• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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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.

• Journal of Preventive Medicine and Public Health
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• 제49권1호
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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.

• Journal of Digestive Cancer Reports
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• 제9권2호
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• pp.50-56
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• 2021

In patients having long-standing ulcerative colitis (UC), the risk of colorectal cancer (CRC) increased compared with general population. Dysplasia is a precancerous lesion of colitic patients, and traditionally total proctocolectomy was considered as a standard therapy to prevent colorectal cancer in UC patients. However, even with ileal pouch-anal anastomosis (IPAA), patients who underwent total proctocolectomy may experience early and late postoperative complications, such as ileus, bleeding, pouchitis, and so on. In addition, the bowel movement after proctocolectomy with IPAA reaches a median of seven times per day, and a considerable proportion of patients require daytime and nighttime pads. Change in the strategy for managing dysplasia started from two early studies, which suggested polypectomy for polypoid dysplasia to prevent CRC in colitic patients. After that, many studies supported that polypectomy should be the first option for the management of polypoid dysplasia. Moreover, recent studies suggested the feasibility of endoscopic submucosal dissection as a therapeutic option for non-polypoid dysplasia, although long term, large studies should be followed.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7425-7430
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• 2015

Colorectal cancer (CRC) incidence and mortality rates have dropped 30% in the US in the last 10 years among adults ages 50 and older due to the widespread uptake of colonoscopy, yet incidences in the Arab countries have been increasing in the past ten years, albeit with lower figures when compared with developed countries. Lifestyle changes, food consumption patterns and obesity have been observed during the past years where the regular consumption of traditional foods is being replaced with more Western-style and ready-made foods. Most high income countries have implemented population based colorectal cancer screening programs, which aid in decreasing the incidence and mortality of cancer, while these are lacking in most of the Arab world countries due to many cultural and religious barriers to CRC screening as well as lack of high education or familiarity. What is needed is health education to modify risky lifestyle, and to increase motives and enhance positive attitudes towards early screening especially amongst high risk groups in addition to policy designed to encourage healthier living.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.957-962
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• 2012

Objective: Rapidly increasing colorectal cancer (CRC) incidence in Malaysia and the introduction of cutting edge new treatments, which prolong survival, mean that treatment outcome measures meed to be evaluated, including consideration of patient's quality of life (QoL) assessment. There are limited data on QoL in CRC patients, especially in Malaysia. Therefore, this study was performed focusing on cancer stages and age groups. Methods: The cross sectional study was conducted from June to September 2011 at three public tertiary hospitals with the EORTC QLQ C-30 questionnaire in addition to face to face interview and review of medical records of 100 respondents. Results: The mean age was 57.3 (SD 11.9) years with 56.0% are males and 44.0% females, 62% of Malay ethnicity, 30% Chinese, 7% Indian and 1% Sikh. Majority were educated up to secondary level (42%) and 90% respondents had CRC stages III and IV. Mean global health status (GHS) score was 79.1 (SD 21.4). Mean scores for functional status (physical, emotional, role, cognitive, social) rangeds between 79.5 (SD 26.6) to 92.2 (SD 13.7). Mean symptom scores (fatigue, pain, nausea/vomiting, constipation, diarrhea, insomnia, dyspnoea, loss of appetite) ranged between 4.00 (SD 8.58) to 20.7 (SD 30.6). Respondents role function significantly deteriorates with increasing stage of the disease (p=0.044). Females had worse symptoms of pain (p=0.022), fatigue (p=0.031) and dyspnoea (p=0.031). Mean insomnia (p=0.006) and diarrhea (p=0.024) demonstrated significant differences between age groups. Conclusion: QOL in CRC patients in this study was comparable to that in other studies done in developed countries. Pain, fatigue and dyspnoea are worse among female CRC patients. Given that functions deteriorates with advanced stage of the disease at diagnosis, a systematic screening programme to detect cases as early as possible is essential nationwide.

