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NCI CANCERLIT® Search: Screening and Prevention of Digestive Cancers - April 2002
National Cancer Institute®
Last Modified: April 1, 2002
Table of Contents
1
UI - 11913910
AU - Bolin T; Cowen AE; Korman MG
TI -
Colorectal cancer prevention.
SO - Med J Aust 2002 Feb 18;176(4):145-6
2
UI - 11913913
AU - Yusoff IF; Hoffman NE; Ee HC
TI -
Colonoscopic surveillance for family history of colorectal cancer: are
NHMRC guidelines being followed?
SO - Med J Aust 2002 Feb 18;176(4):151-4
AD - Department of Gastroenterology, Sir Charles Gairdner Hospital, Nedlands,
WA.
OBJECTIVES: To assess whether referrals for surveillance colonoscopy and
subsequent follow-up recommendations for patients with a family history
of colorectal cancer concurred with the published National Health and
Medical Research Council (NHMRC) guidelines. DESIGN: A prospective audit
of patients with a family history of colorectal cancer referred for
surveillance colonoscopy. Follow-up recommendations were assessed
retrospectively. SETTING AND SUBJECTS: All patients referred to a major
teaching hospital for surveillance colonoscopy on the basis of a family
OUTCOME MEASURES: Concurrence of referrals and recommendations with
NHMRC guidelines. RESULTS: Of 340 patients referred because of a family
history of colorectal cancer, 202 (83 men, 119 women) were asymptomatic.
Their mean age was 50 years (95% CI, 48.3-51.6 years). The family
history of 95 (47%) of these patients satisfied the NHMRC criteria for
colonoscopic surveillance. Another 20 patients (17%) satisfied the
criteria, but were referred before the recommended age to commence
surveillance. Analysis by referral source showed that the proportion of
referrals meeting NHMRC guidelines was higher from specialists than from
general practitioners (75% v 45%), and this difference was significant.
Follow-up recommendations, when made, concurred with NHMRC guidelines in
81% of cases. CONCLUSIONS: Further education of the medical community is
required to increase understanding of colorectal screening strategies
and ensure appropriate resource allocation.
3
UI - 11913914
AU - Bampton PA; Sandford JJ; Young GP
TI -
Applying evidence-based guidelines improves use of colonoscopy resources
in patients with a moderate risk of colorectal neoplasia.
SO - Med J Aust 2002 Feb 18;176(4):155-7
AD - Department of Gastroenterology and Hepatology, Flinders Medical Centre,
Bedford Park, SA. peter.bampton@flinders.edu.au
OBJECTIVES: To determine whether applying National Health and Medical
Research Council (NHMRC) guidelines for colorectal cancer prevention
would reduce the number of follow-up colonoscopies. DESIGN: A
prospective audit of colonoscopic surveillance decisions before and
after the intervention. SETTING: The endoscopy suite at a metropolitan
INTERVENTION: Dissemination of NHMRC guidelines, and supervision of
application of the guidelines by a nurse coordinator. SUBJECTS: We
compared colonoscopic surveillance decisions before and after the
intervention in two groups of 100 consecutive patients after polypectomy
and in two groups of 50 consecutive patients with a family history of
colorectal cancer after a normal colonoscopy. MAIN OUTCOME MEASURES:
Change in concordance of decisions with NHMRC guidelines; and effect on
number of follow-up colonoscopies. RESULTS: After the intervention, the
proportion of postpolypectomy surveillance decisions matching the
guidelines increased from 37% to 96% (P < 0.05). The mean time to repeat
colonoscopy after polypectomy increased from 2.7 to 3.5 years (P <
0.005) (ie, a 23% reduction in the number of postpolypectomy
surveillance colonoscopies performed per year). Likewise, the proportion
of family-history surveillance decisions matching the guidelines
increased from 63% to 96%. Adhering to the guidelines resulted in a 17%
reduction in colonoscopies performed on the basis of a family history of
colorectal cancer. CONCLUSIONS: Supervised application of evidence-based
guidelines to a colorectal cancer surveillance program significantly
reduces the number of surveillance colonoscopies performed.
