RESEARCH UPDATES

11. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age (Apr.10/21)

With recent evidence for the increasing risk of young-onset colorectal cancer (yCRC), the objective of this population-based longitudinal study was to evaluate the incidence of yCRC in one-year age increments, particularly focusing on the screening age of 50 years. The study was conducted using linked administrative health databases in British Columbia, Canada including a provincial cancer registry, inpatient/outpatient visits, and vital statistics from January 1, 1986 to December 31, 2016. We calculated incidence rates per 100,000 at every age from 20 to 60 years and estimated annual percent change in incidence (APCi) of yCRC using joinpoint regression analysis.

3,614 individuals were identified with yCRC (49.9% women). The incidence of CRC steadily rose from 20 to 60 years, with a marked increase from 49 to 50 years. Furthermore, there was a trend of increased incidence of yCRC among women. Analyses stratified by age yielded APCi’s of 2.49% and 0.12% for women aged 30-39 years and 40-49 years, respectively and 2.97% and 1.86% for men. These findings indicate a steady increase over one-year age increments in the risk of yCRC during the years approaching and beyond screening age. These findings highlight the need to raise awareness as well as continue discussions regarding considerations of lowering the screening age.

https://academic.oup.com/jnci/advance-article/doi/10.1093/jnci/djaa220/6119347?guestAccessKey=af490637-e51e-44d0-81b9-d1f2df7b60c9

12. CRC Deaths Rising Among Young People (Apr.27/21)

It is estimated one out of every 20 people will develop colorectal cancer (CRC) in their lifetime. If that number isn’t startling enough, a new study finds this may become the number one cancer-related death for younger people. The problem? The disease often goes undiagnosed until it’s too late.

Danielle Ripley-Burgess hid her symptoms for a long time. “I was probably in eighth grade when I started seeing blood in the stool, and it got worse and worse.” She finally spoke up at 17, and despite her age, her doctor didn’t rule out colorectal cancer. “I showed up, 17 years old, with rectal bleeding, and my GI didn’t hesitate to say, ‘Well, she needs a colonoscopy ASAP,’” she said. “I look back and think his decision helped save my life.” Most young colorectal patients aren’t so fortunate – and the delay can be deadly.

New research finds youth is no longer something doctors should overlook when it comes to CRC.“It’s often misdiagnosed for so long, a lot of early age onset patients are diagnosed at a later stage when the disease is much more difficult to treat,” said Molly McDonnell, Fight Colorectal Cancer’s director of advocacy. A study in the Journal of the American Medical Association predicts it will be the leading cause of cancer-related deaths for people ages 20 to 49 in less than a decade. McDonnel said research regarding why this is happening and how to stop it needs funding now.

https://www.winknews.com/2021/04/27/colorectal-deaths-rising-among-young-people/ 

13. Patients at Average Risk of CRC May Prefer Stool-Based Screenings (Apr.30/21)

Most individuals with an average risk of colorectal cancer (CRC) said they would prefer a stool-based screening test for CRC over colonoscopy, the method most often recommended by health care providers, according to a study published in Cancer Prevention Research. The 3 most common tests are an annual fecal immunochemical test or fecal occult blood test (FIT/FOBT), which detects blood in the stool, the multitarget stool DNA (mt-sDNA) test, which is completed every 3 years and detects altered DNA from cancer cells, precancerous polyps, or blood in the stool, and a colonoscopy every 10 years. Researchers evaluated patient preferences through a survey, which included short descriptions of FIT/FOBT, mt-sDNA, and colonoscopy, and asked a nationally representative sample of adults 40 to 75 years of age to choose between 2 options presented at a time. 

The survey results showed that 66% of respondents preferred mt-sDNA over colonoscopy and 61% said they preferred FIT/FOBT over colonoscopy. When presented with a choice between the 2 stool-based options, 67% indicated a preference for mt-sDNA over FIT/FOBT. Examining demographic differences, the researchers found that although mt-sDNA was preferred over colonoscopy for all age groups examined, a larger proportion of older adults (ages 65 to 75 years) said they preferred colonoscopy compared to those in younger age groups (ages 45 to 54 years). Additionally, half of Hispanic and non-Hispanic Black respondents preferred stool-based tests over colonoscopy, with a preference for mt-sDNA over FIT/FOBT. Respondents without insurance were 2.5 times more likely to prefer less expensive stool-based tests over colonoscopy.

