• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8371-8375
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• 2016

Background: Colorectal cancer is one of the most common neoplasms in Iran. Secondary prevention (colorectal cancer screening) is important and a most valuable method of early diagnosis of this cancer. The objectives of this study were to determine the factors associated with colorectal cancer screening adherence among Iranians 50 years and older using the Health Belief Model. Materials and Methods: This cross-sectional study was conducted from June 2012 to May 2013. A convenience sample of 200 individuals aged 50 and older was recruited from the population at outpatient clinics in teaching hospitals. Data gathering tools were the Champions health belief model scale (CHBMS) with coverage of socio-demographic background and CRC screening information. Multiple logistic regression was performed to identify factors associated with colorectal cancer screening adherence. Results: The mean age of participants was $62.5{\pm}10.8$ and 75.5% were women. A high percentage of the participants had not heard or read about colorectal cancer (86.5%) and CRC screening (93.5%). Perceived susceptibility to colorectal cancer had the lowest percentage of all of the subscales. Participants who perceived more susceptibility (OR =2.99; CI 95%: 1.23-5.45) and reported higher knowledge (OR =1.29; CI 95%: 1.86-3.40) and those who reported fewer barriers (OR =.37; CI 95%:.21-.89), were more likely to have carried out colorectal cancer screening. Conclusions: Our findings indicated that CRC knowledge, perceived susceptibility and barriers were significant predictors of colorectal cancer screening adherence. Strategies to increase knowledge and overcome barriers in risk individuals appear necessary. Education programs should be promoted to overcome knowledge deficiency and negative perceptions in elderly Iranians.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3983-3987
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• 2012

In Malaysia, colorectal cancer is the most common cancer in males and the third most common in females. Mortality due to colorectal cancer can be effectively reduced with early diagnosis. This study was designed to look into colorectal cancer screening participation and its barriers among average risk individuals in Malaysia. A cross sectional study was conducted from August 2009 till April 2010 involving average risk individuals from 44 primary care clinics in West Malaysia. Each individual was asked whether they have performed any of the colorectal cancer screening methods in the past five years. The barrier questions had three domains: patient factors, test factors and health care provider factors. Descriptive analysis was achieved using Statistical Program for Social Sciences (SPSS) version 12.0. A total of 1,905 average risk individuals responded making a response rate of 93.8%. Only 13 (0.7%) respondents had undergone any of the colorectal cancer screening methods in the past five years. The main patient and test factors for not participating were embarrassment (35.2%) and feeling uncomfortable (30.0%), respectively. There were 11.2% of respondents who never received any advice to do screening. The main reason for them to undergo screening was being advised by health care providers (84.6%). The study showed that participation in colorectal cancer screening in Malaysia is extremely low and multiple factors contribute to this situation. Given the importance of the disease, efforts should be made to increase colorectal cancer screening activities in Malaysia.

• Biomedical Science Letters
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• v.8 no.3
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• pp.137-142
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• 2002

The expression of CD44v is known as a marker of cancer progression and its metastasis in colorectal cancer. It has been known that CD44 variant containing sequences encoded by exon 11 (v6) confer metastatic potential to human colorectal cancer cells. The role of CD44 standard (CD44s) and CD44v6 in colorectal cancer was investigated in this study by immunohistochemical staining of the primary tumors obtained from the colorectal cancer patients. Immunohistochemical staining was performed in 40 patients with colorectal cancer who underwent curative surgery at Keimyung University hospital. The expression CD44s and CD44v6 was observed in 24/40 (60%) and 13/40 (32.5%) respectively. The expression of CD44v6 had correlation with TNM stage (P＜0.05), however CD44s had not any correlation with clinicopathological parameters. These results suggest that CD44v6 expression may give an information for tumor progression than decreased expression of CD44s in colorectal cancer cells.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2949-2953
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• 2012

The glutathione S transferase (GST) family is a major part of cellular defense mechanisms against endogenous and exogenous substances, many of which have carcinogenic potential. Alteration in the expression level or structure of the glutathione-S-transferase (GST) enzymes may lead to inadequate detoxification of potential carcinogens and consequently contribute to cancer development. A member of the glutathione-S-transferase (GST) family, GSTP1, is an attractive candidate for involvement in susceptibility to carcinogen-associated colorectal cancer. An $Ag{\rightarrow}G$ transition in exon 5 resulting in an Ile105Val amino acid substitution has been identified which alters catalytic efficiency. The present study investigated the possible impact of Ile105Val GSTP1 polymorphism on susceptibility to colorectal cancer. in Jordan We examined 90 tissue samples previously diagnosed with colorectal carcinoma, and 56 non-cancerous colon tissues. DNA was extracted from paraffin embedded tissues and the status of the GSTP1 polymorphism was determined using a polymerase chain reaction restriction fragment length polymorphism (RFLP) method. No statistically significant differences were found between colorectal cancer cases and controls for the GSTP1 Ile/Ile, Ile/Val and Val/Val genotypes. The glutathione S-transferase polymorphism was not associated with risk in colorectal cancer cases in Jordan stratified by age, sex, site, grade or tumor stage. In conclusion, the GSTP1 Ile105Val polymorphism is unlikely to affect the risk of colorectal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1995-1998
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• 2013

