• Colorectal cancer
• Colorectal cancer screening
• Fecal occult blood
• Hyperspectral imaging

• Humans
• Occult Blood
• Colorectal Neoplasms/diagnosis
• Female
• Male
• Middle Aged
• Aged
• Algorithms
• Feces/chemistry
• Colonoscopy/methods
• Early Detection of Cancer/methods
• Hyperspectral Imaging/methods
• Sensitivity and Specificity
• Predictive Value of Tests
• Adult
• Aged, 80 and over
• Machine Learning

• 2021-S-4 The National Cancer Center Research and Development Fund
• The University of Tokyo

• Asian population
• colorectal cancer
• epidemiology
• risk factor
• screening

• colonic diseases
• colorectal neoplasms
• early detection of cancer
• mass screening
• risk factors

• China/epidemiology
• Cohort Studies
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/prevention & control
• Early Detection of Cancer
• Female
• Humans
• Male
• Mass Screening
• Occult Blood

• Periodontal disease
• colorectal cancer
• incidence
• meta-analysis

Sedation in gastrointestinal endoscopy is rapidly evolving worldwide. However, this has led to significant disagreements, especially regarding the use of propofol by non-anesthesiologists. The aim of this study was to document the practices of Greek gastroenterologists regarding sedation and compare them to previous surveys.

The study was conducted in 2 periods, December 2015 and June 2018. In each period, the same online questionnaire regarding endoscopic sedation practices was sent to all registered Greek gastroenterologists (509 and 547 gastroenterologists, respectively).

The response rates were 38.3% and 47.1%, respectively. In each period, 25.1% and 16.7% of physicians did not use sedation. Most gastroenterologists (approx. 70% in both instances) answered that they “almost never” collaborate with an anesthesiologist during endoscopy. Midazolam was by far the most popular sedation agent, used by almost 90% of physicians in both periods. Propofol was used by 30.8% and 27% of physicians, respectively. Physicians using propofol were significantly more satisfied with the sedation than other physicians, while propofol was the agent selected by most physicians if they were to undergo endoscopy themselves. Most physicians cited medicolegal reasons and inadequate training as chief reasons for not using propofol.

Sedation use is widespread among Greek gastroenterologists. Although midazolam is the most commonly used agent, propofol is preferred (theoretically) by most physicians and achieves the best satisfaction. The introduction of a strict training curriculum for endoscopic sedation can effectively eliminate the barriers preventing gastroenterologists from administering propofol, while at the same time ensuring optimal patient safety during endoscopy.

• Gastrointestinal endoscopy
• Greece
• practice patterns
• questionnaire
• sedation

Colorectal cancer (CRC) screening rates are low in the general population and among health care providers. The aim of this study was to evaluate the CRC screening practices of general surgeons who provide specialized diagnostic testing and CRC treatment and to examine the CRC screening behaviors of their first-degree family members.

A cross-sectional survey was conducted among general surgeons who attended the 21st National Surgical Congress in Turkey held from April 11th to 15th, 2018. The survey included items on demographics, screening-related attitude, CRC screening options, barriers to CRC screening, and surgeons’ annual volumes of CRC cases.

A total of 530 respondents completed the survey. Almost one-third of the responding surgeons (29.4%, n = 156) were aged over 50 years, among whom approximately half (47.1%, n = 74) reported having undergone CRC screening and preferring a colonoscopy as the screening modality (78.4%). Among general surgeons aged 50 years and older, high-volume surgeons (≥25 CRC cases per year) were more likely to undergo screening compared with low-volume surgeons (< 25 CRC cases per year). The respondents aged below 50 years reported that 56.1% (n = 210) of their first-degree relatives were up-to-date with CRC screening, mostly with colonoscopy. Compared to low-volume surgeons aged below 50 years, high-volume surgeons’ first-degree relatives were more likely to be up-to-date with CRC screening.

The survey results demonstrated that routine screening for CRC among surgeons and/or their first-degree relatives is currently not performed at the desired level. However, high-volume surgeons are more likely to participate in routine screening.

