New Cases Of Colorectal Cancer Research Articles

Potential and toxicity effects of fish omega-3 fatty acid as a chemopreventive agent in colorectal cancer: A scoping review

Colorectal cancer (CRC), a malignancy that affects the colon and rectum, is influenced by gene mutations, epigenetic changes, local inflammation, and lifestyle risk factors. New cases of CRC globally account for 10%, with mortality at 9.4%, while Indonesia occupies the top four incidence and mortality cases. A family history of CRC requires preventive measures, including consuming functional foods to maintain the colon microenvironment. This article aims to review the potency and toxicity effects of omega-3 fish fatty acids as a chemopreventive agent against CRC. The data sources were original articles about omega-3 fish fatty acids as CRC chemopreventive agents, published in 2012-2022 and in English or Indonesian. Databases used are Ovid, ScienceDirect, ProQuest, PubMed, Springer Link, EBSCO, and Google Scholar using Boolean search. The selection of studies followed the PRISMA-ScR method. Of the nine articles selected, fish omega-3 fatty acids had the potential as a chemopreventive agent against CRC, with several variations in daily dose ranges accompanied by a good lifestyle. Oral omega-3 fish supplementation gave benefits in the range of 96 mg–2,000 mg of eicosapentaenoic acid (EPA) and between 360 mg–1,000 mg of docosahexaenoic acid (DHA), with a daily intake varying between 0–14 grams/day. One study reported a toxic effect of fish omega-3 fatty acids, which raised the risk of post-operative infection after parenteral (intravenous) administration. There are no reported side effects across eight studies following oral preparation administration. The omega-3 fish fatty acid shows potential as a chemopreventive therapy for CRC; further studies are required to explore the parenteral administration-associated toxic effects.

O156: Post-operative surveillance following curative resection of colorectal cancer in an elderly population

Abstract Introduction There are over 42,000 new cases of colorectal cancer in the UK each year with the highest incidence rates in those aged 85-89. Post-colorectal cancer surveillance aims to reduce cancer incidence and mortality, but its necessity and effectiveness remain debated especially in an elderly population. This study explores the relevance of computer tomography (CT) and colonoscopy surveillance in patients aged 75 and over who have undergone curative resection for colorectal cancer. Methods A retrospective analysis of prospectively collected data was conducted on patients aged 75 and over who had undergone surgical resection of colorectal cancer between November 2014 and August 2021. Data on demographics, treatment, survival, and surveillance were gathered from electronic patient records. The primary outcome was adherence to follow-up colonoscopy and CT-scan surveillance following surgery. Results A total of 417 patients underwent colorectal cancer surgery, with 334 included for analysis. Twelve-month CT surveillance showed normal results in 91.8% of cases, while 24-month CT surveillance demonstrated normal findings in 88.7%. Only 52.4% had colonoscopy follow-up, with 53.7% showing normal results, 42.3% demonstrated benign polyps, and 1.1% had histologically proven cancer. Reasons for not undergoing colonoscopy included patient preference (19.1%) and frailty (28.7%). Conclusion This study reinforces the notion that colonoscopy surveillance in patients over 75 may have limited benefits. In an aging population, benefits of surveillance in terms of early detection of recurrence must be balanced against the risks of harm from the procedure, availability of further management, cost-effectiveness, and patients’ preference.

Study of Impact of Dietary Factors on Prevalence of Colon Cancer

The third most frequent cancer worldwide is colorectal cancer. Globally, 1.5 million new cases of colorectal cancer were reported in 2023, making up 10% of all new cancer cases. According to estimates, colorectal cancer is the fourth most prevalent cancer-related cause of death.be accountable for about 700,000 cancer-related deaths. Survival from colorectal cancer depends on the stage of the disease, with later-stage diagnoses having a worse prognosis. 90% of colorectal cancer patients who receive an early diagnosis survive five years. Western Africa has the lowest estimated rates, while Australia and New Zealand have the highest. Men and women worldwide experience colorectal cancer in similar ways. More than 2.2 million colorectal cancer cases are anticipated to be diagnosed during the next 15 years, a 60% rise. It is one of the malignancies whose incidence is rising globally. The diet has a direct connection with the colon cancer because inflammation in the bowels and gut is influenced by what we consume, and inflammation is a risk factor for the development of colorectal cancer. Researchers have identified sugar, animal fats, red and processed meats as the key food ingredients that produce inflammation in the body and may raise the risk of colon cancer.

