National Cancer Institute®
Last Modified: July 1, 2002
UI - 12055585
AU - Evans RC; Fear S; Ashby D; Hackett A; Williams E; Van Der Vliet M;
TI - Dunstan FD; Rhodes JM Diet and colorectal cancer: an investigation of the lectin/galactose hypothesis.
SO - Gastroenterology 2002 Jun;122(7):1784-92
AD - Department of Medicine, University of Liverpool, England.
BACKGROUND & AIMS: Mucosal expression of terminal unsubstituted galactose is increased in colon cancer and precancer and allows interaction with mitogenic galactose-binding lectins of dietary or microbial origin. This study tests the hypothesis that galactose, which is variably plentiful in fruit and vegetable but not cereal fibers, might prevent cancer by binding and inhibiting such lectins. METHODS: Colorectal cancer cases (512) and controls (512) were matched for age, sex, primary care practitioner, and postal code. A 160-item food-frequency questionnaire was used to estimate their usual pre-illness (6 months previous) diet, aspirin intake, and exercise. RESULTS: Neither cereal fiber nor fruit and vegetable fiber were protective when assessed by univariate analysis, whereas dietary fiber galactose content showed a dose-related protective effect (odds ratio [OR] highest quartile/lowest quartile, 0.67; confidence interval [CI], 0.47-0.95) that remained protective when adjusted for energy, red meat, alcohol, calcium, protein and fat intake, regular aspirin usage, and exercise. Intake of nonlegume green vegetables, assessed because of the high lectin content of legumes, was also protective (OR, 0.54; CI, 0.35-0.81), but this was not independent of galactose. Protective effects of exercise and regular daily aspirin consumption and harmful effects of high energy consumption and high red meat intake were confirmed. CONCLUSIONS: The protective effect of fruit and vegetable fibers may be related to their galactose content. This provides further evidence that the association between diet and colon cancer is mediated via specific food components and may explain the discrepant results of studies addressing the protective effects of fiber.
UI - 12001646
AU - Voutilainen M; Farkkila M; Sipponen P
TI - [Barrett esophagus and inflammation of gastroesophageal junction]
SO - Duodecim 2000;116(17):1899-905
AD - Keski-Suomen keskussairaala, sisatautien poliklinikka 40620 Jyvaskyla.
UI - 12086402
AU - Reddy BS; Rao CV
TI - Novel approaches for colon cancer prevention by cyclooxygenase-2 inhibitors.
SO - J Environ Pathol Toxicol Oncol 2002;21(2):155-64
AD - Nutritional Carcinogenesis and Chemoprevention Program, American Health Foundation, Valhalla, NY 10595, USA. email@example.com
During recent years, multidisciplinary studies in epidemiology and molecular biology, as well as preclinical studies, have contributed much to our understanding of the etiology of colorectal cancer; more importantly they have enabled us to approach its prevention. An impressive body of epidemiological data suggests an inverse relationship between colorectal cancer risk and regular use of nonsteroidal antiinflammatory drugs (NSAIDs), including aspirin. Clinical trials with NSAIDs have demonstrated that NSAID treatment caused regression of preexisting colon adenomas in patients with familial adenomatous polyposis. Preclinical efficacy studies have provided compelling evidence that several phytochemicals with antiinflammatory properties and NSAIDs act to retard, block, or reverse colon carcinogenesis. Equally exciting are opportunities for effective chemoprevention with selective cyclooxygenase-2 (COX-2) inhibitors including celecoxib and rofecoxib in a variety of preclinical models of colon cancer. Naturally occurring COX-2 inhibitors such as curcumin and certain phytosterols have been proven to be effective as chemopreventive agents against colon carcinogenesis with minimal gastrointestinal toxicity. Multistep process of carcinogenesis has provided substantial insights into the mechanisms by which naturally occurring and synthetic antiinflammatory agents modulate these events leading to suppression of tumorigenesis. Growing knowledge in this area has brought about innovative approaches using a combination of agents with different modes of action as a means of increasing efficacy and minimizing toxicity. The natural history of colorectal cancer, from dysplastic aberrant crypts to adenomas and adenocarcinomas, offers multiple opportunities for assessment and intervention. Of further importance would be to identify molecular targets that are critical in the growth and survival of the malignant colorectal cell and are modulated by NSAIDs and COX-2 inhibitors.
UI - 11899367
AU - Mahon SM
TI - Cancer prevention and early detection.
