stage of colorectal malignancy at diagnosis, patient survival, and standardised incidence ratio (SIR) for colorectal malignancy. Forty-eight of 3735 recipients (1.3%) were diagnosed with colorectal malignancy at a median of 7.3 years after OLTx. More advanced colorectal malignancy (regional or metastatic disease) was evident at diagnosis in 20 of the 48 patients; these patients tended to be younger than patients with less advanced malignancy (P = 0.01) and diagnosed sooner after OLTx (P = 0.005). Despite treatment predominantly with surgery, 19 of the 48 patients died from the malignancy. The overall SIR for colorectal malignancy liver transplant recipients compared with the general population of Australia was 2.80 (95% CI, 2.06-3.71). The incidence of colorectal malignancy is increased in liver transplant recipients in comparison with the general population. Of concern is the tendency for advanced malignancy to be diagnosed in younger patients. These data highlight the importance of considering whether specific guidelines for colorectal malignancy screening in the Australasian adult liver transplant population are needed.

Incidence of colorectal cancer in Lower Silesia (Poland) between 1984 and 2003 — trends and perspectives

Abstract The purpose of the present study was to demonstrate the epidemiological characteristics of colorectal cancers (CRCs) diagnosed in Lower Silesia between 1984 and 2003. Data from the Lower Silesian Cancer Registry on the incidence of CRC in the Lower Silesian province were subjected to analysis. The age adjusted incidence of CRC in both genders increased markedly. A higher relative increase of incidence was recorded for colon cancer. The age-specific incidence of either colon or rectal cancer increased markedly with age in both genders. No constant time-trend toward the earlier diagnosis of CRC was noted in the period studied. Although the number of CRC surgeries performed at the Regional Comprehensive Cancer Center in Wroclaw has increased over time, most of the cases that were diagnosed were treated outside that reference center. If an intensive increase in new case numbers, demonstrated in both the locations by 2003, is not moderated, the incidence of colorectal malignancies in Lower Silesia would become one of the highest in Europe.