Epidemiology of Colorectal Cancer in Algeria

Every year, nearly one and a half million new cases of colorectal cancer are diagnosed worldwide. North America and Europe have the highest incidence rates. Algeria has average incidence rates lower than the average incidence in Europe but the highest in Africa, the increase in the annual percentage of colorectal cancer is estimated by Algerian epidemiological experts at +7% . In Algeria, colorectal cancer is the 2nd most common cancer after breast cancer. The standardized annual incidence rates are 23 per 100,000 in men and 16 per 100,000 in women. Around 2,984 people with colorectal cancer died in 2018 according to Globocan 's estimate of the same year. In both sexes, the incidence has increased every year for a decade, while in France and in Europe in general, the incidence has been decreasing and mortality has been decreasing since registry statistics existed, and more markedly in both sexes. According to the most recent estimates, net survival five years after diagnosis of colorectal cancer is 60% in France. The vast majority of studies consider that a diet rich in red meat, high in calories, high in fat and low in fiber is linked to an increased risk of colorectal cancer. Conversely, a diet combining sustained consumption of fruits and vegetables, fish, white meat and whole grains is associated with a reduction in risk. Body mass index is positively correlated with colorectal cancer risk. Studies show a protective effect of physical activity, with a risk reduction of 40 to 50% with a dose-response effect.

THE DEGREE OF AWARENESS OF THE POPULATION OF THE KARAGANDA REGION ON THE INCIDENCE AND PREVENTION OF COLORECTAL CANCER: A LITERATURE REVIEW

Relevance: Colorectal cancer (CRC) is the leading cancer in yearly morbidity and mortality. WHO forecasts that 2030 CRC incidence will exceed 2.2 million cases yearly, and mortality will increase to 1.1 million yearly. More than 3,000 new cases of colorectal cancer are detected annually in Kazakhstan. In disease control, it is necessary to develop preventive measures as much as possible. Preventive measures play a crucial role in reducing mortality from this disease. One of the most critical issues is the lack of public awareness about the disease.
 The study analyzes the global experience in preventing colorectal cancer to develop measures to raise public awareness.
 Methods: A continuous search was performed in the PubMed, CrossRe, Scopus, and Cochrane databases for 2013-2023 for the keywords “colorectal cancer,” “risk factors,” “public awareness,” “medical literacy,” “morbidity,” and “prevention.” In total, more than 75 scientific articles and 500 abstracts were reviewed.
 Results: The problem is aggravated by the fact that among patients with an oncological diagnosis, patients with colorectal cancer, or patients with a confirmed diagnosis of the disease, there is insufficient information about this disease, and they neglect preventive measures. Firstly, we insist that the population is not fully aware of the responsibility for their health (this is influenced by a false sense of shame and insufficient awareness of the disease), and secondly, primary prevention is essential. Accordingly, it is necessary to increase the effectiveness of screening programs, improve awareness, and organize full-fledged assistance from the state in disease control.
 Conclusion: Colorectal cancer is an urgent disease that occupies an essential place in Kazakhstan’s list of oncological diseases. Due to the increased awareness of the population about this disease and the correct solution to prevention issues, it will be possible to reduce the incidence among patients. In this regard, it is necessary to widely disseminate information about the disease among the population and increase patients’ responsibility for their health.

THE DEGREE OF AWARENESS OF THE POPULATION
 OF THE KARAGANDA REGION
 ON THE INCIDENCE AND PREVENTION
 OF COLORECTAL CANCER:
 A LITERATURE REVIEW

