Prevention Of Colorectal Cancer Research Articles

The tissue and circulating cell‐free DNA‐derived genetic landscape of premalignant colorectal lesions and its application for early diagnosis of colorectal cancer

AbstractColorectal adenomas (CRAs) represent precancerous lesions that precede the development of colorectal cancer (CRC). Regular monitoring of CRAs can hinder the progression into carcinoma. To explore the utility of tissue DNA and circulating cell‐free DNA (cfDNA) in early diagnosis of CRC, we retrospectively sequenced paired tissue and plasma samples from 85 patients with conventional CRAs. The genetic alterations identified were compared with those from 78 stage‐I CRC patients (CRC‐I) in the ChangKang project. Within the CRA cohort, we pinpointed 12 genes, notably APC, KRAS, and SOX9, that exhibited significant mutated rates in tissue. Patients harboring KMT2C and KMT2D mutations displayed persistent polyps. By comparing with the mutational profiles of metastatic CRC plasma samples, we found that ZNF717 was exclusively mutated in CRAs, while KMT2C and KMT2D mutations were detected in both CRA and CRC. The presence of cfDNA mutations in plasma was validated through polymerase chain reaction, enhancing the feasibility of using cfDNA mutations for early CRC screening. Compared with CRC‐I, CRAs exhibited a reduced frequency of TP53 and PIK3CA somatic mutations and underwent non‐neutral evolution more often. We established a random forest model based on 15 characteristic genes to distinguish CRA and CRC, achieving an area under the curve of 0.89. Through this endeavor, we identified two novel genes, CNTNAP5 and GATA6, implicated in CRC carcinogenesis. Overall, our findings reveal convincing biomarkers markers for detecting CRAs with a propensity for CRC development, highlighting the importance of early genetic screening in CRC prevention.

Barriers to Colonoscopy Quality Measurement in Rural Wisconsin.

Patients in rural areas have reduced colonoscopy access, which is critical for colorectal cancer prevention. General surgeons perform most colonoscopies in rural areas. The Surgical Collaborative of Wisconsin's Rural Task Force identified colonoscopy as a high priority initiative due to high volume and lack of quality measure access, both necessary for assessing and improving performance. Assess the capacity for colonoscopy quality measurement and improvement in rural Wisconsin hospitals. In October 2019-January 2020, the Surgical Collaborative of Wisconsin, Rural Wisconsin Health Cooperative, and Wisconsin Collaborative for Healthcare Quality collaborated to design/distribute a survey to 44 Rural Wisconsin Health Cooperative hospitals (n = 25 completed, response rate 57%). Descriptive statistics summarized survey items. Surgeons in each of six rural hospitals participated in stakeholder interviews. Rural Wisconsin Health Cooperative hospitals. Colonoscopy providers, procedure volume/capacity, informatics and quality measurement infrastructure, barriers to quality measurement and improvement. Most colonoscopy providers in rural hospitals were surgeons (66.3%) followed by family/internal medicine (20.0%) and gastroenterologists (13.8%). Average hospital volume/week was 19.9 colonoscopies (SD = 13.4). Hospitals reported operating at ~75% capacity. Withdrawal time was the most tracked measure (44.0%), followed by adenoma detection (36.0%), and cecal intubation (28.0%) rates. Approximately one-third of hospitals (36.0%) utilized procedure reporting software. Most hospitals (80.0%) did not have access to onsite pathology. Surgeons reported barriers to quality measurement/improvement, including insufficient resources for electronic medical record-based reporting and the need for targeted educational opportunities that do not require travel. Single state; may not represent experience of all rural hospitals. The lack of access to colonoscopy quality measures suggests the opportunity to develop a flexible approach that considers reporting software availability and electronic medical record differences. Improving access to measures and education/training opportunities may improve availability of high-quality colonoscopy for patients in rural Wisconsin. See Video Abstract.

