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NCI CANCERLIT® Search: Screening and Prevention of Digestive Cancers - August 2002
National Cancer Institute®
Last Modified: August 1, 2002
- Field population-based blocking treatment of esophageal epithelia dysplasia.
- Reduction of the incidence and mortality of rectal cancer by polypectomy: a prospective cohort study in Haining County.
- Flexible sigmoidoscopy: the unkept promise of cancer prevention.
- Flexible sigmoidoscopy: screening for colorectal cancer.
- Overcoming the barriers to change: screening for colorectal cancer.
- Update on colorectal cancer.
- Micronutrients and the risk of colorectal adenomas.
- Food and phytochemicals, magic bullets and measurement error: a commentary.
- Dietary fibre for the prevention of colorectal adenomas and carcinomas.
- [Chemoprevention can hardly substitute for screening for colorectal cancer]
- Barrett's oesophagus--are British gastroenterologists denying their patients prevention of malignant change?
- Recent developments in colorectal cancer screening and prevention.
- Primary chemoprevention of familial adenomatous polyposis with sulindac: more questions than answers.
- Participation rates of Ashkenazi Jews in a colon cancer community-based screening/prevention study.
- The treatment, management and prevention of oesophageal cancer.
- Olive oil as a functional food: epidemiology and nutritional approaches.
- Association between nonsteroidal anti-inflammatory drug use and the incidence of pancreatic cancer.
- Colon cancer.
- Sulindac in familial adenomatous polyposis.
Table of Contents
1
UI - 12046061
AU - Hou J; Lin PZ; Chen ZF; Ding ZW; Li SS; Men FS; Guo LP; He YT; Qiao CY;
TI -
Guo CL; Duan JP; Wen DG
Field population-based blocking treatment of esophageal epithelia
dysplasia.
SO - World J Gastroenterol 2002 Jun;8(3):418-22
AD - Hebei Cancer Institute, Jiankanglu 5, Shijiazhuang 050011, China.
AIM:To confirm the value of blocking treatment by zenshengping (ZSP), a
Chinese herb composite, and Riboflavin for esophageal epithelia
dysplasia cases screened out in high risk area in northern china by
exfoliative balloon cytology (EBC), so to reduce the incidence rate of
esophageal cancer(EC). METHODS: Esophageal epithelium dysplasia cases
including mind esophageal epithelium dysplasia (MEED), stage one severe
esophageal epithelium dysplasia (SEED I), and stage two severe
esophageal epithelium dysplasia (SEED II) were screened out from people
aged 40 years and older in the high risk area of Chixian. These cases
were randomly divided into a treatment and control group. Subjects in
the treatment and control groups took ZSP, riboflavin, and placebo daily
for three years. EC cases registered by cancer registry and identified
by EBC re-screening in the treatment and control groups were used to
calculate incidence and blocking rates to demonstrate the effects of
blocking medication. RESULTS: It was found that 31.92% and 24.15% of
people aged 40 years and older in Cixian could been diagnosed as MEED
and SEED cases. The severity of dysplasia increased with age. ZSP had
blocked EC occurrence by 47.79% after 3 year medication among the SEED
cases. CONCLUSION: ZSP can block the development from SEED I and SEED II
to EC by 47.79%. Efforts should be made to screen and treat dysplasia
cases in people aged 40 years and older in high risk areas to reduce the
mortality figures.
2
UI - 12046076
AU - Zheng S; Liu XY; Ding KF; Wang LB; Qiu PL; Ding XF; Shen YZ; Shen GF;
TI -
Sun QR; Li WD; Dong Q; Zhang SZ
Reduction of the incidence and mortality of rectal cancer by
polypectomy: a prospective cohort study in Haining County.
SO - World J Gastroenterol 2002 Jun;8(3):488-92
AD - Cancer Institute, Zhejiang University, 88 Jiefang Road, HangZhou 310009,
Zhejiang Province, China. zhengshu@mail.hz.zj.cn
AIM: To reduce the incidence and mortality of rectal cancer and address
the hypothesis that colorectal cancer often arise from precursor
lesion(s), either adenomas or non-adenomatous polyps, by conducting a
population-based mass screening for colorectal cancer in Haining County,
Zhejiang, PRC. METHODS: From 1977 to 1980, physicians screened the
population of Haining County using 15 cm rigid endoscopy. Of over 240000
participants, 4076 of them were diagnosed with precursor lesions, either
adenomas or non-adenomatous polyps, which were then removed surgically.
All individuals with precursor lesions were followed up and reexamined
by endoscopy every two to five years up to 1998. RESULTS: After the
initial screening, 953 metachronous adenomas and 417 non-adenomatous
polyps were detected and removed from the members of this cohort.
Further, 27 cases of colorectal cancer were detected and treated.
Log-rank tests showed that the survival time among those cancer patients
who under went mass screening increased significantly compared to that
of other colorectal cancer patients (P<0.0001). According to the
population-based cancer registry in Haining County, age-adjusted
incidence and mortality of rectal cancer decreased by 41% and 29% from
1977-1981 to 1992-1996, respectively. Observed cumulative 20-year rectal
cancer incidence was 31% lower than the expected in the screened group;
the mortality due to rectal cancer was 18% lower than the expected in
the screened group. CONCLUSION:Mass screening for rectal cancer and
precursor lesions with protocoscopy in the general population and
periodical following-up with routine endoscopy for high-risk patients
may decrease both the incidence and mortality of rectal cancer.