Relevance: Colorectal cancer (CRC) is the leading cancer in yearly morbidity and mortality. WHO forecasts that 2030 CRC incidence will
 exceed 2.2 million cases yearly, and mortality will increase to 1.1 million yearly. More than 3,000 new cases of colorectal cancer are detected
 annually in Kazakhstan. In disease control, it is necessary to develop preventive measures as much as possible. Preventive measures play a crucial
 role in reducing mortality from this disease. One of the most critical issues is the lack of public awareness about the disease.
 The study analyzes the global experience in preventing colorectal cancer to develop measures to raise public awareness.
 Methods: A continuous search was performed in the PubMed, CrossRe, Scopus, and Cochrane databases for 2013-2023 for the keywords
 “colorectal cancer,” “risk factors,” “public awareness,” “medical literacy,” “morbidity,” and “prevention.” In total, more than 75 scientific
 articles and 500 abstracts were reviewed.
 Results: The problem is aggravated by the fact that among patients with an oncological diagnosis, patients with colorectal cancer, or patients
 with a confirmed diagnosis of the disease, there is insufficient information about this disease, and they neglect preventive measures. Firstly,
 we insist that the population is not fully aware of the responsibility for their health (this is influenced by a false sense of shame and insufficient
 awareness of the disease), and secondly, primary prevention is essential. Accordingly, it is necessary to increase the effectiveness of screening
 programs, improve awareness, and organize full-fledged assistance from the state in disease control.
 Conclusion: Colorectal cancer is an urgent disease that occupies an essential place in Kazakhstan’s list of oncological diseases. Due to the
 increased awareness of the population about this disease and the correct solution to prevention issues, it will be possible to reduce the incidence
 among patients. In this regard, it is necessary to widely disseminate information about the disease among the population and increase patients’
 responsibility for their health.

Colorectal cancer incidence trends in Golestan, Iran: An age-period-cohort analysis 2004–2018

BackgroundWe investigated the effects of factors including age, birth year (cohort) and diagnosis year (period) on colorectal cancer (CRC) incidence trends in Golestan, Northeast of Iran, 2004–2018. MethodsWe obtained data on incidence cases of CRC from the Golestan Population-based Cancer Registry by sex and area of residence (urban/rural). Age-standardized incidence rates (ASRs) were calculated using the World standard population and presented per 100,000 person-years. We calculated the estimated annual percentage change (EAPC) with 95 % confidence intervals (95 % CI) fitted age-period-cohort (APC) models to assess non-linear period and cohort effects as incidence rate ratios (IRRs). ResultsOverall, 2839 new cases of CRC (ASR = 13.7) were registered in the GPCR over 2004–2018. Our findings suggested significantly increasing trends in CRC incidence rates from 2004 to 2018 (EAPC = 3.7; 95%CI: 0.4, 7.1), with the greatest changes occurring in rural women (EAPC= 4.7; 95%CI: 0.4, 9.2). We observed a strong cohort effect with a consistent increase in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924) (IRR= 0.1 versus the reference birth cohort of 1955) through to the most recent cohort born in 1983 (IRR= 1.9). The largest cohort effects were found among rural females (IRR = 0.0, and IRR = 2.5 for the oldest and the youngest birth cohorts vs. the reference birth cohort, respectively). ConclusionThe increasing trends in CRC rates in Golestan are largely driven by generational changes in exposure to underlying risk factors. Further investigations are warranted to deliver effective prevention strategies for the control of CRC in Golestan.

Chemo-radiotherapy with 177Lu-PLGA(RGF)-CXCR4L for the targeted treatment of colorectal cancer.

More than 1.9 million new cases of colorectal cancer and 935,000 deaths were estimated to have occurred worldwide in 2020. Therapies for metastatic colorectal cancer include cytotoxic chemotherapy and targeted therapies in multiple lines of treatment. Nevertheless, the optimal use of these agents has not yet been resolved. Regorafenib (RGF) is an Food and Drug Administration (FDA)-authorized multikinase inhibitor indicated for patients with metastatic colorectal cancer, non-responding to priority lines of chemotherapy and immunotherapy. Nanoparticles have been used in specific applications, such as site-specific drug delivery systems, cancer therapy, and clinical bioanalytical diagnostics. C-X-C Chemokine receptor type 4 (CXCR4) is the most widely-expressed chemokine receptor in more than 23 human cancer types, including colorectal cancer. This research aimed to synthesize and preclinically evaluate a targeted nanosystem for colorectal cancer chemo-radiotherapy using RGF encapsulated in Poly(D,L-lactic-co-glycolic acid) (PLGA) nanoparticles coated with a CXCR4 ligand (CXCR4L) and 177Lu as a therapeutic β-emitter. Empty PLGA and PLGA(RGF) nanoparticles were prepared using the microfluidic method, followed by the DOTA and CXCR4L functionalization and nanoparticle radiolabeling with 177Lu. The final nanosystem gave a particle size of 280 nm with a polydispersity index of 0.347. In vitro and in vivo toxicity effects were assessed using the HCT116 colorectal cancer cell line. 177Lu-PLGA(RGF)-CXCR4L nanoparticles decreased cell viability and proliferation by inhibiting Erk and Akt phosphorylation and promoting apoptosis. Moreover, in vivo administration of 177Lu-PLGA(RGF)-CXCR4L significantly reduced tumor growth in an HCT116 colorectal cancer xenograft model. The biokinetic profile showed hepatic and renal elimination. Data obtained in this research justify additional preclinical safety trials and the clinical evaluation of 177Lu-PLGA(RGF)-CXCR4L as a potential combined treatment of colorectal cancer.