4
UI - 11904306
AU - Gupta RA; DuBois RN
TI -
Cyclooxygenase-2 inhibitor therapy for the prevention of esophageal
adenocarcinoma in Barrett's esophagus.
SO - J Natl Cancer Inst 2002 Mar 20;94(6):406-7
5
UI - 11904316
AU - Wu K; Willett WC; Fuchs CS; Colditz GA; Giovannucci EL
TI -
Calcium intake and risk of colon cancer in women and men.
SO - J Natl Cancer Inst 2002 Mar 20;94(6):437-46
AD - Department of Nutrition, Harvard School of Public Health, 665 Huntington
Ave., Building 2, Boston, MA 02115, USA.
BACKGROUND: Calcium has been hypothesized to reduce the risk of colon
cancer, and in a recent randomized trial, calcium supplementation was
associated with reduction in the risk of recurrent colorectal adenomas.
We examined the association between calcium intake and colon cancer risk
in two prospective cohorts, the Nurses' Health Study (NHS) and the
Health Professionals Follow-up Study (HPFS). METHODS: Our study
population included 87 998 women in NHS and 47 344 men in HPFS who, at
baseline (1980 for NHS and 1986 for HPFS), completed a food frequency
questionnaire and provided information on medical history and lifestyle
factors. Dietary information was updated at least every 4 years. During
the follow-up period (1980 to May 31, 1996 for the NHS cohort; 1986 to
January 31, 1996 for the HPFS cohort), 626 and 399 colon cancer cases
were identified in women and men, respectively. Pooled logistic
regression was used to estimate relative risks (RRs), and all
statistical tests were two-sided. RESULTS: In women and men considered
together, we found an inverse association between higher total calcium
intake (>1250 mg/day versus < or =500 mg/day) and distal colon cancer
(women: multivariate RR = 0.73, 95% confidence interval [CI] = 0.41 to
1.27; men: RR = 0.58, 95% CI = 0.32 to 1.05; pooled RR = 0.65, 95% CI =
0.43 to 0.98). No such association was found for proximal colon cancer
(women: RR = 1.28, 95% CI = 0.75 to 2.16; men: RR = 0.92, 95% CI = 0.45
to 1.87; pooled RR = 1.14, 95% CI = 0.72 to 1.81). The incremental
benefit of additional calcium intake beyond approximately 700 mg/day
appeared to be minimal. CONCLUSIONS: Higher calcium intake is associated
with a reduced risk of distal colon cancer. The observed risk pattern
was consistent with a threshold effect, suggesting that calcium intake
beyond moderate levels may not be associated with a further risk
reduction. Future investigations on this association should concentrate
on specific cancer subsites and on the dose-response relationship.
6
UI - 11905419
AU - Lambert R
TI -
Early diagnosis and prevention of colorectal cancer. The Third European
Endoscopy Forum: conclusions of a symposium held in Faro, Portugal, June
8-10, 2001, with the help of an educational grant from Olympus.
SO - Endoscopy 2002 Mar;34(3):244-6
7
UI - 11902587
AU - Schoen RE
TI -
The case for population-based screening for colorectal cancer.
SO - Nature Rev Cancer 2002 Jan;2(1):65-70
AD - Division of Gastroenterology, Pennsylvania University Hospital,
Pittsburgh 15213-2582, USA. schoen@msx.dept-med.pitt.edu
Screening for colorectal cancer is commanding increasing attention.
Other cancer screening programmes have been a part of public
consciousness for some time, but, until recently, colorectal cancer
screening has remained in the background. Fuelled by new research,
market opportunities and increased recognition of individual risk,
screening for colorectal cancer is becoming a recommended procedure, but
controversy about how best to implement widespread screening remains.
8
UI - 11932472
AU - Giardiello FM; Yang VW; Hylind LM; Krush AJ; Petersen GM; Trimbath JD;
TI -
Piantadosi S; Garrett E; Geiman DE; Hubbard W; Offerhaus GJ; Hamilton SR
Primary chemoprevention of familial adenomatous polyposis with sulindac.
SO - N Engl J Med 2002 Apr 4;346(14):1054-9
AD - Department of Medicine, Johns Hopkins University School of Medicine,
Baltimore, USA.