Mechanisms and perspectives of B vitamins associated one carbon metabolism on colorectal cancer risk

Colorectal cancer (CRC) represents a significant global health challenge as a common malignancy of the digestive tract. The involvement of B vitamins-specifically folic acid (B9), riboflavin (B2), pyridoxine (B6), and cobalamin (B12)-is crucial in metabolic processes by mediating the transfer of one-carbon (1C) units, which plays a fundamental role in cellular functions and tumor growth. 1C metabolism is involved in synthesis of proteins, lipids, nucleic acids, and other cofactors. 1C metabolism, intertwined with the metabolism of other nutrients, forms complex pathways where B vitamins act as precursors or coenzymes, influencing the production of various intermediates. These vitamins, as essential nutrients, are implicated to varying the pathogenesis and progression of colorectal cancer such as epigenetics. Furthermore, 1C metabolism affects tumor cell fate through multiple aspects including nucleotide synthesis, redox homeostasis, and the interaction with gut microbiota. Given these roles, understanding and monitoring B vitamin levels and their metabolic pathways are essential for colorectal cancer prevention and management. This approach not only helps in reducing tumor-related mortality but also opens new avenues for research into CRC mechanisms and potential therapeutic strategies.

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 < 0.001**), the risk factors (P < 0.001**), and the symptoms of CRC (P < 0.001**), as well as their willingness to choose colonoscopy to conduct colon follow-up screening even without symptoms (P < 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 < 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.

Methanolic Extract of the Nutritional Plant (Diospyros kaki Thunb.) Exhibits Anticancer Activity by Inducing Mitochondrial Dysfunction in Colorectal Cancer Cells.

Background/Objectives:Diospyros kaki, the most widely cultivated species of persimmon, has been long used in traditional medicine since its leaves' extracts contain high amounts of flavonoids and terpenoids, endowed with several beneficial effects. However, its anticancer activity towards colorectal cancer (CRC) has not been investigated in depth. Methods: The effect of a methanolic extract of D. kaki leaves, rich in kaempferol and quercetin derivatives, have been evaluated on an E705 CRC cell line, representative of most CRC patients, and on SW480 cells, carrying a KRAS-activating mutation. Results: This extract is effective in reducing tumor cells' viability without affecting the healthy mucosa cell line CCD 841. In fact, Western blot experiments showed its ability to induce apoptosis in cancer cells by increasing oxidative stress and disrupting mitochondrial functionality, as shown by reactive oxygen species measurement and Seahorse analysis. Conclusions: With the aim of increasing healthspan, as well as the substantial societal and macroeconomic costs associated with cancer, our results could pave the way to a role for D. kaki extract in both CRC treatment and prevention.

A prospective multicenter randomized controlled trial on artificial intelligence assisted colonoscopy for enhanced polyp detection

Colon polyp detection and removal via colonoscopy are essential for colorectal cancer screening and prevention. This study aimed to develop a colon polyp detection program based on the RetinaNet algorithm and verify its clinical utility. To develop the AI-assisted program, the dataset was fully anonymized and divided into 10 folds for 10-fold cross-validation. Each fold consisted of 9,639 training images and 1,070 validation images. Video data from 56 patients were used for model training, and transfer learning was performed using the developed still image-based model. The final model was developed as a real-time polyp-detection program for endoscopy. To evaluate the model’s performance, a prospective randomized controlled trial was conducted at six institutions to compare the polyp detection rates (PDR). A total of 805 patients were included. The group that utilized the AI model showed significantly higher PDR and adenoma detection rate (ADR) than the group that underwent colonoscopy without AI assistance. Multivariate analysis revealed an OR of 1.50 for cases where polyps were detected. The AI-assisted polyp-detection program is clinically beneficial for detecting polyps during colonoscopy. By utilizing this AI-assisted program, clinicians can improve adenoma detection rates, ultimately leading to enhanced cancer prevention.

Data Analytics to Support Policy Making for Noncommunicable Diseases: Scoping Review.