Evaluating mismatch repair deficiency in colorectal cancer biopsy specimens

Mismatch repair (MMR) testing on all new cases of colorectal cancer (CRC) has customarily been preferably performed on surgical specimens, as more tissue is available; however, new clinical trials for the use of immune checkpoint inhibitors in the neoadjuvant setting require MMR testing on biopsy samples. This study aims at identifying advantages, disadvantages and any potential pitfalls in MMR evaluation on biopsy tissue and how to cope with them. The study is prospective-retrospective, recruiting 141 biopsies (86 proficient (p)MMR and 55 deficient (d)MMR) and 97 paired surgical specimens (48 pMMR; 49 dMMR). In biopsy specimens, a high number of indeterminate stains was observed, in particular for MLH1 (31 cases, 56.4%). The main reasons were a punctate nuclear expression of MLH1, relatively weak MLH1 nuclear expression compared to internal controls, or both (making MLH1 loss difficult to interpret), which was solved by reducing primary incubation times for MLH1. A mean of ≥ 5 biopsies had adequate immunostains, compared to ≤ 3 biopsies in inadequate cases. Conversely, surgical specimens rarely suffered from indeterminate reactions, while weaker staining intensity (p < 0.007) for MLH1 and PMS2 and increased patchiness grade (p < 0.0001) were seen. Central artefacts were almost exclusive to surgical specimens. MMR status classification was possible in 92/97 matched biopsy/resection specimen cases, and all of these were concordant (47 pMMR and 45 dMMR). Evaluation of MMR status on CRC biopsy samples is feasible, if pitfalls in interpretation are known, making laboratory-specific appropriate staining protocols fundamental for high-quality diagnoses.

Association between regular physical activity and lower incidence of colorectal cancer in patients with diabetes mellitus: a nationwide cohort study.

The aim of this work was to investigate the association between changes in physical activity (PA) status and the development of colorectal cancer (CRC) in patients with diabetes. This nationwide population study included 1 439 152 patients with diabetes who underwent a health screening provided by the Korean National Health Insurance Service between January 2009 and December 2012 and a follow-up screening after 2 years. Based on changes in PA status, participants were categorized into four groups: remained inactive, remained active, active-to-inactive and inactive-to-active. During the median follow-up period of 5.2 years, 38 244 new cases of CRC were diagnosed. Compared with the remained inactive group, among the three other groups, the remained active group had the lowest risk of CRC [adjusted hazard ratio (aHR) 0.93; 95% CI 0.90-0.96], followed by the inactive-to-active group (aHR 0.97; 95% CI 0.94-1.00) and active-to-inactive group (aHR 0.99; 95% CI 0.96-1.02), after adjusting for confounding variables (p = 0.0007). This reduction in cancer incidence in the remained active group was observed for both rectal cancer (aHR 0.87, 95% CI 0.79-0.95) and colon cancer (aHR 0.93, 95% CI 0.90-0.97), irrespective of sex. In terms of the intensity and amount of PA, moderate intensity PA was the most effective, and a positive correlation was found between the amount of PA and the reduction in CRC incidence. Regular PA was independently associated with a decreased risk of CRC in patients with diabetes. The intensity and amount of physical activity both play a role in reducing the risk.

Association between nonalcoholic fatty liver disease and colorectal cancer: A population-based study.