• Attitude
• Behavior
• Colorectal cancer
• General surgeons
• Screening

Identification of effective biomarkers is crucial for monitoring the treatment and remission of colorectal cancer (CRC) and improving survival. It is particularly important to diagnose CRC before the tumor metastasizes (stage I–II disease) where possible, to provide the greatest opportunity for patient recovery. Here, we evaluated the clinical value of serum chemokine (C-X-C) ligand 7 (CXCL7) concentration as a biomarker for CRC diagnosis. An enzyme-linked immunosorbent assay was used to measure CXCL7 concentration in 560 serum samples from patients with CRC and controls. Logistic regression and receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic efficacy and build mathematical diagnostic models. The concentration of CXCL7 in the CRC group was significantly higher than that in the control group (P < 0.001), with an area under the ROC curve (AUC) value of 0.862 [95% confidence interval (CI): 0.831–0.890]. Further, the AUC of a regression model including the markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and carbohydrate antigen 125 (CA125), along with CXCL7, was 0.933 (95% CI: 0.909–0.952). For stage I–II tumors, CXCL7 had the highest AUC (0.823, 95% CI: 0.783–0.858) among the four individual biomarkers. The AUC value for combination model analysis of samples from patients with stage I–II tumors was 0.904 (95% CI: 0.872–0.930), with a sensitivity of 82.76% and a specificity of 87.14%, and an optimal cut-off value of 2.66. AUC values for application of the regression model in subgroup analysis were 0.947 (0.917–0.968) and 0.919 (0.874–0.951) for males and females, respectively. These results suggest that CXCL7 has potential as a serum diagnostic biomarker for detection of CRC. Importantly, the combination of CXCL7, CEA, CA125, and CA19-9 may facilitate diagnosis of CRC with relatively high sensitivity and specificity.

Clinical Trial Registration Number: LS2017001.

• CXCL7
• cancer biomarker
• colorectal cancer
• diagnosis
• serum

• CNPY2 isoform 2
• colorectal cancer
• combination
• diagnosis

• Asia
• Colonoscopy
• Colorectal cancer
• Epidemiology
• Population
• Screening

• Asia/epidemiology
• Colonoscopy/methods
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/therapy
• Early Detection of Cancer/methods
• Humans
• Incidence
• Mass Screening/methods
• Population Surveillance/methods
• Prognosis

• Anxiety
• Colonoscopy
• Patient characteristics
• Pre-procedure

• Colorectal cancer
• FIT
• colonscopy
• gFOBT
• screening
• surveillance

To determine the pathogenesis and potential single nucleotide polymorphisms (SNPs) as screening sites for colonic polyps, colon cancer and ulcerative colitis, and to analyze the possible association between these genetic polymorphisms and the three diseases.

We evaluated genetic polymorphisms in 144 newly diagnosed colonic polyp patients, 96 colon cancer patients and 44 ulcerative colitis patients. The four SNPs genotyped were rs4809957, rs6068816, rs6091822 and rs8124792. The control group consisted of 504 East Asians enrolled in the 1000 Genomes Project. Correlations between CYP24A1 SNPs and the diseases were analyzed by Fisher’s exact probability test.

CYP24A1 polymorphisms rs4809957 A/G and rs6068816 C/T showed a statistically significant association with risk of the three diseases, when both the genotypes and allele frequencies were considered. With regard to rs6091822 G/T, all three diseases were related to risk allele carriers (GT + TT) vs wild-type (GG), but the associations between the allele frequencies and the diseases were not significant. The risk of colonic polyps and colon cancer was related to the allele frequencies of rs8124792 G/A, and this association remained for genotype frequencies of this SNP.

Four SNPs are related to the risk of colonic polyps and colon cancer. G allele in rs6091822 G/T may play an anti-cancer role only if it is homozygous. The A allele, which is a minor component of rs8124792, may be indicated in the diagnosis of colonic polyps or colon cancer rather than ulcerative colitis.

• CYP24A1
• Single nucleotide polymorphisms
• Colonic polyps
• Colon cancer

• Adult
• Aged
• Asian People/genetics
• Biomarkers, Tumor/genetics
• Case-Control Studies
• Colitis, Ulcerative/genetics
• Colonic Neoplasms/genetics
• Colonic Polyps/genetics
• Early Detection of Cancer/methods
• Female
• Gene Frequency/genetics
• Genetic Predisposition to Disease
• Genotype
• Humans
• Male
• Mass Screening/methods
• Middle Aged
• Polymorphism, Single Nucleotide
• Vitamin D3 24-Hydroxylase/genetics

• Colonoscopy
• Colorectal cancer
• Colorectal cancer screening
• Fecal immunochemical test
• Fecal occult blood test