SO - Clin J Oncol Nurs 2001 May-Jun;5(3):105-7
AD - firstname.lastname@example.org
Advances in the area of cancer prevention and early detection are being made constantly. Basic epidemiologic research continues to provide insight into the impact of carcinogen exposure and the development of cancer. It is exciting to note that the study of Tamoxifen and Raloxifene chemoprevention trial is successfully recruiting women, including minority women, to participate. This large chemoprevention trial is providing much insight into how to recruit and retain women to take a chemoprevention agent to ultimately prevent the development of cancer. Advances also are being made in the knowledge base of how to best detect cancer in asymptomatic people. The best screening tool recommendation for the early detection of colorectal cancer remains controversial. Screening for colorectal cancer, however, is the only way to ultimately decrease the morbidity and mortality associated with the disease. Oncology nurses need to accurately risk for colorectal cancer and provide patients with the necessary information to make an informed choice about the most appropriate screening for their situation. Oncology nurses need to be familiar with new research and advances in cancer prevention and early detection so they can share information with patients and their families.
UI - 12010887
AU - Scholefield JH; Moss S; Sufi F; Mangham CM; Hardcastle JD
TI - Effect of faecal occult blood screening on mortality from colorectal cancer: results from a randomised controlled trial.
SO - Gut 2002 Jun;50(6):840-4
AD - Division of GI Surgery, University Hospital, Nottingham NG7 2UH, UK. email@example.com
BACKGROUND: Three large randomised trials have shown that screening for colorectal cancer using faecal occult blood (FOB) tests can reduce the mortality from this disease. Two national pilot studies have recently been launched in the UK to investigate the feasibility of population screening for colorectal cancer in the National Health Service. The largest of the randomised trials was conducted in Nottingham and randomised 152 850 individuals between the ages of 45 and 74 years to receive biennial Haemoccult (FOB) test kit (intervention group) or to a control group. AIMS: We have compared the mortality in the intervention group compared with the control group. METHODS: The 152 850 randomised individuals were followed up through local health records and central flagging (Office for National Statistics) over a median follow up period of 11 years. RESULTS: At a median follow up of 11 years there was a 13% reduction in colorectal cancer mortality (95% confidence interval 3-22%) in the intervention group despite an uptake at first invitation of only approximately 50%. The mortality reduction for those accepting screening was 27%. The reduction in mortality was independent of sex and site of tumour. There was no significant difference in mortality from causes other than colorectal cancer between the intervention and control groups. CONCLUSIONS: Although the reduction in colorectal cancer mortality was sustained, further follow up of this population is required to determine whether a significant reduction in the incidence of colorectal cancer will be achieved.
UI - 12048224
AU - Smith-Warner SA; Elmer PJ; Fosdick L; Randall B; Bostick RM; Grandits G;
TI - Grambsch P; Louis TA; Wood JR; Potter JD Fruits, vegetables, and adenomatous polyps: the Minnesota Cancer Prevention Research Unit case-control study.
SO - Am J Epidemiol 2002 Jun 15;155(12):1104-13
AD - Division of Epidemiology, University of Minnesota, Minneapolis, MN, USA.
Although high vegetable intakes have been associated with a lower risk of colorectal cancer, this relation is less well established for the precursor lesions, adenomatous polyps. With a case-control design involving adenomatous polyp cases (n = 564), colonoscopy-negative controls who were polyp free at colonoscopy (n = 682), and community controls (n = 535), this 1991-1994 Minnesota Cancer Prevention Research Unit study investigated the relation between fruit and vegetable consumption and first incident adenomatous polyps. Dietary intake was assessed using a food frequency questionnaire. For women, adenoma risk was approximately halved in the highest versus lowest quintile of juice consumption (cases vs. colonoscopy-negative controls: odds ratio (OR) = 0.50, 95% confidence interval (CI): 0.27, 0.92; cases vs. community controls: OR = 0.56, 95% CI: 0.30, 1.06). The association was stronger for adenomas with moderate or severe dysplasia compared with mild dysplasia. Juice was not associated with adenoma risk in men. The results for fruits, vegetables, total fruits and vegetables, green leafy vegetables, and several botanically and phytochemically defined subgroups generally were not statistically significant. Because elevated vegetable consumption has been associated with a lower risk of colorectal cancer, vegetables may have a stronger role in preventing the progression of adenomas to carcinomas rather than in preventing the initial appearance of adenomas.
UI - 12099002
AU - Sasagawa Y; Sasagawa T; Takasaki K
TI - [Mass screening for gastric cancer performed in Costa Rica]
SO - Nippon Shokakibyo Gakkai Zasshi 2002 Jun;99(6):577-83
AD - Tokyo Women's Medical University, Institute of Gastroenterology, Department of Surgery.