The overall awareness of stool-based tests was about 60%, compared to 90% for colonoscopy. According to the researchers, this indicates that there is an opportunity to improve patient education about stool-based options. Participants who were aware of stool-based tests were twice as likely to prefer mt-sDNA over FIT/FOBT, and those who had previously had a stool-based test were 2.8 times more likely to choose FIT/FOBT over colonoscopy. In contrast, respondents who had previously had a colonoscopy were less than half as likely to prefer a stool-based test over colonoscopy and those who had a provider recommend colonoscopy in the past 12 months were 40% less likely to prefer mt-sDNA over colonoscopy.

https://www.pharmacytimes.com/view/patients-at-average-risk-of-colorectal-cancer-may-prefer-stool-based-screenings 

Source de l'image : https://synappsehealth.com/en/articles/i/the-faecal-occult-blood-test-fobt-what-is-it-and-how-to-prepare-for-it/

14. CRC Screening: One of The Best Weapons in Your Health Toolbox (Apr.30/21)

Regular colorectal cancer (CRC) screening through colonoscopy is one of the most powerful tools against CRC. A colonoscopy is the examination of the large bowel and part of the small bowel. Utilizing a small camera on a flexible tube, doctors screen for polyps or bowel cancer and help diagnose symptoms such as unexplained diarrhea, abdominal pain or blood in the stool. 

This screening can help find cancer or pre-cancer (polyps) in those who have no signs or symptoms. Given that polyps can take 10 years or more to develop into cancer, regular screenings can help prevent the disease. If you are 45 years or older and at average risk of colon cancer (no colon cancer risk factors other than age), your doctor may recommend a colonoscopy every 10 years or sometimes sooner.

“Prevention through CRC screening is the best thing we can do, since some people who have CRC have no signs or symptoms,” says Christina Wu, gastroenterologist and medical oncologist at Winship Cancer Institute. “If you are over 45 years old or have a family member who has had CRC, reach out to your primary care physician to see if a screening is right for you.”

https://news.emory.edu/stories/2021/04/er_colorectal_cancer/campus.html 

Source de l'image : https://www.cedars-sinai.org/blog/at-home-colorectal-cancer-screening.html 

15. Intestinal Polyps in Close Relatives can Increase Risk of CRC (May.04/21)

In the largest registry study to date, researchers at Karolinska Institutet in Sweden and Harvard University in the USA demonstrate the relationship between colorectal cancer (CRC), and having a first-degree relative (i.e. parents and siblings) with a colorectal polyp. The study, which is published in the British Medical Journal, is of potential consequence for different countries’ screening procedures.

They found that approximately 8.4% of the participants with CRC had a sibling or parent with colorectal polyps, as opposed to 5.7% of the control group. The results show that heredity for colorectal polyps had a 40% increased risk of CRC. The researchers found what appear to be several hereditary risk relationships. “The risk was double in people with at least two first-degree relatives with polyps or a first-degree relative who had a colorectal polyp diagnosed before the age of 60.” says the study’s first author Mingyang Song, researcher at Harvard University.

“If additional studies reveal a link between a family history of polyps and the risk of CRC, it is something to take into account in the screening recommendations, especially for younger adults,” says Jonas F. Ludvigsson, paediatrician at Orebro University Hospital and professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

https://www.eurekalert.org/pub_releases/2021-05/ki-ipi050321.php 

16. Study Finds Disparities in CRC Screenings (May.03/21)

Patients with one or more health conditions are more likely to be screened for colorectal cancer (CRC) than those without comorbidities, according to new research in the Journal of Osteopathic Medicine. However, patients with five or more health conditions are also less likely to be screened than patients with two to four health conditions. The study found patients with diabetes, hypertension, skin cancer, chronic obstructive pulmonary disease (COPD), arthritis, depression, and chronic kidney disease were significantly more likely to be screened than those without these health conditions. It also found that an increase in screening adherence of roughly 40% corresponded with a 52% reduction in cancer mortality. 

“It may be that the treating physician or a patient suffering from five or more additional disease states is fatigued by more pressing treatment needs and therefore not prioritizing important screenings,” said Dr. Greiner. “I also worry about the person who has no other health conditions and is either not seeing their doctor on a regular basis or, because of their otherwise clean bill of health, not following the screening recommendation.” According to the American Cancer Society (ACS), the lifetime risk of developing colorectal cancer is about 1 in 23 (4.3%) for men and 1 in 25 (4.0%) for women. The ACS guidelines recommend that all patients aged 45 or older be screened.

https://www.eurekalert.org/pub_releases/2021-05/aoa-sfd050321.php