• Adult
• Aged
• Canada
• Colonoscopy
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/mortality
• Early Detection of Cancer/methods
• Feces
• Female
• Geography
• Global Health
• Humans
• Immunochemistry
• Incidence
• Male
• Mass Screening/methods
• Middle Aged
• Netherlands
• Occult Blood

• apcs score
• chinese population
• screening for colorectal cancer

• Adult
• Aged
• Asymptomatic Diseases/epidemiology
• China/epidemiology
• Colonoscopy/methods
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/epidemiology
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Neoplasm Staging/methods
• Prospective Studies
• Reproducibility of Results
• Risk Assessment/methods
• Survival Rate/trends

Colorectal cancer (CRC) is a major health problem in Asia. It has been reported that the Chinese are more susceptible to CRC than many other ethnic groups. Screening for CRC is a cost-effective prevention and control strategy; however, the screening rates among the Chinese are sub-optimal. We conducted a review to identify the factors associated with CRC screening participation among Chinese people. Twenty-two studies that examined the factors related to CRC screening behaviors among the Chinese were identified through five databases. Seven factors were consistently reported to influence CRC screening behaviors in at least one of the studies: socio-demographic characteristics (educational level, health insurance, and knowledge about CRC and its screening); psychological factors (perceived severity of CRC, susceptibility of having CRC, and barriers to screening); and contact with medical provider (physician recommendation). The evidence base for many of these relationships is quite limited. Furthermore, the associations of many factors, including age, gender, income, cancer worry/fear, and self-efficacy with CRC screening behaviors, were mixed or inconsistent across these studies, thereby indicating that more studies are needed in this area.

• Chinese
• colorectal cancer
• literature review
• risk factors
• screening

• Asian People
• China
• Colorectal Neoplasms/diagnosis
• Early Detection of Cancer
• Humans
• Mass Screening

• Asia
• colonoscopy
• colorectal cancer
• fecal occult blood test
• screening

• Adult
• Aged
• Colonoscopy
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/epidemiology
• Early Detection of Cancer
• Asia, Eastern/epidemiology
• Female
• Humans
• Incidence
• Male
• Mass Screening
• Middle Aged

• Chinese
• Colorectal cancer screening
• Extended parallel processing model
• Health belief model
• Oncology

• COLONOSCOPY
• COLORECTAL ADENOMAS
• COLORECTAL CANCER
• COLORECTAL CANCER SCREENING
• COLORECTAL NEOPLASM

• Asian People
• China
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/economics
• Computer Simulation
• Cost-Benefit Analysis
• Early Detection of Cancer/economics
• Humans
• Markov Chains
• Urban Population

• Adult
• Black or African American/psychology
• Black or African American/statistics & numerical data
• Aged
• Female
• Financing, Personal
• Health Behavior/ethnology
• Health Status
• Health Surveys
• Humans
• Interview, Psychological
• Logistic Models
• Male
• Middle Aged
• Patient Acceptance of Health Care/ethnology
• Patient Acceptance of Health Care/psychology
• Poverty Areas
• Program Evaluation
• Qualitative Research
• Self Report
• Social Class
• Transportation
• White People/psychology
• White People/statistics & numerical data

• U54 CA153460 NCI NIH HHS
• U54 CA154253 NCI NIH HHS
• U54CA154253 NCI NIH HHS
• U54CA153460 NCI NIH HHS

AIM: To study the epidemiologic indicators of uptake and characteristic colonoscopic findings in the Croatian National Colorectal Cancer Screening Program.

METHODS: Colorectal cancer (CRC) was the second leading cause of cancer mortality in men (n = 1063, 49.77/100  000), as well as women (n = 803, 34.89/100  000) in Croatia in 2009. The Croatian National CRC Screening Program was established by the Ministry of Health and Social Welfare, and its implementation started in September, 2007. The coordinators were recruited in each county institute of public health with an obligation to provide fecal occult blood testing (FOBT) to the participants, followed by colonoscopy in all positive cases. The FOBT was performed by hypersensitive guaiac-based Hemognost card test (Biognost, Zagreb). The test and short questionnaire were delivered to the home addresses of all citizens aged 50-74 years consecutively during a 3-year period. Each participant was required to complete the questionnaire and send it together with the stool specimen on three test cards back to the institute for further analysis. About 4% FOBT positive cases are expected in normal risk populations. A descriptive analysis was performed.