3
UI - 9930122
AU - Rodney WM
TI -
Flexible sigmoidoscopy: the unkept promise of cancer prevention.
SO - Am Fam Physician 1999 Jan 15;59(2):270, 273
4
UI - 9930126
AU - Johnson BA
TI -
Flexible sigmoidoscopy: screening for colorectal cancer.
SO - Am Fam Physician 1999 Jan 15;59(2):313-24, 327-8
AD - Hamot Medical Center, Erie, PA 16550, USA.
Flexible sigmoidoscopy is an important screening procedure because of
its ability to detect early changes in the distal colon. The 60-cm
flexible sigmoidoscope provides excellent visualization with minimal
discomfort to patients. Successful sigmoidoscopy requires adequate
patient preparation, proper equipment and an experienced examiner who
can recognize both normal and abnormal findings. Complications arising
from sigmoidoscopy are rare, but patients may experience some cramping,
gas or watery stools. Screening and primary preventive measures,
including regular exercise and increased dietary fiber intake, can lower
the morbidity and mortality associated with colorectal cancer.
5
UI - 10750871
AU - Woolf SH
TI -
Overcoming the barriers to change: screening for colorectal cancer.
SO - Am Fam Physician 2000 Mar 15;61(6):1621-2, 1628
6
UI - 10750881
AU - Rudy DR; Zdon MJ
TI -
Update on colorectal cancer.
SO - Am Fam Physician 2000 Mar 15;61(6):1759-70, 1773-4
AD - Department of Family Medicine, Finch University of Health
Sciences/Chicago Medical School, Illinois 60064, USA.
An estimated 129,400 new cases of colorectal cancer occurred in the
United States during 1999. The lifetime risk of developing this cancer
is 2.5 to 5 percent in the general population but two to three times
higher in persons who have a first-degree relative with colon cancer or
an adenomatous polyp. Between 70 and 90 percent of colorectal cancers
arise from adenomatous polyps, whereas only 10 to 30 percent arise from
sessile adenomas. Tumors or polyps that develop proximal to the splenic
flexure carry a poorer prognosis than those that arise more distally, in
part because of delayed diagnosis secondary to later development of
symptoms. The Dukes system is the classic staging method for colorectal
cancer; the TNM staging system is more detailed and therefore more
useful for surgical purposes. Although screening guidelines vary, most
agree that colorectal cancer screening should begin at 50 years of age
in patients without a personal or family history of colorectal cancer.
7
UI - 8942430
AU - Tseng M; Murray SC; Kupper LL; Sandler RS
TI -
Micronutrients and the risk of colorectal adenomas.
SO - Am J Epidemiol 1996 Dec 1;144(11):1005-14
AD - Department of Epidemiology, University of North Carolina at Chapel Hill,
USA.
Recent studies suggest that micronutrients, especially folate, calcium,
iron, and antioxidant vitamins, affect the risk of colorectal neoplasia.
The objective of this case-control study was to examine the association
between these micronutrients and the risk of colorectal adenomas. The
study was based on 236 cases with adenomatous polyps or cancer and 409
controls, all colonoscopy patients at University of North Carolina
were interviewed using a semi-quantitative food frequency questionnaire,
and average daily nutrient intakes were calculated. Sex-specific odds
ratios relative to the lowest quartile of intake for each micronutrient
were determined using unconditional logistic regression while adjusting
for a number of potential confounders. In women, folate, iron, and
vitamin C were inversely related to the risk of adenomas. Folate
appeared to be most protective, with women in the highest quartile only
40% as likely to develop adenomas compared with women in the lowest
(odds ratio = 0.39, 95% confidence interval 0.15-1.01). In men, greater
vitamin E and calcium intakes were associated with reduced risk of
adenomas, with vitamin E showing the strongest inverse association. Men
in the highest vitamin E quartile had a risk of 0.35 (95% confidence
interval 0.14-0.92) relative to those in the lowest. These study results
support previous research findings that selected micronutrients protect
against colorectal neoplasia.
8
UI - 8942432
AU - Potter JD
TI -
Food and phytochemicals, magic bullets and measurement error: a
commentary.
SO - Am J Epidemiol 1996 Dec 1;144(11):1026-7
AD - Cancer Prevention Research Program, Fred Hutchinson Cancer Research
Center, Seattle, WA 98104-2092, USA.
9
UI - 12076480
AU - Asano T; McLeod RS
TI -
Dietary fibre for the prevention of colorectal adenomas and carcinomas.
SO - Cochrane Database Syst Rev 2002;(2):CD003430
AD - General Surgery, University of Toronto, Mount Sinai Hospital, 600
University Avenue, Suite 449, Toronto, Ontario, Canada, M5G 1X5.
tasano@mtsinai.on.ca
BACKGROUND: Colorectal cancer (CRC) is a major cause of morbidity and
mortality in industrialized countries. Experimental evidence has
supported the hypothesis that dietary fibre may be protective for the
development of CRC, although epidemiologic data have been inconclusive.