There is an emerging need for evidence-based approaches harnessing large amounts of health care data and novel technologies (such as artificial intelligence) to optimize public health policy making. The aim of this review was to explore the data analytics tools designed specifically for policy making in noncommunicable diseases (NCDs) and their implementation. A scoping review was conducted after searching the PubMed and IEEE databases for articles published in the last 10 years. Nine articles that presented 7 data analytics tools designed to inform policy making for NCDs were reviewed. The tools incorporated descriptive and predictive analytics. Some tools were designed to include recommendations for decision support, but no pilot studies applying prescriptive analytics have been published. The tools were piloted with various conditions, with cancer being the least studied condition. Implementation of the tools included use cases, pilots, or evaluation workshops that involved policy makers. However, our findings demonstrate very limited real-world use of analytics by policy makers, which is in line with previous studies. Despite the availability of tools designed for different purposes and conditions, data analytics is not widely used to support policy making for NCDs. However, the review demonstrates the value and potential use of data analytics to support policy making. Based on the findings, we make suggestions for researchers developing digital tools to support public health policy making. The findings will also serve as input for the European Union-funded research project ONCODIR developing a policy analytics dashboard for the prevention of colorectal cancer as part of an integrated platform.

Colorectal cancer research priorities in Uganda: perspectives from local key experts and stakeholders.

The incidence of colorectal cancer (CRC) is increasing in Uganda but there is limited local research to guide policy and programming for CRC prevention and control. A stakeholder engagement workshop took place in Kampala on 19March 2024 to identify challenges and opportunities for CRC prevention and control in Uganda. A total of 30 stakeholders with expertise in CRC primary and secondary prevention, diagnosis, treatment, palliative care as well as cancer survivors participated in the workshop. Key challenges for primary prevention included low knowledge/awareness of CRC among the general population and health workers, and rising prevalence of CRC related risk factors. Limited CRC screening, diagnostic facilities and specialists were identified as barriers to diagnosis. Treatment related challenges included limited accessibility to surgical services and drugs, late-stage presentation leading to poor treatment response, treatment abandonment and drug related toxicity. Lack of universal health coverage policies, limited community-based cancer awareness programs, and lack of national cancer registries were cited as policy and economics challenges. Opportunities to address these challenges were discussed. Our findings highlight areas for further research and prioritization to address Uganda's growing CRC burden and may be applicable to other low-resource settings.

The impact of linked color imaging on adenoma detection rate in colonoscopy: a systematic review and meta-analysis.

Colorectal cancer prevention relies on surveillance colonoscopy, with the adenoma detection rate as a key factor in examination quality. Linked color imaging (LCI) enhances lesion contrast and improves the examination performance. This systematic review and meta-analysis aimed to evaluate the effect of LCI on adenoma detection rate in adults who underwent colonoscopy. We searched the Medline, PubMed, BIREME, LILACS, and Scientific Electronic Library Online databases for randomized controlled trials comparing the use of LCI versus white light (WL), published up to March 2023. The outcomes included lesion characteristics, number of adenomas per patient, and the additional polyp detection rate. Sixteen studies were included in the analysis, which showed that LCI was more accurate than WL in detecting adenomas, with an increased number of adenomas detected per patient. Although LCI performed well in terms of lesion size, morphology, and location, the subgroup analyses did not reveal any statistically significant differences between LCI and WL. The addition of LCI did not result in significant improvements in the detection of serrated lesions, and there were no differences in the withdrawal time between groups. LCI has been shown to be effective in detecting colonic lesions, improving the number of adenomas detected per patient and improving polyp detection rate without negatively affecting other quality criteria in colonoscopy.

Preliminary Assessment of the Protective and Antitumor Effects of Several Phytoene-Containing Bacterial and Microalgal Extracts in Colorectal Cancer.

The identification of new functional food constituents is a priority to improve the prognosis and prevention of colorectal cancer (CRC). In this study, several bacterial and algal phytoene-enriched extracts were obtained, and their potential activity against oxidative damage and their ability to inhibit proliferation and cell migration in several human colon-adenocarcinoma-derived cell lines were assessed. The main conclusions indicate that total extracts of Sphingomonas echinoides and Chlorella sorokiniana exhibited the highest protective effect against oxidative damage. All extracts enhanced the activity of detoxifying enzymes, particularly importantly the increase of NAD(P)H:quinone oxidoreductase activity, which reached a value 40% higher than that of untreated control cells upon exposure to Escherichia coli extracts. Staphylococcus haemolyticus and transgenic E. coli extracts significantly arrested the migration capacity of both cell lines, while S. haemolyticus and C. sorokiniana extracts inhibited cell proliferation by 15 to 20% compared to untreated cells. These results point to these extracts as potential antioxidant complements able to protect cells against oxidative damage and with a moderate ability to inhibit the proliferation and migration of CRC tumor cells, paving the way to design functional foods or probiotic formulations with preventive properties against oxidative stress-related diseases, such as cancer, or as starting point for purifying anticancer compounds.

