• Title, Summary, Keyword: Colorectal Neoplasms

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Diverticular Disease and Colorectal Neoplasms: Association between Left Sided Diverticular Disease with Colorectal Cancers and Right Sided with Colonic Polyps

  • Wong, E Ru;Idris, Fazean;Chong, Chee Fui;Telisinghe, Pemasari Upali;Tan, Jackson;Chong, Vui Heng
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2401-2405
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    • 2016
  • Background: Both colorectal cancer (CRC) and diverticular disease (DD) are common in the affluent West, and their prevalence is also increasing in the rest of the world with economic development. Both diseases have common epidemiologic characteristics; increasing incidence, more common with advancing age and related to specific dietary changes. However, studies of associations between the two have generated mixed results with some showing positive correlations, whilst others have shown no or negative links. Most of these studies have been from the West with study populations that were predominantly Caucasians. Here the focus was on DD and colorectal neoplasms, including CRC, in Brunei. Materials and Methods: All patients who had undergone complete colonoscopy between 2011 and 2014 were identified and retrospectively reviewed. Patients under the age of 18 years old or had previous colonic surgeries (including previous CRC resection) were excluded. Results: The total number of colonoscopies included in the study was 2,766 (mean age $53.2{\pm}14.8$ years old, male 51.8%), of which DD, CRC and colonic polyps were detected in 17.3%, 4.7% and 28.2% respectively. The proportions of DD, polyps and CRC increased proportionally with age (<30 years, 30-49, 50-69 and ${\geq}70$). Overall, there was no association between the presence of DD and CRC (3.6% vs. 5.0%, p=0.179) but there was a significant association between CRC and left sided DD (p=0.034 by trend). There were also a significant association between presence of DD and polyps (36.1% vs. 28.2%, p=0.001), in particular with right-sided and pan-DD (p=0.001 for trend). Conclusions: Our study showed that the prevalence of DD, CRC and polyps increases with age. There were significant associations between presence of left-sided DD with CRC and right-sided or pan-DD with colonic polyps. This suggests shared risk factors. Further studies are required to assess links in other countries of the Asian Pacific region.

Evaluation of the Immunohistochemical Staining Pattern of the mTOR Signaling Proteins in Colorectal Cancers and Adenoma Lesions (대장암과 선종 병변에서 mTOR 신호 단백질의 면역조직화학 염색성 평가)

  • Kim, Jin Mok;Lee, Hyoun Wook
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.4
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    • pp.470-476
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    • 2017
  • Changes in the mammalian target of the rapamycin (mTOR) signaling proteins have been observed in many types of cancer. Accordingly, these proteins have recently become an exciting new target for molecular therapeutics. This study examined the expression of an activated mTOR signaling protein in patients with colorectal adenocarcinoma (CRAC) and colorectal adenoma lesion. Immunohistochemical analysis was performed on human CRAC and adenoma for the mTOR signaling components, including mTOR, phosphorylation, and activation of S6 kinase (p70-S6K), S6 ribosomal protein (S6), and eukaryotic initiation factor 4E-binding protein (4EBP1). A total of 100 cases with colorectal adenocarcinoma (CARC; N=40), adenoma with high-grade intraepithelial neoplasms (HIN; N=30), and adenoma with low-grade intraepithelial neoplasms (LIN; N=30) were enrolled in this study. p-mTOR expression was observed in 30 cases of the CRAC tissues (75%), 9 cases of adenoma with HIN (30%), and 2 cases of adenoma with LIN (7%). In addition, p-S6 expression was observed in 22 cases of CRAC tissues (55%), 8 cases of adenoma with HIN (27%), and 3 cases of adenoma with LIN (10%). A significant correlation was observed among the p-mTOR, p-S6 expression, and the adenoma-carcinoma sequence. Interestingly, the p-S6 protein was activated more in early CRAC than in advanced CRAC.