RESULTS: A total of 1  056  694 individuals (born between 1933-1945 and 1952-1957) were invited to screening by the end of September 2011. In total, 210  239 (19.9%) persons returned the envelope with a completed questionnaire, and 181 102 of them returned it with a correctly placed stool specimen on FOBT cards. Until now, 12  477 (6.9%), FOBT-positive patients have been found, which is at the upper limit of the expected values in European Guidelines for Quality Assurance in CRC Screening and Diagnosis [European Union (EU) Guidelines]. Colonoscopy was performed in 8541 cases (uptake 66%). Screening has identified CRC in 472 patients (5.5% of colonoscopied, 3.8% of FOBT-positive, and 0.26% of all screened individuals). This is also in the expected range according to EU Guidelines. Polyps were found and removed in 3329 (39% of colonoscopied) patients. The largest number of polyps were found in the left half of the colon: 64% (19%, 37% and 8% in the rectum, sigma, and descendens, respectively). The other 36% were detected in the proximal part (17% in the transverse colon and 19% in ceco-ascending colon). Small polyps in the rectum (5-10 mm in diameter), sigmoid and descending colon were histologically found to be tubular adenomas in 60% of cases, with a low degree of dysplasia, and 40% were classified as hyperplastic. Polyps of this size in the transverse or ceco-ascending colon in almost 20% had a histologically villous component, but still had a low degree of dysplasia. Polyps sized 10-20 mm in diameter were in 43% cases tubulovillous, and among them, 32% had areas with a high degree of dysplasia, especially those polyps in the ceco-ascending or transverse part. The characteristics of the Croatian CRC Screening National Program in the first 3 years were as follows: relatively low percentage of returned FOBT, higher number of FOBT-positive persons but still in the range for population-based programs, and higher number of pathologic findings (polyps and cancers).

CONCLUSION: These results suggest a need for intervention strategies that include organizational changes and educational activities to improve awareness of CRC screening usefulness and increase participation rates.

• Colorectal cancer screening
• Fecal occult blood testing
• Croatian National Colorectal Cancer Screening Program
• Colonoscopy
• Uptake

AIM: To explore the value of serum M2-pyruvate kinase (M2-PK) in colorectal cancer (CRC) mass screening.

METHODS: We conducted a molecular epidemiology study in Hangzhou, China, from year 2006 to year 2008. Serum samples were collected from 93 CRC, 41 advanced adenomas, 137 adenomas, 47 non-adenomatous polyps, and 158 normal participants in a community setting. Serum M2-PK and carcinoembryonic antigen (CEA) were measured using Enzyme-linked immunosorbent assay. SPSS 16.0 software was used to perform data analysis. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificities were estimated for serum M2-PK in diagnosis of colorectal lesions and compared with CEA.

RESULTS: Average serum M2-PK value among 158 normal people was 2.96 U/mL and not affected by gender (P = 0.47) or age (P = 0.59). Average serum M2-PK (U/mL) was 14.75 among stage III and 13.10 among stage I and II CRC patients, about 4 times higher than that among normal people. Average serum M2-PK was 8.58, 6.70, 5.13 and 2.51 U/mL among advanced adenoma, adenomas, non-adenomatous polyps, and inflammatory bowel disease patients, respectively. AUC for serum M2-PK was greater than that for CEA among all colorectal lesions. AUC for serum M2-PK was 0.89 (0.84, 0.94) (95% confidence interval), higher than that for CEA [0.70 (0.62-0.79)] in CRC stage I and II, 0.89 (0.84-0.94) vs 0.73 (0.63-0.83) in CRC stage III, 0.81 (0.74-0.86) vs 0.63 (0.53 - 0.73) in advanced adenomas, 0.69 (0.64-0.76) vs 0.54 (0.47-0.60) in adenomas, and 0.69 (0.62-0.78) vs 0.58 (0.48-0.68) in non-adenomatous polyps. The diagnostic sensitivity for all colorectal lesions increased with decrease in the cut-off value of serum M2-PK. The diagnostic sensitivity (%) of serum M2-PK was 100.00 for CRC, 95.12 advanced adenoma, 82.48 adenoma, and 82.98 non-adenomatous polyp. There were no CRC cases missed and 40.51% of unnecessary colonoscopies were avoided when the cut-off value was 2.00 U/mL.