B-330 Reducing Inappropriate Fecal Immunochemical Test

Abstract Background Colorectal cancer is the third most common cancer worldwide. The risk of colorectal cancer increases with age and predominantly affects individuals over the age of 50. Regular screening is crucial for early detection and prevention of colorectal cancer. Pre-cancerous polyps and colorectal cancers can bleed into the gastrointestinal tract. While the presence of blood in the stool cannot always be seen visually, it can be detected by the Fecal Immunochemical Test (FIT), currently the most sensitive method for directly measuring hemoglobin in this specimen type. In our province, FIT is recommended for testing average-risk asymptomatic patients aged 50 to 74 every 1-2 years. Patients aged 40 to 49 or 75 to 84 can be tested if they meet specific criteria. Like many other tests in the lab, FIT can be used inappropriately. The focus of this study was to examine the utilization of FIT in our institution. Methods Data were collected from our institution's laboratory information system for the FIT performed on-site from July to December 2023. Results We performed 91,545 FIT tests during the 6-month period with an overall positive rate of 6.8%. Of the total tests performed, 87.9% were for patients aged 50-74 years, 10.6% for patients aged 40-49 or 75-84 years, and 1.2% for patients outside the approved age range. Each year, we performed over 2,000 FIT tests for patients outside the accepted screening age, with an estimated cost of over 30,000 CAD. Conclusions Our results showed a significant number of FITs were ordered inappropriately by healthcare providers. Considering the relatively high cost of FIT kits, labor, reagents, etc., the overall cost per reportable is significant. Thus, we have started engaging healthcare providers involved in FIT testing to strategize approaches to improve utilization.

Assessing the Impact of Serum Calcium, 25-Hydroxy Vitamin D, Ferritin, and Uric Acid Levels on Colorectal Cancer Risk.

The aim of this study is to investigate whether vitamin D, calcium, ferritin, and uric acids play a beneficial biomarker role in the prevention of colorectal cancer (CRC) risk. The case-control design was employed, including 650 CRC cases and 650 controls aged 35 to 70 years, comprising both men and women. The study encompasses sociodemographic data, clinical information, radiological diagnoses, and biochemical measurements. Statistically significant differences were observed between CRC and controls in terms of age, diagnostic radiology, tomography, positron emission tomography/computed tomography (PET/CT), colonoscopy, CRC awareness, risk factors, age, genetics, exposure to chemicals, inadequate nutrition, smoking, hookah and alcohol use. Significant differences were also identified in intestinal inflammations, obesity, processed foods (P < 0.001), abdominal pain and cramps, diarrhea, constipation, blood in stool, bloating (gas), irritable bowel, nausea/vomiting, anemia, stress, fatigue, weakness, and weight loss. Regarding biochemical parameters, statistically significant differences were found between CRC and controls in terms of hemoglobin, glycated hemoglobin (HbA1c), fasting blood glucose (FBG), vitamin D, neutrophil level, red blood cell (RBC), white blood cell (WBC), platelet level, platelet count, hematocrit, potassium, sodium (Na), calcium, creatinine, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), bilirubin, uric acid, iron (Fe), ferritin, C-reactive protein (CRP), total protein, systolic blood pressure (SBP), and diastolic blood pressure (DBP) parameters (P < 0.001). Multivariate stepwise regression analysis was performed to find the best risk factors for the diagnosis of CRC as the dependent variable. As a result of the analysis, intestinal inflammation (P < 0.001), nausea/vomiting (P < 0.001), stomach pain (P = 0.003), hookah-smoking (P = 0.034), uric acid (P < 0.001), bilirubin (P < 0.001), cigarette smoke exposure (P = 0.033), processed food consumption (P = 0.002), calcium levels (P = 0.029), vitamin D deficiency (P < 0.001), and ferritin (P < 0.001) levels were identified as significant determinants for CRC. The current study demonstrated that vitamin D, calcium, ferritin, and uric acids play a beneficial biomarker role in reducing the risk of CRC prevention. The increase in CRC rates may be associated with lifestyle, environmental and hereditary factors, nutrition, alcohol consumption, hookah use, and cigarette smoking.

