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March 02, 2020
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Colorectal cancer awareness month: 10 recent updates on screening, risk

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Colorectal cancer is one of the most commonly diagnosed cancers in the Untied States, with the American Cancer Society estimating more than 147,000 new cases in 2020. Although the disease becomes more preventable with early detection, many individuals are not up to date on screening.

Throughout March, Colorectal Cancer Awareness Month highlights the importance of screening and honors those impacted by the disease. Healio Gastroenterology and Liver Disease compiled 10 recent updates on CRC risk and screening.

Gut bacteria may be factor in rising colorectal cancer incidence among younger adults

Fusobacterium nucleatum may be partially responsible for the sharp increase in colorectal cancer incidence among individuals aged younger than 45 years, according to preliminary results of an ongoing study presented at Gastrointestinal Cancers Symposium.

“We haven’t seen large genetic differences in colorectal tumors in younger vs. older people, so we think that something in the microbiome may be behind the rise in incidence of colorectal cancer in young people,” Benjamin Adam Weinberg, MD, assistant professor of medicine at Georgetown University and a HemOnc Today Next Gen Innovator, told Healio. READ MORE

Berberine safe, effective in reducing risk for recurrent colorectal adenoma

Berberine, a supplement originally extracted from the Chinese herb Coptis chinensis, helped to reduce risk for recurrent colorectal adenoma, according to study results.

Ying-Xuan Chen, MD, from the division of gastroenterology and hepatology at Shanghai Jiao-Tong University School of Medicine in China, and colleagues wrote that while berberine has been used to treat diarrhea and enteritis, recent research has shown it may have anti-tumor activity. READ MORE

Real-time colonoscopy system increases adenoma yield

A real-time colonoscopy quality improvement system known as ENDOANGEL helped improve adenoma detection, according to study results.

Honggang Yu, MD, PhD, of the department of gastroenterology at Wuhan University, and colleagues wrote that blind spots come up during colonoscopies because of endoscope slipping and differences in control among endoscopists. READ MORE

CRC incidence spikes between ages 49 and 50 years

A steep increase in incidence of colorectal cancer among patients aged between 49 and 50 years may suggest that many cases go undetected in younger patients before they reach routine, average-risk screening at age 50 years, according to data published in JAMA Network Open.

“Given the current debate over colorectal cancer screening at age 45 vs. 50, we felt it would be revealing to conduct an incidence rate analysis by yearly-age, as opposed to age range blocks (30-39, 40-49, etc.) as has been done in prior studies,” Jordan J. Karlitz, MD, director of the GI Hereditary Cancer and Genetics Program at Tulane University School of Medicine, told Healio Gastroenterology and Liver Disease. “To our knowledge, a yearly-age incidence rate analysis had not been performed in the past. This type of analysis would allow a more detailed assessment of the incidence rates of those approaching or at screening age. In particular, we were interested in the transition from age 49 to 50 as this is when average risk screening has historically been recommended.” READ MORE

CRC surveillance may be unnecessary after polypectomy in some patients

Patients at low and intermediate risk for colorectal cancer may not require postpolypectomy surveillance, according to research published in Gut.

Amanda J. Cross, PhD, of the department of surgery and cancer at Imperial College London, and colleagues wrote that current guidelines may put a burden on colonoscopy resources. READ MORE

Weight loss may be an early clinical sign of early-onset CRC

Researchers from the University of California, San Diego, identified several factors, including increasing age and male sex, as potential risk factors for early-onset colorectal cancer, according to study results.

Additionally, they found that weight loss may signal risk for developing the cancer. READ MORE

Computer-aided colonoscopy improves adenoma detection

A computer-aided colonoscopy system helped detect adenomas that were initially missed by the endoscopist, according to study results.

Pu Wang, MD, of the department of gastroenterology at Sichuan Academy of Medical Sciences and Sichuan People’s Hospital in China, and colleagues wrote that even with recent advances in colorectal cancer screening technology, some adenomas are still missed. READ MORE

Endocuff Vision misses fewer adenomas than cuff-assisted endoscopy

The Endocuff Vision endoscopy device achieved a higher adenoma detection rate and missed fewer adenomas than cap-assisted endoscopy, according to study results.

Rajaratnam Rameshshanker, MBBS, MRCP, from St. Mark’s Hospital and Academic Institute in the United Kingdom, and colleagues wrote that devices like Endocuff Vision (Arc Medical Design) and cap-assisted endoscopy (CAC) are designed to counteract some of the factors that make adenoma detection difficult, and they sought to compare the devices head-to-head. READ MORE

Recurrent low-grade dysplasia increases CRC risk in patients with IBD

Patients with inflammatory bowel disease who have recurrent low-grade dysplasia on follow-up colonoscopy are at increased risk for advanced neoplasia, according to study results.

Michiel E. de Jong, MD, of the Inflammatory Bowel Disease Centre at Radboud University Medical center in the Netherlands, and colleagues wrote that patients with IBD are already considered at high risk for advanced neoplasia, but data on the proper screening strategy for these patients are unclear. READ MORE

Check-Cap reports positive results from CRC screening pilot study

Check-Cap announced positive results from a pilot study of its C-Scan system, an ingestible X-ray scanning capsule for no-prep colorectal cancer screening, according to a press release.

“The results of the study are promising, both in terms of safety and patient compliance of the procedure,” Seth A. Gross, MD, associate professor of medicine at NYU Langone Health and principal investigator of the study, said in the press release. "Most non-invasive colorectal cancer screening options currently available have modest efficacy detecting pre-cancerous polyps. We are excited about the potential of the C-Scan System offering a patient friendly screening option that could detect pre-cancerous polyps before they become malignant, and we look forward to seeing the C-Scan System advancing into the U.S. pivotal study in the future." READ MORE