BACKGROUND: Familial adenomatous polyposis is caused by a germ-line
mutation in the adenomatous polyposis coli gene and is characterized by
the development of hundreds of colorectal adenomas and, eventually,
colorectal cancer. Nonsteroidal antiinflammatory drugs can cause
regression of adenomas, but whether they can prevent adenomas is
unknown. METHODS: We conducted a randomized, double-blind,
placebo-controlled study of 41 young subjects (age range, 8 to 25 years)
who were genotypically affected with familial adenomatous polyposis but
phenotypically unaffected. The subjects received either 75 or 150 mg of
sulindac orally twice a day or identical-appearing placebo tablets for
48 months. The number and size of new adenomas and side effects of
therapy were evaluated every four months for four years, and the levels
of five major prostaglandins were serially measured in biopsy specimens
of normal-appearing colorectal mucosa. RESULTS: After four years of
treatment, the average rate of compliance exceeded 76 percent in the
sulindac group, and mucosal prostaglandin levels were lower in this
group than in the placebo group. During the course of the study,
adenomas developed in 9 of 21 subjects (43 percent) in the sulindac
group and 11 of 20 subjects in the placebo group (55 percent) (P=0.54).
There were no significant differences in the mean number (P=0.69) or
size (P=0.17) of polyps between the groups. Sulindac did not slow the
development of adenomas, according to an evaluation involving linear
longitudinal methods. CONCLUSIONS: Standard doses of sulindac did not
prevent the development of adenomas in subjects with familial
adenomatous polyposis.
9
UI - 11932478
AU - Chau I; Cunningham D
TI -
Cyclooxygenase inhibition in cancer--a blind alley or a new therapeutic
reality?
SO - N Engl J Med 2002 Apr 4;346(14):1085-7
10
UI - 11942288
AU - Pieribone D
TI -
Reducing your risk for rectal cancer.
SO - Posit Living 2002 Feb-Mar;11(1):11, 13
11
UI - 11910370
AU - Fennerty MB
TI -
Barrett's-related esophageal cancer: has the final hurdle been cleared,
now paving the way for human chemoprevention trials?
SO - Gastroenterology 2002 Apr;122(4):1172-5
12
UI - 11819768
AU - Miehlke S; Kirsch C; Dragosics B; Gschwantler M; Oberhuber G; Antos D;
TI -
Dite P; Lauter J; Labenz J; Leodolter A; Malfertheiner P; Neubauer A;
Ehninger G; Stolte M; Bayerdorffer E
Helicobacter pylori and gastric cancer:current status of the Austrain
Czech German gastric cancer prevention trial (PRISMA Study).
SO - World J Gastroenterol 2001 Apr;7(2):243-7
AD - Medical Department I, Technical University Hospital Carl Gustav Carus,
Fetscherstrabetae 74, D 01307 Dresden, Germany.
AIM: To test the hypothesis that Helicobacter pylori eradication alone
can reduce the incidence of gastric cancer in a subgroup of individuals
with an increased risk for this fatal disease. METHODS: It is a
prospective, randomized, double blind, placebo controlled multinational
multicenter trial. Men between 55 and 65 years of age with a gastric
cancer phenotype of Helicobacter pylori gastritis are randomized to
receive a 7 day course of omeprazole 2 X 20mg, clarithromycin 2 X 500mg,
and amoxicillin 2 X 1g for 7 days, or omeprazole 2 X 20mg plus placebo.
Follow-up endoscopy is scheduled 3 months after therapy, and thereafter
in one-year intervals. Predefined study endpoints are gastric cancer,
precancerous lesions (dysplasia, adenoma), other cancers, and death.
patients (18.3%) had a corpus dominant type of H. pylori gastritis, and
167 of those were randomized (58.8%). In the active treatment group (r =
86), H. pylori infection infection was cured in 88.9% of patients.