Construction and validation of a novel forecasting nomogram to the risk of colorectal adenomas: preventing colorectal cancer at its origin.

Colorectal adenomas are responsible for the origin of most colorectal cancers (CRC). Early detection together with active intervention of colorectal adenomas plays a crucial role in the prevention of colorectal cancer. This study aimed to construct and validate a new nomogram for the forecasting of the risk of colorectal adenomas based on lifestyle risk factors that could offer potential benefits for CRC prevention. Colonoscopy reports, pathology reports, physical factors, family history, personal history of disease, diet, and lifestyle habits were collected from 1133 subjects who underwent complete colonoscopy. All subjects were divided into the training cohort (n = 792) and the validation cohort (n = 341). A nomogram predicting the risk of colorectal adenoma development was constructed using the training cohort and the C-index was calculated. The predictive accuracy and clinical applicability of the nomogram were verified in the validation cohort. The nomogram was constructed by 6 statistically significant variables selected from 18 health factors, including advanced age, male, smoking, drinking, pickles, and irregular defecation. The C-index of the training cohort was 0.778 and the C-index of the validation cohort was 0.754. The calibration curve and decision curve analysis (DCA) also confirmed that the model has good predictive ability and high profit. The nomogram constructed in this study was validated and can be applied to predicting the occurrence risk of colorectal adenoma. The model can guide the identification of patients with non-symptomatic colorectal adenomas and the recognition of high-risk individuals for whom a colonoscopy is advisable.

Getting a colonoscopy at The Valley Hospital.

71 Background: Colorectal cancer (CRC) is the 3rd most common cancer in the U.S., yet it is preventable with evidence-based strategies such as early screening. The Valley Hospital (TVH) located in Bergen County NJ, is recognized for its high insured payer mix and median household income. According to the 2016 TVH Community Health Needs Assessment, only 71.4% of patients in TVH service area have had a CRC screening. The American Cancer Society National Colorectal Cancer Roundtable (NCCRT) campaigned to reach CRC screening rates of 80% and higher in communities across the nation. The Fast Track Screening Colonoscopy Program (FTSCP) at TVH was created to streamline the process of obtaining a screening colonoscopy and reach the NCCRT’s goal. Through the FTSCP, patients can omit the initial consultation with a gastroenterologist or colorectal surgeon. Patients are instead screened via a telephone call by a Physician Assistant (PA) or Advanced Practice Nurse (APN). The FTSCP is cost effective for patients as it potentially eliminates the initial consultation copayment and/or coinsurance. Methods: The purpose of the FTSCP is to achieve the NCCRT’s 80% goal of CRC screenings in TVH service area. An interdisciplinary team of gastroenterologists, colorectal surgeons, oncologists, anesthesiologists, and administration collaborated to create the FTSCP. A screening questionnaire was developed using the Lincoln Hospital in NYC’s existing criteria for patients who are eligible for a direct endoscopy referral. The questionnaire criteria ensures patients are safe to eliminate the initial consultation. A PA or APN determines the patients’ eligibility for the FTSCP over a screening telephone call. To qualify, patients cannot have significant medical comorbidities or exhibit signs or symptoms of CRC. If deemed eligible, the PA or APN sends a bowel preparation prescription to the patient’s pharmacy, reviews the instructions with them, and meets with them on the day of the procedure at TVH to perform a pre-procedural physical exam. To promote awareness and education of the FTSCP, multiple ongoing outreach events are held in the community. Patients also learn about the FTSCP through primary and specialty care referrals. Results: Since the inception of FTSCP in 2018, over 1300 patients have been screened for CRC. Additionally, adenocarcinomas, carcinoid tumors and tubular adenomas with high grade dysplasia have been detected. 394 tubular adenomas (30%) were identified and removed. In 2018, 59 patients were screened. The number of patients increased by 500% to 296 in 2023. The 2022 TVH Community Health Needs Assessment showed an increase to 79.6% of patients in TVH service area who have undergone CRC screening. Conclusions: The FTSCP at TVH is maximizing patient’s access to the prevention and timely screening for CRC. Additionally, TVH’s relocation from Ridgewood, NJ to Paramus, NJ offers further opportunities to educate a new community on CRC prevention.