Colorectal cancer (CRC) and nonalcoholic fatty liver disease (NAFLD) have high prevalence rates and place a considerable burden on the health-care industry. The association between both diseases is controversial. Our aim was to examine the association between NAFLD and CRC. Using data extracted from the Taiwan National Health Insurance Research Database (NHIRD) from 2000 to 2015, we enrolled 60 298 patients with NAFLD. Of these, 52,986 met the inclusion criteria. A comparison group was selected using 4-fold propensity score matching by age, sex, and year of index date. The primary outcome was the cumulative incidence of CRC in patients with NAFLD. Over a mean follow-up period of 8.5 years, 160 new cases of CRC were identified. The incidence rate of CRC was higher in the NAFLD group (12.23 per 100,000 person-years) than in the comparison cohort (6.0 per 100,000 person-years). Cox proportional hazards regression analysis revealed that the adjusted hazard ratio (HR) of CRC was 1.259 in the study group (95% confidence interval [CI]: 1.047-1.486, P = .003). Using Kaplan-Meier analysis, we ascertained that the cumulative incidence of CRC was significantly high in the NAFLD group. Patients older than 50 years, with diabetes mellitus (DM), and with chronic liver disease also exhibited a high risk of CRC. NAFLD was associated with a high risk of CRC. CRC occurs more frequently in patients with NAFLD aged between 50 and 59 years and those older than 60 years with comorbidities, including DM and chronic liver disease. Physicians should consider the subsequent risk of CRC when treating patients with NAFLD.

Prevalence of colorectal cancer in 2020: a comparative analysis between China and the world

Objective: To demonstrate the disease burden and epidemiological characteristics of colorectal cancer in different regions by analyzing the incidence and mortality data in China and worldwide in 2020. Methods: Estimation of the incidence and mortality data of colorectal cancer were obtained from the GLOBOCAN 2020 database. The incidence, death, age standardized incidence rate (ASIR) and age standardized mortality rate (ASMR) of colorectal cancer in China and 20 regions in the world were compared. The correlation between the Human Development Index (HDI) and ASIR/ASMR was analyzed. Results: In 2020, the number of new cases of colorectal cancer in the world reached 1 931 600, and the number of deaths reached 935 200. The incidence and mortality in all regions of the world continued to rise in the age group above 50 years old. The morbidity and mortality in male were higher than those in female. East Asia ranked the highest number of incidence cases and deaths in the world, which were 740 000 and 360 100 respectively. There were significant differences in incidence and mortality among regions in the world. The highest ASIR and ASMR were observed in Northern Europe (33.61/100 000) and Eastern Europe (14.53/100 000), whereas the lowest ASIR and ASMR were both observed in South-Central Asia (5.46/100 000 and 3.16/100 000). HDI had significant exponential relationship with ASIR (r(2)=0.59, P<0.001) and ASMR (r(2)=0.38, P<0.001). There were 555 500 new cases and 286 200 death cases of colorectal cancer in China, accounting for about 30% of the world and more than 75% of East Asia. The ASIR of China was 24.07/100 000, ranking at the medium level, while the ASMR was 12.07/100 000, ranking at the high level of world. Conclusion: The incidence and mortality of colorectal cancer are highly correlated with HDI. China is one of the countries with the heaviest disease burden of colorectal cancer in the world.

Is there a Role for Primary Surgical Resection in the Palliative Rectal Cancer Setting: A Systematic Re-view

Introduction: There are over 42,000 new cases of colorectal cancer diagnosed every year in the UK alone, a third of those being rectal in origin. Although there has been significant progress in the treatment of rectal cancer, overall, 5-year survival can still be as low as 17% for those with advanced disease. We aimed to assess the impact on of overall survival and quality of life of primary tumour resection in the palliative setting. Method: A literature search was performed using Pubmed and Cochrane databases in March 2022. Bias was assessed using the Joanna Briggs institute checklist. Results: Seven papers were included in the review; all retrospective cohort. A total of 809 patients underwent rectal resection in the presence of metastatic disease +/- adjuvant therapy. The median age was 61years, 59.7% male. 68.6% of patients presented with liver metastasis at the time of diagnosis. The most commonly reported symptoms preoperatively were bleeding and tenesmus. 4-50% of patients in each cohort underwent neoadjuvant therapy. Highest 30-day mortality reported was 7.3%. Both studies comparing resection v none demonstrated a higher overall survival for those undergoing surgery, with one showing 1year overall survival 65v20%. Quality of life was not addressed across the literature. Conclusion: Although there is some evidence to show a favourable overall survival for patients undergoing primary tumour resection in the palliative setting, this data is mainly old and across a heterogeneous population. A larger scale prospective study would be required to assess its potential role and impact upon quality of life.