Currently, the cumulative follow-up time is 3046 months (253.38 patient
years, median follow up 16 months). So far, none of the patients
developed gastric cancer or any precancerous lesion. Three (1.8%)
patients reached study endpoints other than gastric cancer. CONCLUSION:
Among men between 55 and 65 years of age, the gastric cancer phenotype
of H. pylori gastritis appears to be more common than expected. Further
follow up and continuing recruitment are necessary to fulfil the main
aim of the study.
13
UI - 9062331
AU - Burke W; Petersen G; Lynch P; Botkin J; Daly M; Garber J; Kahn MJ;
TI -
McTiernan A; Offit K; Thomson E; Varricchio C
Recommendations for follow-up care of individuals with an inherited
predisposition to cancer. I. Hereditary nonpolyposis colon cancer.
Cancer Genetics Studies Consortium.
SO - JAMA 1997 Mar 19;277(11):915-9
AD - Department of Medicine, University of Washington, Seattle 98105-6920,
USA.
OBJECTIVE: To provide recommendations for cancer surveillance and risk
reduction for individuals carrying mutations associated with hereditary
nonpolyposis colon cancer (HNPCC). PARTICIPANTS: A task force with
expertise in medical genetics, oncology, primary care, gastroenterology,
and epidemiology convened by the Cancer Genetics Studies Consortium
(CGSC), organized by the National Human Genome Research Institute
(previously the National Center for Human Genome Research). EVIDENCE:
Studies evaluating cancer risk, surveillance, and risk reduction in
individuals genetically susceptible to colon cancer were identified
using MEDLINE and bibliographies of articles thus identified. Indexing
terms used were "genetics" in combination with "colon cancer," and
"screening" in combination with "cancer family" and "HNPCC." For studies
evaluating specific interventions, quality of evidence was assessed
using criteria of the US Preventive Services Task Force. CONSENSUS
PROCESS: The task force developed recommendations through discussions
over a 14-month period. CONCLUSIONS: Efficacy of cancer surveillance or
other measures to reduce risk in individuals who carry
cancer-predisposing mutations is unknown. Based on observational
studies, colonoscopy every 1 to 3 years starting at age 25 years is
recommended for individuals known to have HNPCC-associated mutations.
Endometrial cancer screening is also recommended, based on expert
opinion concerning presumptive benefit. No recommendation is made for or
against prophylactic surgery (ie, colectomy, hysterectomy); these
surgeries are an option for mutation carriers, but evidence of benefit
is lacking. It is recommended that individuals considering genetic
testing be counseled regarding the unknown efficacy of measures to
reduce risk and that care for individuals with cancer-predisposing
mutations be provided whenever possible within the context of research
protocols designed to evaluate clinical outcomes.
14
UI - 10736622
AU - Russo GL; Della Pietra V; Mercurio C; Palumbo R; Iacomino G; Russo M;
TI -
Tosto M; Zappia V
Protective effects of butyric acid in colon cancer.
SO - Adv Exp Med Biol 1999;472():131-47
AD - Institute of Food Science and Technology, National Research Council,
Avellino, Italy.
15
UI - 11922582
AU - Hamajima N; Matuo K; Watanabe Y; Suzuki T; Nakamura T; Matsuura A; Yamao
TI -
K; Ohashi K; Tominaga S
A pilot study to evaluate stomach cancer risk reduction by Helicobacter
pylori eradication.
SO - Am J Gastroenterol 2002 Mar;97(3):764-5
16
UI - 11159898
AU - Kurtz RC; Zhang ZF
TI -
Gastric cardia cancer and dietary fiber.
SO - Gastroenterology 2001 Feb;120(2):568-70
17
UI - 11665692
AU - Fishman V; Friedel D
TI -
Inverse association between intake of cereal fiber and risk of gastric
cardia cancer.
SO - Gastroenterology 2001 Oct;121(4):1024-5
18
UI - 11924073
AU - Tracy GE
TI -
Make colorectal cancer screening. A part of routine care.
SO - S D J Med 2002 Mar;55(3):104-5
19
UI - 11959871
AU - Dong Z; Tang P; Li L; Wang G
TI -
The strategy for esophageal cancer control in high-risk areas of China.