Multicentre study to assess the performance of an artificial intelligence instrument to support qualitative diagnosis of colorectal polyps

ObjectiveComputer-aided diagnosis (CAD) using artificial intelligence (AI) is expected to support the characterisation of colorectal lesions, which is clinically relevant for efficient colorectal cancer prevention. We conducted this study to...

Gene-environment interactions and colorectal cancer risk: A case-control study on xenobiotic metabolizing enzyme polymorphisms in the Jammu& Kashmir, India population

BackgroundCancer remains a significant global health concern, with colorectal cancer (CRC) showing a rising incidence, particularly among younger populations. Most CRC cases are linked to a complex interplay of genetic and environmental factors. The cytochrome P450 (CYP) superfamily, including enzymes like CYP2A13 and CYP2A6, plays a vital role in metabolizing environmental carcinogens such as polycyclic aromatic hydrocarbons (PAHs) and nitrosamines. Polymorphisms in these genes, alongside phase II glutathione-S-transferases (GSTs) involved in detoxification, can influence individual cancer risk. This study focuses on the association between these genetic polymorphisms and CRC risk in the Jammu & Kashmir, population, a region with high exposure to dietary and lifestyle-related carcinogens. MethodologyThis hospital-based case-control study was conducted at the Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, J&K, India between March 2019 and March 2022. The study included 246 histopathologically confirmed colorectal cancer (CRC) cases, and an equal number of matched controls based on age (±5 years), gender, and place of residence. Blood samples were collected for DNA extraction, followed by genotyping of xenobiotic-metabolizing enzyme (XME) genes, including CYP2A13, CYP2A6, and GSTs using standard PCR-RFLP and multiplex PCR methods. Statistical analyses were performed using STATA software to assess the association between gene polymorphisms and CRC risk. ResultsThe study revealed key associations between genetic and environmental factors and CRC risk. The analysis demonstrated that cases had significantly lower education levels than controls. Family history of cancer, smoking, and dietary factors like red meat and salt tea consumption were more prevalent among cases. Genetic analysis identified significant interactions between various CYP and GST genotypes, and environmental factors such as smoking, pesticide exposure, and diet, with varying effects on CRC risk. ConclusionThe research underscores the influence of genetic and environmental factors on colorectal cancer (CRC) risk. Lower educational was associated with a heightened risk of CRC. Certain genotype variants of xenobiotic metabolizing enzymes (XME) were found to increase CRC risk, particularly in conjunction with smoking, pesticide exposure, and sun-dried vegetable consumption. A family history of cancer, especially CRC, further amplified the risk. These findings emphasize the importance of developing personalized CRC prevention and screening strategies that account for gene-environment interactions.

Progress of “Yiqi and Spleen Enhancement Method” in the Treatment of Colorectal Cancer based on Intestinal Flora

The intestinal microbiota is located close to the colorectal epithelium and consists of a large microbiota that interacts with host cells to regulate many physiological processes such as energy harvesting, metabolism and immune responses [1]. It corresponds to the functions of the “spleen” in Chinese medicine, which is responsible for the transportation of water and grains and the resistance to evil. The balance of intestinal flora directly reflects the functional status of the “spleen” in TCM. Sequencing studies have revealed the microbial composition and ecological changes in colorectal cancer (CRC) patients, and functional animal model studies have clarified the role of several bacteria in colorectal carcinogenesis, including Clostridium nucleatum, Escherichia coli, and Pseudomonas fragilis strains, which are closely related to CRC [2]. Based on this, this paper reviews the research progress on the mechanism of intestinal flora affecting CRC and the intervention of intestinal flora against CRC by Yiqi and Spleen Method, which provides ideas and references for the prevention of colorectal cancer by traditional Chinese medicine.

A New Combination of Bifidobacterium bifidum and Lactococcus lactis Strains with Synergistic Effects Alleviates Colitis-Associated Colorectal Cancer.