The incidence of colorectal cancer (CRC) in Georgia continues to increase: A population-based registry study

IntroductionCRC is one of the most common and serious public health problem. In Georgia, it ranks among the top five most fatal cancers for both men and women. This study aimed to utilize cancer registry data to evaluate the incidence and stage distribution of CRC in Georgia. MethodsThe study included all new cases of CRC registered in Georgia during the period 2018–2021 (classified under ICD-10 codes C18-C21). The annual gender- and age-group-specific population figures were obtained from the National Statistics Office of Georgia (GEOSTAT). ResultsAmong the cases analyzed, the majority of patients were men (53.23%). Only about one third of the cases were diagnosed at the localized stage. The study found that the number of patients diagnosed with CRC in Georgia gradually increased from 2018 to 2021. The age-standardized incidence rates of CRC in men and women in 2021 were 17.09 and 12.04 per 100,000 individuals, respectively, with men having a slightly higher rate. The crude and direct age-standardized incidence rates increased over the 4-year period, but slightly changed in 2020. The directly adjusted incidence rate over the 4-year period was 55.44 per 100,000 population. The share of distant stage has reduced in both men and women from 2018 to 2021, but detection at localized stage remains low. ConclusionsThe incidence of colorectal cancer in Georgia increased with advancing stage, emphasizing the need to enhance the country's cancer control program to improve screening uptake.

Long-term trend of colorectal cancer survival rate in Qidong, 1972-2016

Objective: The survival of colorectal cancer in Qidong City, Jiangsu Province from 1972 to 2016 was analyzed to provide a basis for the evaluation of prognosis and the formulation of prevention and control measures. Methods: Colorectal cancer data were obtained from the Qidong Cancer Registration and Reporting System, and the follow-up was up to December 31, 2021. The observed survival rate (OSR) and relative survival rate (RSR) were calculated by SURV 3.01 software, and the trend test was performed by Hakulinen's likelihood ratio test. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) of survival, and the ARIMA model was used to predict the trend of colorectal cancer survival. Results: There were 8 637 new cases of colorectal cancer in Qidong from 1972 to 2016. Dividing 1972-2016 into 9 periods at 5-year intervals, the 5-year OSR from 1972-1976 to 2012-2016 increased from 21.86% to 48.86%, and the 5-year RSR increased from 26.45% to 59.91%. The increasing trend of RSR was statistically significant (χ(2)=587.47, P<0.001). From 1972 to 2016, the survival rates of colorectal cancer in different sexes in Qidong were similar, and the 5-year RSR was 44.63% for men and 44.07% for women. Since the 1990s, the 5-year OSR and RSR for men have been lower than those for women. From 1972 to 2016, the 5-year RSR of colorectal cancer in Qidong was significantly improved in the 65-74 and ≥75-year-old groups, but the survival rate of the ≥75-year-old group was still the lowest (36.78%), followed by the 35-44-year-old group ( 43.04%). The time trend showed that the overall AAPC of colorectal cancer 5-year RSR in Qidong from 1972 to 2016 was 2.50% (t=16.45, P<0.001). The upward trend of different sexes was consistent, and the increase was greater in women (AAPC for males=2.18%, AAPC for females=2.54%, both P<0.05). The 5-year RSR of colorectal cancer in each age group showed an upward trend, and the AAPCs of the 35-44, 45-54, 55-64, 65-74, and ≥75-year-old groups were 1.54%, 1.83%, 2.00%, 3.51% and 4.35%, respectively (all P<0.05). The prediction results of colorectal cancer survival rate showed that the 5-year RSR of colorectal cancer in Qidong will increase to 71.62% by 2026. Conclusions: The overall survival rate of colorectal cancer patients in Qidong has been greatly improved, but there is still room for improvement. We should continue to pay attention to the early diagnosis and early treatment of colorectal cancer.

