Colorectal Cancer

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Colorectal Cancer

Diagnosis, Imaging, and Screening

NEWS:

Colon Cancer Screening Is Saving Lives

Colonoscopies Should Last at Least 6 Minutes: Study shows higher detection rate with longer exams "Doctors who perform colonoscopies for early detection of colorectal cancer get better results if they spend at least six minutes looking for abnormal growths, a new study shows.

Combined Imaging Improves Colorectal Cancer Diagnosis "The combination of two imaging techniques -- positron emission tomography and computed tomography -- provides quicker and more precise information to guide the treatment of colorectal cancer , German doctors report."

Finding Hidden Colon Cancer Lowers Recurrence Rate "Injecting a blue dye into colon tumors is helping doctors dramatically reduce the recurrence of colon cancer. Colon cancer is the second most common cause of cancer death. When caught in time, it's treatable. But if tiny cancer cells are left behind after surgery or chemotherapy, it can come back and will more likely kill the patient."

How can we best detect hereditary non-polyposis colorectal cancer?

New Screening Combo May Improve Colorectal Cancer Testing

Single Office-Based Fecal Occult Blood Testing May Be Inadequate for Colorectal Screening

ARTICLES:

Colon Cancer Screening "Colon cancer (cancer of the large bowel) is the second leading cause of cancer deaths in the United States, exceeded only by lung cancer. Colon cancer can be treated and often cured if it is found early. Because death from colon cancer is preventable, doctors want to look for colon cancer before it grows too large or spreads to other organs. Testing persons without symptoms or signs of colon cancer (such as blood in the stool or low blood count) is called screening. Screening for colon cancer is recommended for everyone aged 50 years and older. …"

Study: Men Need Earlier Colonoscopies

Tips For Getting Screened

JOURNAL ARTICLES:

Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. (N Engl J Med. 2006) "CONCLUSIONS: We detected advanced neoplasia at a significantly higher rate in men than in women, which may warrant refinement of the screening recommendations for colorectal cancer."

Colonoscopy in the Elderly: Low Risk, Low Yield in Asymptomatic Patients. (Dis Colon Rectum. 2006)

Colonoscopy May Be the Preferred Method of Screening for Colorectal Cancer in Women

Comparison of virtual colonoscopy with conventional colonoscopy in detection of colorectal polyps. (Turk J Gastroenterol. 2006) "Conclusion: Multidetector computed tomography-based virtual colonoscopy has excellent sensitivity for the detection of clinically important colorectal polyps."

CT colonography: surveillance in patients with a history of colorectal cancer. (bdom Imaging. 2006) "Colorectal cancer is a leading cause of morbidity and mortality in the United States. It is also a disease that is preventable if precursor adenomatous polys are removed. Once a diagnosis of colorectal cancer is made, surgical resection is the only means of cure. The ability to resect colorectal cancer for cure is largely dependent upon the stage of tumor at presentation. Once a patient has been treated for colorectal cancer with surgery and in some cases neo-adjuvant or adjuvant therapy, they will present for follow-up. Surveillance is performed on these patients in order to detect local recurrence that if detected early can be surgically resected for cure. Surveillance also allows detection of distant metastatic disease that may in some cases also be cured with resection. Finally, surveillance of the remaining colon is important to detect the development of new or metachronous adenomatoid polyps that if left in place could develop into new colon cancers."

Diagnostic accuracy of colorectal cancer staging with whole-body PET/CT colonography. (JAMA. 2006) "CONCLUSIONS: In this preliminary study, PET/CT colonography is at least equivalent to CT + PET for tumor staging in patients with colorectal cancer. Thus, PET/CT colonography in conjunction with optical colonoscopy may be a suitable concept of tumor staging for patients with colorectal cancer."

Does a negative screening colonoscopy ever need to be repeated? (Gut. 2006)

Does fecal occult blood testing really reduce mortality? A reanalysis of systematic review data. (Am J Gastroenterol. 2006)

Factors influencing lymph node retrieval in colorectal cancer and its effect on survival. (olorectal Dis. 2006) "Conclusions: This study demonstrates that within a single unit the reporting pathologist significantly influences LN yield in CRC treatment and that a minimum of eight lymph nodes needs to be examined to stage CRC as Dukes' C accurately. In this unit the surgeon was not a significant variable."

FDG-PET for prediction of survival of patients with metastatic colorectal carcinoma. (Ann Oncol. 2006) "CONCLUSION: A significant survival benefit was observed in patients with low FDG uptake in metastases of colorectal cancer."

FDG-PET in colorectal cancer. (Cancer Imaging. 2006)

PET/CT detects abdominal wall and port site metastases of colorectal carcinoma. (Br J Radiol. 2006)

Repeat colonoscopy has a low yield even in symptomatic patients. (Gastrointest Endosc. 2006) "CONCLUSIONS: Yield of repeat colonoscopy is significantly lower than for initial colonoscopy, irrespective of indication. In symptomatic patients within a polyp surveillance program, the yield is negligible when a colonoscopy is performed before the recommended surveillance interval. The need for a repeat colonoscopy should be carefully considered, and patients who have never had a colonoscopy must take priority on waiting lists over those awaiting repeat examinations."

Reported symptoms, diagnostic delay and stage of colorectal cancer: a population-based study in Denmark. (olorectal Dis. 2006) "Conclusions Initial symptoms of CC were often very vague, making it difficult to identify a precise start date. The most frequent initial symptom/symptom complex for RC - rectal bleeding - was better defined. Rectal bleeding was significantly associated with nonadvanced CC and RC and a significantly decreased relative risk of having an advanced cancer."

Risk in primary care of colorectal cancer from new onset rectal bleeding: 10 year prospective study. (BMJ. 2006) "CONCLUSIONS: One in 10 patients aged 45 or more with new onset rectal bleeding had colonic neoplasia, so investigation of the bowel should be offered to all such patients, whether or not they have other symptoms."

Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies. (JAMA. 2006) "CONCLUSIONS: The risk of developing colorectal cancer remains decreased for more than 10 years following the performance of a negative colonoscopy. There is a need to improve the early detection rate of right-sided colorectal neoplasia in usual clinical practice."

Screening colonoscopy in very elderly patients: prevalence of neoplasia and estimated impact on life expectancy. (JAMA. 2006) "CONCLUSIONS: Even though prevalence of neoplasia increases with age, screening colonoscopy in very elderly persons (aged > or =80 years) results in only 15% of the expected gain in life expectancy in younger patients. Screening colonoscopy in very elderly patients should be performed only after careful consideration of potential benefits, risks, and patient preferences."

Surveillance colonoscopy in individuals at risk for hereditary nonpolyposis colorectal cancer: an evidence-based review. (Dis Colon Rectum. 2006)

The case for direct colonoscopy screening for colorectal cancer. (Am J Gastroenterol. 2006)

The Prevalence Rate and Anatomic Location of Colorectal Adenoma and Cancer Detected by Colonoscopy in Average-Risk Individuals Aged 40-80 Years (Am J Gastroenterol. 2006)

Ultrasonography in diagnosing colorectal cancers in patients presenting with abdominal distension. (Med J Aust. 2006) "CONCLUSION: Ultrasonography is a sensitive tool for diagnosing colorectal cancer in patients presenting with abdominal distension."

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