We performed mass screening for gastric cancer by means of X-ray in Costa Rica from 1996 through 1999. Screening was performed on 10,064 subjects and 69 gastric cancers were detected (screening group). During the same period 172 gastric cancer patients were referred to us (non-screening group). Results of screening in Japan (Japanese group) were quoted from the annual report of the Japanese Society of Gastroenterological Mass Survey. This study is a comparison of these 3 groups. The detection rate was 0.68% in the screening group, 0.11% in the Japanese group. The operability was 92.7%, 76.1%, 97.0%, the resectability 96.8%, 83.2%, 98.6%, the rate of early gastric cancer 64.5%, 30.3%, 65.9%, and the rate of curability A 79.0%, 38.5%. 82.6% in the screening group, non-screening group and Japanese group respectively. The results in the screening group were exactly equal to those in the Japanese group. These results show that the same results can be obtained in Costa Rica as in Japan, if screening is performed with the same diagnostic level and skill as in Japan.
UI - 12086298
AU - Lema MJ
TI - Emerging options with coxib therapy.
SO - Cleve Clin J Med 2002;69 Suppl 1():SI76-84
AD - Department of Anesthesiology, State University of New York at Buffalo School of Medicine, USA. firstname.lastname@example.org
Future clinical applications of cyclooxygenase (COX)-2-selective inhibitors (coxibs) are likely to extend beyond their current use as oral analgesics in high-risk arthritis patients. The clinical utility of coxibs for the treatment of Alzheimer's disease (AD) is under investigation. Epidemiological surveys, preclinical studies, and preliminary clinical trials with nonsteroidal anti-inflammatory drugs (NSAIDs) have suggested that inflammatory mechanisms play a role in the neurodegeneration of AD. Clinical trials are currently being conducted to determine the effect of coxibs on the rate of AD progression. The use of coxibs as chemopreventive agents in colorectal cancer (CRC) is also under investigation. The chemopreventive benefits of coxibs to promote cell death (apoptosis) and inhibit angiogenesis in CRC have been shown in tumor cell lines and in animal and human models. In addition, palliative care clinicians and oncologists are increasingly including coxibs in their management of cancer pain. Coxibs are utilized for their opioid-sparing effect in the management of cancer pain, without impairing wound healing, or promoting bleeding diathesis (antiplatelet effects) or adverse gastrointestinal effects in patients receiving chemotherapy or radiation treatment.
UI - 12075629
AU - Rollins G
TI - Updated guidelines call for higher colorectal cancer screening rates.
SO - Rep Med Guidel Outcomes Res 2001 Apr 5;12(7):5-7
UI - 11817790
AU - Puliyel JM; Taneja V; Jindal K; Thomas N
TI - Hepatitis B leading to hepatocellular carcinoma: calculating the risk.
SO - Indian J Gastroenterol 2001 Nov-Dec;20(6):251-2
UI - 11998610
AU - Giarelli E
TI - Prophylactic gastrectomy for CDH1 mutation carriers.
SO - Clin J Oncol Nurs 2002 May-Jun;6(3):161-2
AD - IMLNG@aol.com
Gastric cancer is difficult to diagnose at an early stage. Signs and symptoms of the disease often only occur when advanced or metastatic disease is present. A very small number of gastric cancers are hereditary. The mutation to the E-cadherin gene has high penetrance and confers a lifetime risk of gastric cancer of 80% for carriers. Because of the high penetrance of the mutation and the difficulty of diagnosing gastric cancer at an early stage, carriers of the mutation may be candidates for prophylactic gastrectomy. Although limited data are available about the complications and outcomes associated with prophylactic gastrectomy, nurses should be knowledgeable about prophylactic surgery for hereditary cancers and prepared to answer patients' questions about their prevention.
UI - 12068739
AU - Pox C; Schmiegel W
TI - [Coloretal cardinoma--prevention, screening and endoscopic therapy]
SO - Z Arztl Fortbild Qualitatssich 2002 May;96(4):227-31
AD - Ruhr-Universitat Bochum, Medizinische Universitatsklinik, Knappschaftskrankenhaus.