PD32 Cost-Utility Of Selective Internal Radiation Therapy Using Y-90 Resin Microspheres For Chemotherapy-Refractory Metastatic Colorectal Cancer In Brazil

IntroductionThere were an estimated 55,102 new cases of colorectal cancer (CRC) in Brazil in 2020, comprising 9.3 percent of all newly diagnosed cancers, and making it the third most common cancer in the Brazilian population. Up to half of all patients with CRC will develop liver metastases, and the prognosis for these patients is poor. The objective of the present analysis was to evaluate the cost-utility of selective internal radiation therapy (SIRT) using Y-90 resin microspheres versus best supportive care (BSC) in patients with unresectable, liver-dominant, chemotherapy-refractory metastatic CRC (mCRC).MethodsA three-state partitioned survival model was developed in Microsoft Excel to evaluate the cost-utility of SIRT using Y-90 resin microspheres versus BSC. Membership of the three model states of pre-progression, post-progression and death was governed by parametric models of Kaplan-Meier data from a retrospective, interventional study. Costs associated with SIRT using Y-90 resin microspheres, BSC, and adverse events were obtained from Brazilian sources and reported in 2021 United States dollars (USD). Future costs and effects were discounted at 5 percent. One-way and probabilistic sensitivity analyses (PSA) were performed. A willingness-to-pay threshold of USD 53,936 was used based on a 2017 review of Brazilian healthcare technology adoption.ResultsThe base case analysis showed that Y-90 resin microspheres would result in an increase of 0.76 QALYs versus BSC, increasing quality-adjusted life expectancy from 0.67 QALYs to 1.43 QALYs. The improvement in quality-adjusted life expectancy was accompanied by an increase in costs from USD 9,884 to USD 40,399 over the model time horizon, corresponding to an increase of USD 30,515, and yielding an incremental cost-utility ratio (ICUR) of USD 40,265 per QALY gained. PSA showed there was a 90.8 percent likelihood of cost-effectiveness at USD 53,936 per QALY gained.ConclusionsSIRT using Y-90 resin microspheres was cost-effective versus BSC in the treatment of unresectable, liver-dominant mCRC patients and should be considered for incorporation in the Brazilian Private Healthcare System.

Global trend of colorectal cancer, prevention, and control in China: challenges and strategies

<p indent="0mm">As the third most common malignancy worldwide and the second most deadly cancer, the global burden of colorectal cancer (CRC) is substantial and growing. It induced 1.93 million cases and 0.94 million deaths worldwide in 2020, accounting for 10% of the global cancer incidence and 9.4% of cancer deaths, just lower than lung cancer. With an alarming increase in cases of early-onset CRC, the situation of CRC in China is grim. In 2020, China recorded 560,000 new cases of CRC, accounting for 28.8% of global CRC cases, and 290,000 CRC deaths, accounting for 30.6% of global CRC deaths. The estimated number of CRC incident cases in China increased by 64%, from 0.56 million in 2020 to 0.91 million in 2040. CRC prevention and control in China faced severe challenges, such as the low population coverage ratio of the cancer registry, low population coverage of the screening programs, increased exposure to lifestyle risk factors, and a lack of public belief that CRC can be prevented. Coping strategies include the following: (1) The national policy is to tilte toward prevention, increase financial investment, and rapidly construct regional high-quality cancer monitoring sites in China. (2) Resource-based targeted interventions, including primary prevention among low-income people and early screening detection in high-income settings, are necessary. (3) All kinds of recreational physical activity should be encouraged, and healthy dietary patterns should be promoted. (4) The clinical practice of stratified CRC subtype mode should be promoted based on molecular biological characteristics and individualized minimally invasive precise CRC radical mode to maximize the treatment benefit of patients with CRC.