CONCLUSION: Serum M2-PK can be used as a primary screening test in CRC mass screening. It may be a promising non-invasive biomarker for CRC early detection.

• Serum M2-pyruvate kinase
• Colorectal cancer screening
• Serum biomarker
• Carcinoembryonic antigen

• anesthesia
• endoscopy
• procedure
• seer

• Behavior
• Colorectal cancer
• Screening
• Survey
• Willingness

• China
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/prevention & control
• Colorectal Neoplasms/psychology
• Data Collection
• Early Detection of Cancer/psychology
• Educational Status
• Female
• Health Knowledge, Attitudes, Practice
• Humans
• Male
• Mass Screening/psychology
• Middle Aged
• Outpatients/psychology
• Surveys and Questionnaires

• colonic polyp screening
• colorectal cancer prevention
• early detection
• computed tomography
• magnetic resonance imaging
• virtual colonoscopy
• optical colonoscopy

• R01 CA082402 NCI NIH HHS
• R21 CA120917 NCI NIH HHS
• R33 CA120917-03 NCI NIH HHS
• R01 CA082402-07 NCI NIH HHS
• R33 CA120917 NCI NIH HHS

AIM: To determine the basic demographic features of colorectal cancer (CRC) in five hospitals located in four different areas of Guangdong Province, China.

METHODS: A review of patient records from 1986 to 2006 from five hospitals was conducted. Patient data was obtained, including age, gender, location of lesions, staging and histological type of CRC. The Chi-square test was used to assess differences in rates and a significance level of 0.05 was used. Univariate comparisons were made via Fisher’s exact tests.

RESULTS: Analysis was carried out on 8172 CRC patents, 6.1% (499/8172) of the patients were aged ≤ 30 years. The peak incidence was between the ages 61-70 years (27.8%). The mean age at CRC diagnosis increased from 52 years (1986-1988) to 60 years (2004-2006) and the proportion of young CRC patients decreased from 8.0% to 5.9% over the same period. Of 8172 lesions, 4434 (54.3%) were located in rectum and 3738 (45.7%) in colon. The incidence of rectal cancer decreased significantly from 59.4% (1989-1991) to 51.8% (2004-2006) and right sided colon cancer increased from 40.6% to 48.2%. The mean age, anatomic distribution, histological type and differentiation degree were significantly different among the four geographical areas (P < 0.05).

CONCLUSION: The hospitalization rate for CRC has increased in Guangdong in recent years. The characteristics of CRC from the five hospitals located in the four different areas of Guangdong Province are also different. Further studies are needed to assess more recent trend in the incidence and prevalence of CRC as well as the respective roles of genetic and environmental factors in CRC.

• Colorectal cancer
• Survey
• Characteristics
• Differentiation

AIM: To increase attendance for colonoscopy among nonadherent high-risk individuals for colorectal cancer (CRC) screening in China.

METHODS: During the first 12 mo without intervention, only 428 of the 2398 high-risk subjects attended a scheduled colonoscopy examination. The 1970 subjects who did not attend for CRC screening were enrolled in the present study. Prior barrier investigation was performed to ascertain the reasons for nonadherence. A barrier-focused intervention program was then established and implemented among eligible nonadherent subjects by telephone interviews and on-site consultations. The completion rates of colonoscopy during the first 12 mo without intervention and the second 12 mo with intervention were compared. Variations in the effect of the intervention on some high-risk factors and barrier characteristics were analyzed using logistic regression.

RESULTS: 540 subjects who were not eligible were excluded from the study. The colonoscopy attendance rate was 23.04% (428/1858) during the first 12 mo without intervention, and 37.69% (539/1430) during the second 12 mo with intervention (P < 0.001). Logistic regression analysis showed that the intervention was more effective among subjects with only objective barriers (OR: 34.590, 95% CI: 23.204-51.563) or subjects with some specific high-risk characteristics: first-degree relatives diagnosed with CRC (OR: 1.778, 95% CI: 1.010-3.131), personal history of intestinal polyps (OR: 3.815, 95% CI: 1.994-7.300) and positive result for immunochemical fecal occult blood testing (OR: 2.718, 95% CI: 1.479-4.996).

CONCLUSION: The barrier-focused telephone or on-site consultation intervention appears to be a feasible means to improve colonoscopy attendance among nonadherent high-risk subjects for CRC screening in China.

• Colorectal cancer
• Screening
• Intervention
• Colonoscopy
• Attendance