• 생명과학회지
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• 제26권6호
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• pp.705-710
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• 2016

대장암은 세계적으로 3번째로 흔한 암종이며, 암으로 인한 사망의 주요 원인이 되고 있다. 비록 다양한 진단방법이나 치료 방법이 이용되고는 있으나 병의 진행에 관여하는 분자메커니즘 이해의 부족 때문에 여전히 완전한 치료는 어려운 실정이다. 마이크로알엔에이는 단백질 정보를 코딩하고 있지 않은 작은 알엔에이 단편이다. 이러한 마이크로알엔에이는 특정 유전자의 전사과정 또는 번역과정을 조절하는 강력한 유전자 조절자로서의 기능을 가진다. 암의 발생과정에서 중요한 세포신호 전달 과정의 손상이 빈번하게 발생 하는데, 다양한 마이크로알엔에이의 이상발현이 그 원인이 되고 있다. 마이크로알엔에이-31은 암유전자의 역할을 하며 발암과정에 관여하는 다양한 유전자를 조절한다고 알려져 있다. 따라서, 본 연구에서는 대장암에서 마이크로알엔에이-31 발현의 임상적의의를 규명하고자 하였다. 175례의 대장암 조직과 16례의 정상 대장조직에서 실시간 유전자 증폭장치를 이용하여 마이크로알엔에이-31의 발현을 분석하고, 임상병리적 요인들과의 상관관계를 분석하고 임상적 유용성을 연구해 보았다. 마이크로알엔에이-31은 정상조직에 비해 대장암 조직에서 과발현이 되어 있었다. 175례 대장암 조직을 이용한 분석에서 마이크로알엔에이-31의 발현은 병기의 진행 정도에 따라 발현이 증가 되고 있었으며, 실제 마이크로알엔에이-31의 발현이 높은 대장암 환자군의 생존률이 그렇지 않은 환자군에 비해 통계적으로 유의하게 나쁜 것으로 확인 되었다. Cox 비례위험 모형과 로지스틱 회귀 모형을 이용한 분석에서 마이크로알엔에이-31의 과발현이 직접적으로 대장암 환자의 예후 및 원발전이와 연관성이 있는 것이 확인 되었다. 따라서, 이상의 연구결과를 종합해볼 때 대장암에서 과발현 된 마이크로알엔에이-31은 대장암 환자의 예후예측 및 전이예측 바이오마커로서의 활용 가능성이 높다고 볼 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3133-3137
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• 2014

Background: To determine the histopathological pattern of colorectal cancer (CRC) among Saudi patients with a view to determine various epidemiological and histopathological features of the disease. Materials and Methods: We retrospectively collected and analyzed the demographic and histopathological data of all the patients with CRC diagnosed at King Fahad Hospital, Madinah, Saudi Arabia over a period of 8 years from January 2006 to December 2013. Results: Of 324 cases of CRC reviewed, 200 cases (61.7%) were males while 124 cases (38.3%) were females giving a male to female ratio of 1.6: 1. Age of the patients ranged from 20 to 100 years with a mean age 57.9 years. The rectosigmoid region was the most frequent anatomical site (13.6%) involved and adenocarcinoma (88.6%) was the most common histopathological type. The majority of adenocarcinomas (87.3%) were moderately differentiated. A total of 47.8% of patients were in stage B and 43.5% of patients were in stage C of the Aster-Coller classification. Most patients (75.7%) presented with large size tumors. Lymphovascular invasion and lymph node metastasis were recorded in 67.9% and 43.6% of cases, respectively. Conclusions: Colorectal cancer is common in our environment and the majority of patients present late with an advanced stage. Screening programs regarding CRC should be enhanced to improve the outcome of the patients.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2319-2324
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• 2012