Chronic inflammation is a factor in the development of cancer, and probiotics play a role in preventing or treating inflammation as an adjuvant therapy. To investigate potential probiotics for the prevention of colitis-associated colorectal cancer (CAC), Bifidobacterium bifidum H3-R2 and Lactococcus lactis KLDS4.0325 were used to examine the effects on colon cancer cells and in an inflammation-related cancer animal model. The results revealed that B. bifidum H3-R2 in combination with L. lactis KLDS4.0325 caused apoptosis in colon cancer cells by increasing caspase-3 and caspase-9 protein levels, enhancing Bax expression, and lowering Bcl-2 expression. In addition, the combination of the two strains relieved the tissue damage; reduced proinflammatory cytokines, myeloperoxidase (MPO) activity, and hypoxia-inducible factor 1-alpha (HIF-1α) level; upregulated anti-inflammatory cytokines; increased colonic tight junction protein expression; regulated intestinal homeostasis by inhibiting NLRP3 inflammasome signaling pathway; and improved the imbalance of gut microbiota in animal models. Moreover, the combination of the two strains had a greater preventive impact than each strain alone. These findings are supportive of clinical studies and product development of multi-strain probiotic preparations for diseases associated with colitis.

AI4CRC: A Deep Learning Approach Towards Preventing Colorectal Cancer

Each year, more than 1.9 million cases of colorectal cancer (CRC) are diagnosed worldwide. By 2040, the burden of colorectal cancer is estimated to reach 3.2 million new cases per year and 1.6 million deaths per year worldwide. As of 2024, it ranks as the third most prevalent form of cancer, contributing to over 10% of all new cancer cases annually, with a 5-year survival rate of only 65%. With effective early detection mechanisms in place, the survival rate could potentially increase to 90%. However, current detection mechanisms are manual and error-prone. This study presents a deep learning-based approach to automating the detection of polyps, the tumor that causes colorectal cancer, in the human colon. Various state-of-the-art deep learning models – including VGG, ResNet, DenseNet, and EfficientNet were trained and tested on a publicly available dataset. The findings of this study show that deep learning models can significantly automate the early diagnosis process of colorectal cancer with high accuracy, especially the DenseNet and EfficientNet models – attaining 99% and 99.4% respectively for both accuracy and F1 score metrics on the test dataset. This study validates the potential of deep learning to enhance the accuracy and reliability of colorectal cancer detection and prevention, ultimately contributing to better quality of diagnosis and patient outcomes.

Visceral Fat Thickness, Serum Adiponectin, and Metabolic Syndrome in Patients with Colorectal Adenomas.

Most cases of colorectal cancer (CRC) arise from adenomatous polyps. Identifying risk factors for colorectal adenoma (CRA) is critical for CRC prevention. Emerging evidence suggests a link between metabolic syndrome (MetS) and an elevated risk of CRA and CRC, potentially mediated by visceral obesity and adiponectin (APN). We aimed to evaluate the association between different markers of visceral obesity, serum APN, MetS, and the presence of CRA. A cross-sectional study was conducted at the University Clinical Center of Vojvodina, involving 120 patients, aged 40-75 years, who underwent colonoscopy between January 2022 and January 2023. Sixty patients with CRA were compared to 60 controls with normal colonoscopy findings. Visceral fat thickness (VFT) was measured using ultrasound (US), and bioelectrical impedance analysis (BIA) was used to assess visceral fat area (VFA). Serum APN levels, anthropometric measures, and MetS components were also evaluated. Patients with CRA had significantly higher VFT measured by US (p < 0.05), but no significant differences were found in VFA measured by BIA, waist circumference (WC), or waist-to-hip ratio (WHR). MetS was significantly more prevalent in the CRA group (55% vs. 31.6%, p < 0.05), and logistic regression confirmed MetS as a significant predictor of CRA presence (OR = 2.6). Serum APN levels were inversely correlated with visceral fat measurements and MetS (p < 0.01), but no significant difference in APN levels was observed between patients with and without CRA. This study highlights the importance of VFT measured by US and the presence of MetS as significant factors associated with CRA.