Colorectal cancer (CR) is the second leading cause of cancer-related deaths in Germany. Screening strategies have been shown to be effective in reducing CRC mortality. One priority has to be identifying persons at increased risk of developing CRC. Family history is one important factor. Persons at risk of developing hereditary forms of CRC have to be included in specially-adapted surveillance schemes. To increase the efficacy of the surveillance programs the co-operation of the population at large must be improved. As 90 percent of colorectal carcinomas arise from adenomas, a consistent and rigorous polypectomy will lead to a reduction in CRC incidence. Persons with adenomas have an increased risk of recurrence after polypectomy and should hence be followed up. If the removed polyp contains a carcinoma further measures depend on its histo-pathological staging.
UI - 12118971
AU - U.S. Preventive Services Task Force
TI - Screening for colorectal cancer: recommendation and rationale.
SO - Ann Intern Med 2002 Jul 16;137(2):129-31
This statement summarizes the current U.S. Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer and the supporting scientific evidence and updates the 1995 recommendations contained in the Guide to Clinical Preventive Services, 2nd edition. At that time, the USPSTF recommended screening for colorectal cancer with annual fecal occult blood testing, periodic sigmoidoscopy, or the combination of fecal occult blood testing and sigmoidoscopy but concluded that the evidence was insufficient to recommend for or against colonoscopy or barium enema. The complete USPSTF recommendation and rationale statement on this topic, which includes a brief review of the supporting evidence, is available through the USPSTF Web site (http://www.preventiveservices.ahrq.gov), the National Guideline Clearinghouse (http://www.guideline.gov), and in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (telephone, 800-358-9295; e-mail, email@example.com). The complete information on which this statement is based, including tables and references, is available in the accompanying article in this issue and in the summary of the evidence and systematic evidence review on the Web sites already mentioned.
UI - 12118972
AU - Pignone M; Rich M; Teutsch SM; Berg AO; Lohr KN
TI - Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force.
SO - Ann Intern Med 2002 Jul 16;137(2):132-41
AD - University of North Carolina at Chapel Hill, Department of Medicine and Cecil Sheps Center for Health Services Research, 5039 Old Clinic Building, CB #7110, Chapel Hill, NC 27599, USA.
PURPOSE: To assess the effectiveness of different colorectal cancer screening tests for adults at average risk. DATA SOURCES: Recent systematic reviews; Guide to Clinical Preventive Services, 2nd edition; authors also conducted hand searches, reviewed bibliographies, and consulted context experts to ensure completeness. STUDY SELECTION: When available, the most recent high-quality systematic review was used to identify relevant articles. This review was then supplemented with a MEDLINE search for more recent articles. DATA EXTRACTION: One reviewer abstracted information from the final set of studies into evidence tables, and a second reviewer checked the tables for accuracy. Discrepancies were resolved by consensus. DATA SYNTHESIS: For average-risk adults older than 50 years of age, evidence from multiple well-conducted randomized trials supported the effectiveness of fecal occult blood testing in reducing colorectal cancer incidence and mortality rates compared with no screening. Data from well-conducted case-control studies supported the effectiveness of sigmoidoscopy and possibly colonoscopy in reducing colon cancer incidence and mortality rates. A nonrandomized, controlled trial examining colorectal cancer mortality rates and randomized trials examining diagnostic yield supported the use of fecal occult blood testing plus sigmoidoscopy. The effectiveness of barium enema is unclear. Data are insufficient to support a definitive determination of the most effective screening strategy. CONCLUSIONS: Colorectal cancer screening reduces death from colorectal cancer and can decrease the incidence of disease through removal of adenomatous polyps. Several available screening options seem to be effective, but the single best screening approach cannot be determined because data are insufficient.
UI - 12118964
AU - Pignone M; Saha S; Hoerger T; Mandelblatt J
TI - Cost-effectiveness analyses of colorectal cancer screening: a systematic review for the U.S. Preventive Services Task Force.
SO - Ann Intern Med 2002 Jul 16;137(2):96-104
AD - Department of Medicine, Division of General Internal Medicine, University of North Carolina, 5039 Old Clinic Building 226, CB 7110, Chapel Hill, NC 27599.