Aim: To investigate the expression of three components of the Hedgehog (Hh) signaling pathway (SHH, SMO and GLI1) in human colorectal cancer (CRC) tissues and evaluate their association with clinicopathologic characteristics of the patients. Methods: Fresh tumor tissues and matched tissues adjacent to the tumor were collected from 43 CRC patients undergoing surgery. Normal colorectal tissues from 20 non-CRC cases were also sampled as normal controls. The expression of SHH, SMO, GLI1 mRNAs was assessed by RT-PCR and proteins were detected by immunohistochemical staining. Associations with clinicopathological characteristics of patients were analyzed. Results: SHH mRNA was expressed more frequently in tumor tissues than in normal tissues, but the difference did not reach significance in comparison to that in the adjacent tissues. SMO and GLI1 mRNAs were expressed more frequently in tumor tissues than in both adjacent andnormal tissues. The expression intensities of SHH, SMO, GLI1 mRNA in tumor tissues were significantly higher than those in adjacent tissues and normal tissues. Proteins were also detected more frequently in tumors than other tissues. No significant links were apparent with gender, age, location, degree of infiltration or Dukes stage. Conclusion: Positive rates and intensities of mRNA and protein expression of Hh signaling pathway related genes SHH, SMO, GLI1 were found to be significantly increased in CRC tissues. However, over-expression did not appear to be associated with particular clinicopathological characteristics.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.969-973
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• 2014

Background: The number of colorectal cancer (CRC) patients in Taiwan has increased in recent years; therefore, the effective dissemination of information related to symptom care has become especially important. Previous studies indicated that the physical and psychological status of cancer patients can be effectively improved by telephone counseling services (TCS). Thus, determining the most effective means of establishing a TCS to support the clinical practice of oncology has become a crucial goal for nursing. The purposes of this study were to analysis the content of the TCS for CRC and explore stratification of the TCS. Materials and Methods: The study design was retrospective. A total of 850 calls were made to CRC patients in the cancer center of Southern Taiwan during the period of January 2007- December 2011. A structure questionnaire was adopted to analysis satisfaction. Results: Responses provided by the TCS included information regarding nutrition, side effects resulting from chemotherapy and pain. Moreover, 28.7% of CRC patients needed advanced treatment. More than 90% satisfaction with all aspects of the calls was found. Conclusions: The TCS coulkd be shown to provide an effective means by which to expand the reach of nursing care to different times, places and patients, allowing for greater cost efficiency and more rapid service.

• Journal of Preventive Medicine and Public Health
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• 제56권4호
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• pp.312-318
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• 2023

Objectives: We reviewed the operational definitions of colorectal cancer (CRC) from studies using the Korean National Health Insurance Service (NHIS) and compared CRC incidence derived from the commonly used operational definitions in the literature with the statistics reported by the Korea Central Cancer Registry (KCCR). Methods: We searched the MEDLINE and KoreaMed databases to identify studies containing operational definitions of CRC, published until January 15, 2021. All pertinent data concerning the study period, the utilized database, and the outcome variable were extracted. Within the NHIS-National Sample Cohort, age-standardized incidence rates (ASRs) of CRC were calculated for each operational definition found in the literature between 2005 and 2019. These rates were then compared with ASRs from the KCCR. Results: From the 62 eligible studies, 9 operational definitions for CRC were identified. The most commonly used operational definition was "C18-C20" (n=20), followed by "C18-C20 with claim code for treatment" (n=3) and "C18-C20 with V193 (code for registered cancer patients' payment deduction)" (n=3). The ASRs reported using these operational definitions were lower than the ASRs from KCCR, except for "C18-C20 used as the main diagnosis." The smallest difference in ASRs was observed for "C18-C20," followed by "C18-C20 with V193," and "C18-C20 with claim code for hospitalization or code for treatment." Conclusions: In defining CRC patients utilizing the NHIS database, the ASR derived through the operational definition of "C18-C20 as the main diagnosis" was comparable to the ASR from the KCCR. Depending on the study hypothesis, operational definitions using treatment codes may be utilized.