Colorectal cancer screening: Clinical guidelines and rationale

Evidence exists that reductions in colorectal cancer (CRC) mortality are often achieved through detection and treatment of early-stage CRCs and therefore the identification and removal of adenomatous polyps, the precursor to those cancers. An expert, multidisciplinary panel was convened to review this evidence and to supply recommendations to guide clinicians and therefore the public in making decisions regarding CRC screening and surveillance. As a part of its review, the panel also commissioned a simulation model that estimates and compares the clinical consequences (benefits and major complications) of every screening approach. This guideline report presents the panel’s recommendations with reference to screening and surveillance in people at average risk for CRC and people at increased risk due to a case history of CRC or genetic syndromes or a private history of adenomatous polyps, inflammatory bowel disease, or curative-intent resection of CRC. The cost- effectiveness of potential screening strategies was taken under consideration when preparing the recommendations. A summary of the evidence on each screening test’s performance, effectiveness, frequency, complications, ‘and patient acceptance is included. Also provided are suggestions for tactics to extend compliance with the recommendations, questions that additional research is required , and therefore the results of the simulation model on screening consequences. [1]

Surgery for colorectal cancer in elderly patients: a systematic review

Background: The effectiveness of surgery for colorectal cancer depends thereon being administered safely, which allows most patients to return to productive lives, with an improved postoperative anticipation , or a minimum of one that’s not diminished by the surgery. Because colorectal cancer may be a major explanation for morbidity and mortality in elderly people, we’ve examined how the outcomes of surgery in elderly patients differ from those in younger patients.

Methods: We did a scientific review of published and aggregate data provided by investigators. Studies were identified by computerised and manual searches of published and unpublished reports, scanning references, and contacting investigators. Within each study, outcomes for patients aged 65–74 years, 75–84 years, and 85+ years were expressed in reference to those aged but 65 years. [2]

Hereditary Colorectal Cancer

The annual incidence of colorectal cancer within the us is approximately 148,300 (affecting 72,600 males and 75,700 females), with 56,600 deaths (in 27,800 males and 28,800 females).1 The lifetime risk of colorectal cancer within the general population is about 5 to six percent.1 Patients with a familial risk — those that have two or more first- or second-degree relatives (or both) with colorectal cancer — structure approximately 20 percent of all patients with colorectal cancer, whereas approximately 5 to 10 percent of the entire annual burden of colorectal cancer is mendelian in nature — that’s , it’s inherited in an autosomal dominant manner. during this review we’ll specialise in the 2 major sorts of hereditary colorectal cancer, familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer. [3]

Serine racemase enhances growth of colorectal cancer by producing pyruvate from serine

Serine racemase (SRR) catalyses not only the racemization but also the dehydration of L-serine and D-serine, leading to the formation of pyruvate and ammonia. Although SRR activity is vital within the central systema nervosum , SRR has not been linked to cancer metabolism before. Here we show that SRR supports proliferation of colorectal-cancer cells. we discover that SRR expression is upregulated in colorectal adenoma and adenocarcinoma lesions compared with non-neoplastic mucosa in human colorectal-cancer specimens. SRR-mediated dehydration of serine contributes to the pyruvate pool in colon-cancer cells, enhances proliferation, maintains mitochondrial mass and increases basal reactive oxygen species production, which has anti-apoptotic effects. [4]

Alterations of Tumor Suppressor Genes Expression in Colorectal Cancer: Their Impact on Progression and Prediction of Patients Outcome

Background: Deregulation of tumor suppressor genes as APC, DCC and SMAD2 are associated with tumorgenesis thus we aimed to research their expression among colorectal cancer to validate their relation with clinicopathological factors and therefore the clinical outcome for CRC patients.

Materials and Methods: Formalin-fixed paraffin samples from 115 colorectal cancer were investigated for APC, DCC and SMAD2 organic phenomenon using quantitative PCR (QPCR) and therefore the ir levels were analyzed versus clinicopathological factors and the overall survival (OS) of colorectal cancer patients.

Results: a big relation was reported between DCC and SMAD2 organic phenomenon with clinical stages as they reported decrease expression among those with stage III. The three investigated genes were decreased significantly with poor histological differentiation colorectal cancer patients. The correlations between the expressions of the investigated genes revealed a big correlation between SMAD2 and APC also as between SMAD2 and DCC. Moreover patients with mean levels below and equal their expression values showed a substantial difference with OS. [5]

Reference

[1] Winawer, S.J., Fletcher, R.H., Miller, L., Godlee, F., Stolar, M.H., Mulrow, C.D., Woolf, S.H., Glick, S.N., Ganiats, T.G., Bond, J.H. and Rosen, L., 1997. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology, 112(2), (Web Link)

[2] Simmonds, P.D., Best, L., George, S., Baughan, C., Buchanan, R., Davis, C., Fentiman, I., Gosney, M., Northover, J., Williams, C. and Group, C.C.C., 2000. Surgery for colorectal cancer in elderly patients: a systematic review. The Lancet, 356(9234), (Web Link)

[3] Lynch, H.T. and De la Chapelle, A., 2003. Hereditary colorectal cancer. New England Journal of Medicine, 348(10), (Web Link)

[4] Serine racemase enhances growth of colorectal cancer by producing pyruvate from serine
Kenji Ohshima, Satoshi Nojima, Shinichiro Tahara, Masako Kurashige, Keisuke Kawasaki, Yumiko Hori, Moyu Taniguchi, Yutaka Umakoshi, Daisuke Okuzaki, Naoki Wada, Jun-ichiro Ikeda, Eiichiro Fukusaki & Eiichi Morii
Nature Metabolism (2020) (Web Link)

[5] Swellam, M., E. Mosa, T., Afify, M., D. E. Abdelmaksoud, M. and R. Ezz El Arab, L. (2018) “Alterations of Tumor Suppressor Genes Expression in Colorectal Cancer: Their Impact on Progression and Prediction of Patients Outcome”, Asian Journal of Research in Biochemistry, 2(1), (Web Link)

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