Objective: To study the expression of the mismatch repair proteins hMSH2 and nm23 in sporadic colorectal cancer, determine any inter-relationship, and further investigate any clinical significance. Methods: Expression of hMSH2 and nm23 proteins was assessed in 87 colorectal cancer tissues by SP immunohistochemistry, with analysis of survival using follow-up data. Results: In the sporadic colorectal cancer tissues, nm23 protein expression appeared independent of the histological type (P>0.05), but correlated with the invasion depth and lymphatic metastasis (P<0.05). In contrast, hMSH2 protein expression was not significantly correlated with these clinicopathologic features (P>0.05), although it positively correlated with that of nm23 protein in the sporadic colorectal cancers (rs=0.635, P<0.05). Combined expression of the two was found to be related with invasion depth, lymphatic metastasis and prognosis of sporadic colorectal cancer (P<0.05). Conclusion: nm23 protein level was related with the degree of malignancy, and could be used as an index to predict the invasion and metastasis potential. The expression of hMSH2 protein is positively correlated that of nm23 protein, and the combined expression of the two has certain guiding significance for the prognosis of sporadic colorectal cancer.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.147-152
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• 2002

Objectives : A hospital-based case-control study was conducted to evaluate the role of obesity in the development of colorectal cancer. Methods : Three hundred and twenty four histologically confirmed female colorectal cancer cases and 26,998 non-cancer controls were selected from patients invited to the Aichi Cancer Center, Nagoya, Japan between 1989 and 1995. Information concerning demographic factors, medical history, family medical history, reproductive factors and dietary factors were obtained from self-administered questionnaires and medical records. The effects of weight and body mass index to colorectal cancer were examined using multiple logistic regression to control for other risk factors. Results : There was no significant association between female colorectal cancer and obesity. Heavier weight adjusted for height or body mass index did not increase the risk of colorectal cancer. Conclusions : These results suggest that there is no association between colorectal cancer risk and obesity in women.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2901-2904
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• 2014

The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

• Annals of Coloproctology
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• v.34 no.6
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• pp.292-298
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• 2018

Purpose: This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator. Methods: From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery. Results: Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time ($137.4{\pm}43.2minutes$ vs. $155.5{\pm}47.9minutes$, P < 0.001) and shorter incision length ($5.3{\pm}2.2cm$ vs. $7.8{\pm}1.2cm$, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size. Conclusion: RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1807-1811
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• 2013

Background: Colorectal cancer is a main leading cause of cancer death in western countries. Although many studies have been conducted on incidence trends all over the world in recent years, information regarding changes in incidence of colorectal cancer in Iran is insufficient. The present study of colorectal cancer in the west of Iran during recent years was therefore performed. Materials and Methods: The registered data for colorectal cancer cases in National Cancer Registry System were extracted from the Ministry of Health and Medical Education, Center for Disease Control and Management. The codes from 18-21 among cancers were selected for colon and rectum cancers. Incidence rates were standardized directly using WHO population. The significance of incidence rate trends during 2000-2005 was tested through Poisson regression. Results: 762 cases of colorectal cancer were observed during 6 years in this region, with a gender ratio of men to women of 1.2. It increased from 65 cases in 2000 to 213 cases in 2005 or from 1.5 per100,000 per persons per year to 4.8. Significant increasing trends were evident in Kermanshah and Hamadan provinces; however, change did not reach significance in Ilam and Kurdistan provinces. Conclusions: Colorectal cancer has an increasing trend in the west of Iran. Although it seems that the increasing rate of colorectal cancer is due to increasing of cancer risk factors, some proportion may be related to the improvement of surveillance systems in Iran.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8345-8349
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• 2016

Background: Although the incidence of colorectal cancer in Malaysia is increasing, awareness of this cancer, including its symptoms, risk factors and screening methods, remains low among Malaysian populations. This survey was conducted with the aim of (i) ascertaining the awareness level regarding colorectal cancer symptoms, risk factors and its screening among the general populations and (ii) assessing the public preference and willingness to pay for colorectal cancer screening. Materials and Methods: The questionnaire was distributed in eight major cities in West Malaysia during the World Health Digestive Day (WDHD) campaign. Two thousand four hundred and eight respondents participated in this survey. Results: Generally, awareness of colorectal cancer was found to be relatively good. Symptoms such as change in bowel habit, blood in the stool, weight loss and abdominal pain were well recognized by 86.6%, 86.9%, 83.4% and 85.6% of the respondents, respectively. However, common risk factors such as positive family history, obesity and old age were acknowledged only by less than 70% of the respondents. Almost 80% of the respondents are willing to take the screening test even without any apparent symptoms. Colonoscopy is the preferred screening method, but only 37.5% were willing to pay from their own pocket to get early colonoscopy. Conclusions: Continous cancer education should be promoted with more involvement from healthcare providers in order to make future colorectal cancer screening programs successful.