D2, D3 LYMPH NODE DISSECTION IMPORTANCE IN COLON CANCER SURGERY

Colorectal cancer (CRC) is a relevant issue of modern oncology and ranks the third place among most common malignancies. Every year, more than 1 million new cases of CRC are diagnosed worldwide, with approximately the same frequency of prevalence among the male and female population. Colon cancer (CC) amounts for more than half of all cases of CRC, and it’s incidence and mortality remain rather high. Surgery remains the main method of CRC treatment, and determining the extent of surgery and lymph node dissection remains an urgent problem. For the first time in Japan, a classification of groups of lymph nodes (l.n.) was proposed depending on the level of lymph outflow and location in relation to the main vessels. According to the numbering of l.n. groups by the Japanese Society for Cancer of the Colon and Rectum (JSCCR), all lymph nodes are numbered with three digits. As a rule, lymphogenic metastasis occurs in one direction, bilateral spread is possible if the tumor is located at the same distance from two feeding vessels. With tumors of the right-sided localization, all groups of l.n. located along the branches of the superior mesenteric artery are removed, and with tumors of the left half of the colon, all l.n. located along the trunk of the inferior mesenteric artery are removed. The presence of affected l.n. is important for assessing the prognosis and further determining the need for adjuvant therapy. Some literature data demonstrate good results of surgical interventions performed in accordance with the concept of embryonic planes and complete mesocolonic excision. D3 lymph node dissection is not performed in daily practice in some European countries and North America, unlike a number of Eastern countries. However, the level of vessel ligation remains the subject of scientific discussion. The purpose of this review was to analyze the available literature on the problem of choosing the level of lymph node dissection in CC surgery.

Structure-Based Virtual Screening, Molecular Docking, Molecular Dynamics Simulation and Pharmacokinetic modelling of Cyclooxygenase-2 (COX-2) inhibitor for the clinical treatment of Colorectal Cancer

ABSTRACT Colorectal cancer is the third most frequent cause of cancer worldwide and is more prevalent in older individuals of all ages. The recent statistics from World Health Organisation (WHO) on cancer accounted for 1.93 million new cases of colorectal cancer alone, in 2020[1]. The exact cause of this disease is still unknown; however, obesity, sedentary lifestyle, and changed food consumption habit are thought to be driving forces. Earlier clinical studies have found non-steroidal anti-inflammatory drugs (NSAIDs) to be potent in treating colorectal cancer by inhibiting cyclooxygenase enzyme, and further research ascertained cyclooxygenase-2 gene (COX-2) inhibitors to be the most effective chemotherapy treatment. The aim of this study is to find the most effective inhibitor with a superior affinity against COX-2 protein and its pharmacological profile. The pre-established compound, parecoxib (PubChem ID: 119828) was taken up for Structure-based Virtual Screening to identify a novel compound (PubChem ID: 10151468) that has a strong binding affinity than the established compound. Additionally, the comparative studies of both the screened and established compounds were examined using the MD simulation approach to confirm structural stability. Our conclusion suggests that the virtual screened compound (PubChem ID: 10151468) could be a potential therapeutic for the treatment of colorectal cancer.

Differentiated embryonic chondrocyte expressed gene-1 (DEC1) enhances the development of colorectal cancer with an involvement of the STAT3 signaling.

Colorectal cancer (CRC) is the second deadly and the third most common malignancy worldwide. It has been projected that annual new cases of CRC will increase by 63% in 2040, constituting an even greater health challenge for decades to come. This study has linked DEC1 (differentiated embryonic chondrocyte expressed gene 1) to the pathogenesis of CRC. Based on the analysis of patient samples and database data, DEC1 is expressed much higher in CRC than the adjacent normal tissues. CRC patients with higher DEC1 expression have a shorter survival time. The carcinogenesis protocol with azoxymethane/dextran sulfate induces a higher number of tumors with larger sizes in DEC1+/+ than DEC1−/− mice. Overexpression of DEC1 increases the expression of proliferation- and antiapoptosis-related genes, but decreases the level of proapoptotic genes. Mechanistically, this study has shown that DEC1 is functionally looped to the IL-6/STAT3 signaling pathway (interleukin-6/signal transducer and activator of transcription 3). IL-6 induces DEC1, and DEC1 enhances the phosphorylation of STAT3, resulting in increased pSTAT3/STAT3 ratio. DEC1 and STAT3 are present in reciprocal immunocomplexes, pointing to physical interactions (presumably with pSTAT3). These findings establish that DEC1 is a CRC enhancer. The enhancement is achieved largely through the IL-6/STAT3 pathway. The potential of the physical interaction between DEC1 and STAT3 will likely serve as a foundation to develop intervention strategies for CRC prevention and therapy.