A Comparison Study: the Risk Factors in the Lifestyles of Colorectal Cancer Patients and Healthy Adults (대장암 환자와 건강인의 생활습관 비교)

  • Yoo, Yang Gyeong
    • Journal of Korean Public Health Nursing
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    • v.28 no.3
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    • pp.471-483
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    • 2014
  • Purpose: This study explored possible risk factors influencing the development of colorectal cancer by comparing life habits of colorectal cancer patients and healthy adults. Methods: The study was designed as a retrospective comparison survey study of the colorectal cancer patient group and healthy adult group. 107 colorectal cancer patients in a university hospital and 124 healthy adults were recruited from October 2011 to August 2012. Data were analyzed using descriptive statistics, ${\chi}^2$-test/t-test and logistic regression with the SPSS program. Results: Consumption of instant food products, lower stress management, burned meats and unhealthy eating habits were shown to be risk factors in development of colorectal cancer. Conclusion: Based on the results of this study comparing colorectal cancer patients and healthy adults, minimizing consumption of instant food products, development of healthy eating habits of consuming more vegetables, cooking meat slightly, and effective management of stress levels are recommended.

Screening strategy for colorectal cancer according to risk (발생위험도에 따른 대장암 선별전략)

  • Han, Dong Soo
    • Journal of the Korean Medical Association
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    • v.60 no.11
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    • pp.893-898
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    • 2017
  • Incidence and prevalence of colorectal cancer is increasing worldwide. It related with Westernized life style change, easier access to endoscopic facilities and organized cancer prevention program. The pathogenesis of colorectal cancer is multifactorial, most of cases are sporadic. The risk of colorectal cancer is increasing by age, sex, previous history of colon polyps and cancer, family history of colorectal cancer, hereditary colorectal cancer syndrome, and other modifiable conditions. It is best to screen with organized colorectal cancer screening program for average risk patients at the age of 50 and modify screening strategy by risk factors.

Repeat Colonoscopy Every 10 Years or Single Colonoscopy for Colorectal Neoplasm Screening in Average-risk Chinese: A Cost-effectiveness Analysis

  • Wang, Zhen-Hua;Gao, Qin-Yan;Fang, Jing-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1761-1766
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    • 2012
  • Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.

Psychosocial Adjustment in Korean Colorectal Cancer Survivors

  • Sun, Hyejin;Lee, Jia
    • Journal of Korean Academy of Nursing
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    • v.48 no.5
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    • pp.545-553
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    • 2018
  • Purpose: The increasing survival rate of colorectal cancer demands various nursing interventions and continuous care for patients to adapt to their psychosocial daily lives. The purpose of this study was to identify factors associated with psychosocial adjustment in colorectal cancer survivors. Methods: A cross-sectional descriptive study with face-to-face interviews was conducted of 156 colorectal cancer survivors after surgery visiting an outpatient cancer clinic at a tertiary hospital in S city, Korea. Posttraumatic growth, health-promoting behavior, length of treatment, difficulty in activities of daily living, and having a stoma were entered into the linear regression model. Results: The strongest factor influencing the level of psychosocial adjustment was health-promoting behavior (${\beta}=.33$, p<.001), followed by difficulty in activities of daily living (${\beta}=-.24$, p=.001), posttraumatic growth (${\beta}=.20$, p=.004), and having a stoma (${\beta}=-.19$, p=.004). Conclusion: Nursing interventions for psychosocial adjustment in colorectal cancer survivors need to include the contents for posttraumatic growth, as well as health-promoting behavior, and activities of daily living.

Influencing Factors on Medication Adherence in Colorectal Cancer Patients Receiving Oral Chemotherapy (대장암 환자의 경구용 항암제 복용이행과 영향요인)

  • Kim, Jeong-Hye
    • Asian Oncology Nursing
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    • v.12 no.3
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    • pp.213-220
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    • 2012
  • Purpose: The purpose of this study was to identify factors that influence medication adherence in colorectal cancer patients receiving oral chemotherapy. Methods: One hundred and nine colorectal cancer patients receiving oral chemotherapy were recruited in the cross-sectional survey design. A survey including medication adherence, knowledge about chemotherapy, self-efficacy, depression and symptom experience were completed. Results: The level of medication adherence was $7.38{\pm}.80$. Medication adherence showed significant differences according to perceived health status and combination of IV chemotherapy. Medication adherence was significant correlated with self-efficacy, depression and symptom experience. On stepwise regression analysis, the most important factors related to the medication adherence were symptom experience, perceived health status and combination of IV chemotherapy. These variables explained 17% of medication adherence. Conclusion: The level of medication adherence in colorectal cancer patients receiving oral chemotherapy was relatively high. It is important to develop nursing intervention for medication adherence in colorectal cancer patients that focus on symptom experience and to consider about perceived health status and combination of IV chemotherapy.