SO - Jpn J Clin Oncol 2002 Mar;32 Suppl():S10-2
AD - Department of Epidemiology, Cancer Institute and Hospital (CI/H),
Chinese Academy of Medical Sciences (CAMS), Beijing, China.
Even though the mortality from esophageal cancer has decreased during
the last two decades nationwide in China, the mortality from esophageal
cancer in high-risk areas is still at a high level. Moreover, the 5-year
survival rate of patients with resectable esophageal cancer after
treatment ranges between 20 and 30%, as majority of patients with
esophageal cancer were diagnosed in late stages. Therefore, esophageal
cancer control in high-risk areas in China remains a critical task. A
strategy is proposed that the high-risk population would be screened by
endoscopy with mucosal iodine staining and biopsy of all unstained
lesions and diagnosis of severe dysplasia carcinoma in situ, and
intra-mucosal carcinoma could be cured by radical mucosectomy. A pilot
study showed that the strategy is feasible and cost-effective for the
high prevalence of premalignant lesions and carcinomas in early stages.
It would be expected that the mortality from esophageal cancer could be
decreased in high-risk areas if the proposed strategy is carried out on
a large scale.
20
UI - 11941648
AU - Pikkarainen P
TI -
[Colorectal cancer screening is profitable]
SO - Duodecim 1999;115(17):1813-4
21
UI - 11921656
AU - Anonymous
TI -
[Mesalazine in ulcerative colitis. Fewer cases of colorectal carcinoma]
SO - MMW Fortschr Med 2002 Feb 28;144(9):51
22
UI - 11930777
AU - Fischman J
TI -
Cancer and diet. Colon vitamins.
SO - US News World Rep 2002 Mar 25;132(9):49
23
UI - 11965269
AU - Ransohoff DF
TI -
Lessons from the UK sigmoidoscopy screening trial.
SO - Lancet 2002 Apr 13;359(9314):1266-7
AD - Department of Medicine, University of North Carolina at Chapel Hill,
Chapel Hill, NC 27599, USA. ransohof@med.unc.edu
24
UI - 11965274
AU - UK Flexible Sigmoidoscopy Screening Trial Investigators
TI -
Single flexible sigmoidoscopy screening to prevent colorectal cancer:
baseline findings of a UK multicentre randomised trial.
SO - Lancet 2002 Apr 13;359(9314):1291-300
BACKGROUND: This randomised controlled trial is examining the hypothesis
that a single flexible sigmoidoscopy screening offered at around age 60
years can lower the incidence and mortality of colorectal cancer. We
report here on acceptability, safety, feasibility, and yield. METHODS:
Men and women aged 55-64 years, in 14 UK centres, who responded to a
mailed questionnaire that they would attend for flexible sigmoidoscopy
screening if invited, were randomly assigned screening or control (ratio
one to two). The control group was not contacted. Small polyps were
removed during screening, and colonoscopy was undertaken if high-risk
polyps (three or more adenomas, size 1 cm or greater, villous, severely
dysplastic, or malignant) were found. FINDINGS: Of 354,262 people asked
about their interest in having flexible sigmoidoscopy screening, 194,726
(55%) responded positively, and 170,432 eligible individuals were
randomised. Attendance among those assigned screening was 71% (40,674 of
57,254). 2131 (5%) were classified as high-risk and referred for
colonoscopy; 38,525 with no polyps or only low-risk polyps detected were
discharged. Distal adenomas were detected in 4931 (12.1%) and distal
cancer in 131 (0.3%). Proximal adenomas were detected in 386 (18.8% of
those undergoing colonoscopy) and proximal cancer in nine cases (0.4%).
62% of cancers were Dukes' stage A or locally excised. There was one
perforation after flexible sigmoidoscopy and four after colonoscopy. An
average of 48 people were screened, and two or three colonoscopy
referrals generated, per centre each week.Interpretation Our flexible
sigmoidoscopy screening regimen is acceptable, feasible, and safe. The
prevalence of neoplasia is high, and colonoscopy referral rates of 5%
are acceptable.
25
UI - 11964331
AU - Mayor S
TI -
Single flexible sigmoidoscopy screening could help prevent colorectal
cancer.
SO - BMJ 2002 Apr 20;324(7343):934
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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