PURPOSE: To perform a systematic review of the cost-effectiveness of colorectal cancer screening for the U.S. Preventive Services Task Force. DATA SOURCES: MEDLINE and the British National Health Service Economic SELECTION: Original economic evaluations of colorectal cancer screening in average-risk patients were reviewed. The authors sought studies addressing the incremental cost-effectiveness of different screening strategies compared with no screening, of different screening strategies compared with one another, and of different ages of screening initiation and cessation. Two investigators independently reviewed each abstract, and potentially eligible articles were retrieved. A four-member working group reached consensus regarding final inclusion or exclusion of articles. DATA EXTRACTION: One reviewer extracted data into evidence tables. The results were checked by other members and discrepancies resolved by consensus. DATA SYNTHESIS: Among 180 potential articles identified, 7 were retained in the final analysis. Compared with no screening, cost-effectiveness ratios for screening with any of the commonly considered methods were generally between 10, 000 dollars and 25, 000 dollars per life-year saved. No one strategy was consistently found to be the most effective or to have the best incremental cost-effectiveness ratio. Currently available models provided insufficient evidence to determine optimal starting and stopping ages for screening. CONCLUSIONS: Screening for colorectal cancer appears cost-effective compared with no screening, but a single optimal strategy cannot be determined from the currently available data. Additional data regarding adherence with screening over time, complication rates in real-world settings, and colorectal cancer biology are needed. Additional analyses are necessary to determine optimal ages of initiation and cessation.
UI - 12118986
AU - Anonymous
TI - Summaries for patients. Screening for colorectal cancer: recommendations from the United States Preventive Services Task Force.
SO - Ann Intern Med 2002 Jul 16;137(2):I38
UI - 11902587
AU - Schoen RE
TI - The case for population-based screening for colorectal cancer.
SO - Nat Rev Cancer 2002 Jan;2(1):65-70
AD - Division of Gastroenterology, Pennsylvania University Hospital, Pittsburgh 15213-2582, USA. firstname.lastname@example.org
Screening for colorectal cancer is commanding increasing attention. Other cancer screening programmes have been a part of public consciousness for some time, but, until recently, colorectal cancer screening has remained in the background. Fuelled by new research, market opportunities and increased recognition of individual risk, screening for colorectal cancer is becoming a recommended procedure, but controversy about how best to implement widespread screening remains.
UI - 11848667
AU - Hawley ST; Foxhall L; Vernon SW; Levin B; Young JE
TI - Colorectal cancer screening by primary care physicians in Texas: a rural-urban comparison.
SO - J Cancer Educ 2001 Winter;16(4):199-204
AD - Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA. email@example.com
BACKGROUND: Little is known about colorectal cancer (CRC) screening practices of primary care physicians (PCPs) in rural versus urban locations. METHODS: The authors surveyed 3,380 PCP members of the Texas Medical Association (TMA), stratified by specialty and rural/urban status. Factors associated with PCPs' self-reported practices of CRC screening by fecal occult blood test (FOBT) and/or flexible sigmoidoscopy (SIG) were examined using chi-square tests and multivariate regression. RESULTS: Over 80% of both rural and urban PCPs reported CRC screening with the FOBT, while 70% reported screening with SIG. Many reported doing FOBTs in the office versus using the take-home kit. Variations were found in recommended ages and screening intervals among all respondents. CONCLUSIONS: Geographic location was less important than knowledge and attitudes in predicting PCPs' CRC screening practices. More specific education regarding CRC screening guidelines needs to be directed towards all PCPs.
UI - 11974730
AU - Swan E
TI - The nurse's role in bowel awareness.
SO - Nurs Times 2002 Apr 2-8;98(14):42-3
AD - Walsall Manor Hospital, West Midlands.
Promoting good health and preventing ill health are part of the nurse's role, and using a model for health promotion in the colorectal nursing service is an effective way to improve patient care. This article considers referral guidelines for patients with suspected colorectal cancer and suggests methods of raising public awareness.
UI - 12085252
AU - Nagata C; Takatsuka N; Kawakami N; Shimizu H
TI - A prospective cohort study of soy product intake and stomach cancer death.
SO - Br J Cancer 2002 Jul 1;87(1):31-6
AD - Department of Public Health, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500-8705, Japan. firstname.lastname@example.org
The relationship between intake of soy products and death from stomach cancer was examined in a community-based prospective study of Japanese men and women in Takayama, Japan. Over 7 years of follow-up, 121 deaths from stomach cancer (81 men and 40 women) occurred among 30,304 (13,880 men and 16,424 women) participants who were at least 35 years of age. Diet including the intake of soy products and isoflavones was assessed by a validated semiquantitative food-frequency questionnaire at the beginning of the study. In men, the highest compared to the lowest tertile of total soy product intake was significantly inversely associated with death from stomach cancer after controlling for covariates (hazard ratios=0.50; 95% confidence intervals (CIs) 0.26-0.93, P for trend=0.03). Decreased hazard ratios for the highest compared to the lowest tertiles of total soy product intake (hazard ratios=0.49; 95% CI 0.22-1.13) was observed in women, although this association was of marginal significance. These data suggest that soy intake may reduce the risk of death from stomach cancer. Copyright 2002 Cancer Research UK
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.