Cutaneous metastasis: a rare phenomenon of colorectal cancer

  • Wang, Dan Yang;Ye, Feng;Lin, Jian Jiang;Xu, Xiao
    • Annals of Surgical Treatment and Research
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    • v.93 no.5
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    • pp.277-280
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    • 2017
  • Cutaneous metastases from colorectal cancer are extremely rare and generally appear several years after diagnosis or resection of the primary tumor. Although this phenomenon is uncommon, it is very important and often indicates a poor prognosis. We present a case of a 76-year-old female patient with multiple cutaneous metastatic nodules on the back, just 1 month after resection of rectal cancer. Unfortunately, the patient gave up the follow-up treatment due to her age and poor physical condition; she died 3 months later. In view of its rarity of occurrence and lack of experience in treatment, we reviewed the literature and report as follows.

A Survival Analysis of Gastric or Colorectal Cancer Patients Treated With Surgery: Comparison of Capital and a Non-capital City

  • Hong, Nam-Soo;Lee, Kyeong Soo;Kam, Sin;Choi, Gyu Seog;Kwon, Oh Kyoung;Ryu, Dong Hee;Kim, Sang Won
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.5
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    • pp.283-293
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    • 2017
  • Objectives: The objective of the present study was to compare prognosis of patients with gastric or colorectal cancer according to places where they received surgeries. Methods: The cancer patients underwent surgeries in sampled hospitals located in Daegu were matched 1:1 to the patients who visited sampled hospitals in Seoul using propensity score method. After the occurrences of death were examined, Kaplan-Meier method was used for survival analysis and the log-rank test was performed to compare the survival curves. Results: A total of six out of 291 gastric cancer patients who had surgeries in Daegu died (2.1%) and ten deaths (3.4%) occurred from patients went Seoul hospitals. Out of 84 gastric cancer patients who had chemotherapy after surgeries in Daegu, 13 (15.5%) patients died while 18 (21.4%) deaths occurred among patients underwent surgeries in Seoul. Six deaths (6.9%) out of 87 colorectal cancer patients who had surgeries in Daegu were reported. Five patients (5.7%) died among the patients underwent surgeries in Seoul. Among the colorectal cancer patients with chemotherapy after surgeries, 13 patients (12.4%) who visited hospitals in Daegu and 14 (13.3%) patients who used medical centers in Seoul died. There were no significant differences according to places where patients used medical services. Conclusions: The result of this study is expected to be used as basic data for policy making to resolve centralization problem of cancer patients and to help patients to make rational choices in selection of medical centers.

Diabetes Mellitus and Site-specific Colorectal Cancer Risk in Korea: A Case-control Study

  • Woo, Hyeongtaek;Lee, Jeeyoo;Lee, Jeonghee;Park, Ji Won;Park, Sungchan;Kim, Jeongseon;Oh, Jae Hwan;Shin, Aesun
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.1
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    • pp.45-52
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    • 2016
  • Objectives: Previous large-scale cohort studies conducted in Korea have found a positive association between diabetes mellitus (DM) and colorectal cancer (CRC) in men only, in contrast to studies of other populations that have found significant associations in both men and women. Methods: A total of 1070 CRC cases and 2775 controls were recruited from the National Cancer Center, Korea between August 2010 and June 2013. Self-reported DM history and the duration of DM were compared between cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary and polytomous logistic regression models. Results: DM was associated with an elevated risk of CRC in both men (OR, 1.47; 95% CI, 1.13 to 1.90) and women (OR, 1.92; 95% CI, 1.24 to 2.98). This association remained when we controlled for age, body mass index, alcohol consumption, and physical activity level. In sub-site analyses, DM was associated with distal colon cancer risk in both men (multivariate OR, 2.04; 95% CI, 1.39 to 3.00) and women (multivariate ORs, 1.99; 95% CI, 1.05 to 3.79), while DM was only associated with rectal cancer risk in women (multivariate OR, 2.05; 95% CI, 1.10 to 3.82). No significant association was found between DM and proximal colon cancer risk in either men (multivariate OR, 1.45; 95% CI, 0.88 to 2.41) or women (multivariate OR, 1.79; 95% CI, 0.78 to 4.08). Conclusions: Overall, DM was associated with an increased risk of CRC in Koreans. However, potential over-estimation of the ORs should be considered due to potential biases from the case-control design.