OBJECTIVES: We have conducted a systematic review and meta-analysis to
assess the effect of dietary fibre on the incidence or recurrence of
colorectal adenomas, the incidence of CRC, and the development of
adverse events. SEARCH STRATEGY: We identified randomized controlled
trials from Medline, Embase, and the Cochrane Controlled Trials Register
up to Oct 2001 SELECTION CRITERIA: Randomized or quasi-randomized
controlled trials were assessed. The population included all subjects
that had adenomatous polyps but no previous history of colorectal cancer
(CRC), a documented "clean colon" at baseline and repeated visualization
of the colon/rectum after at least two years of follow-up. Dietary fibre
was the intervention. The primary outcomes were the number of subjects
with: a) at least one adenoma, b) more than one adenoma, c) at least one
adenoma greater than or equal to 1 cm or d) a new diagnosis of CRC. The
secondary outcome was the number of adverse events. DATA COLLECTION AND
ANALYSIS: Two reviewers independently extracted data, assessed trial
quality and resolved discrepancies by consensus. The outcomes were
reported as relative risks (RR) and risk difference (RD) with 95%
confidence intervals (CI). If statistical significance was reached, the
number need to treat (NNTT) or harm (NNTH) was reported. The study data
were combined with the fixed effects model if it was clinically,
methodologically, and statistically reasonable. MAIN RESULTS: Five
studies with 4349 subjects met the inclusion criteria. The interventions
were wheat bran fibre, ispaghula husk, or a comprehensive dietary
intervention with high fibre whole food sources alone or in combination.
When the data were combined there was no difference between the
intervention and control groups for the number of subjects with at least
one adenoma [RR 1.04 (95% CI 0.95,1.13); RD 0.01 (95% CI 0.02,0.04)]. As
well, the combined results for the number of subjects with more than one
adenoma [RR 1.02 (95% CI 0.89,1.17), RD 0.00 (-0.02,0.03)] or at least
one adenoma 1 cm or greater [RR 0.94 (95% CI 0.77,1.15), RD -0.01
(-0.02,0.01)] were not statistically significant. Other primary and
secondary outcomes and subanalyses by type of fibre intervention were
not statistically or clinically significant. REVIEWER'S CONCLUSIONS:
There is currently no evidence from RCTs to suggest that increased
dietary fibre intake will reduce the incidence or recurrence of
adenomatous polyps within a two to four year period.
10
UI - 12043410
AU - Pahlman L
TI -
[Chemoprevention can hardly substitute for screening for colorectal
cancer]
SO - Lakartidningen 2002 Apr 25;99(17):1917
AD - Akademiska sjukhuset, Uppsala. Lars.pahlman@kirurgi.uu.se
11
UI - 12109604
AU - Rosin RD
TI -
Barrett's oesophagus--are British gastroenterologists denying their
patients prevention of malignant change?
SO - J R Coll Surg Edinb 2002 Jun;47(3):521-2
AD - St Mary's Hospital, Imperial College School of Medicine, London, UK.
rdrosin@uk-consultants.co.uk
Adenocarcinoma of the lower oesophagus is rapidly increasing in
industrialised countries. The importance of Barrett's oesophagus is
because of the potential for it to progress to oesophageal
adenocarcinoma. It has a strong correlation to chronic GORD. Symptomatic
patients or those with a long segment, if dysplasia is present or the
patient is under 50 years of age, should be offered anti-reflux surgery.
Patients may be denied the procedure by some gastroenterologists
12
UI - 12152966
AU - Pignone M; Levin B
TI -
Recent developments in colorectal cancer screening and prevention.
SO - Am Fam Physician 2002 Jul 15;66(2):297-302
AD - Division of General Internal Medicine, University of North Carolina at
Chapel Hill School of Medicine, 27599-7110, USA. pignone@med.unc.edu
Colorectal cancer is a significant contributor to morbidity and
mortality in the United States. Studies published in the early 1990s,
showing that screening for colorectal cancer can reduce colorectal
cancer-related mortality, led many organizations to recommend screening
in asymptomatic, average-risk adults older than 50 years. Since then,
however, national screening rates remain low. Several important studies
published over the past four years have refined our understanding of
existing screening tools and explored novel means of screening and
prevention. The most important new developments, which are reviewed in
this article, include the following: Additional trial results support
the effectiveness of fecal occult blood testing in reducing the
incidence of, and mortality from, colorectal cancer. New studies
document the sensitivity of fecal occult blood testing, sigmoidoscopy,
and double-contrast barium enema compared with colonoscopy.
Cost-effectiveness models show that screening by any of several methods
is cost-effective compared to no screening. Randomized trials show that
calcium is effective but fiber is not effective in preventing
reoccurrence of adenomatous polyps. Preliminary data suggest that
nonsteroidal anti-inflammatory drugs may prevent adenomatous polyps and
that DNA stool tests and virtual colonoscopy may show promise as
screening tools. This new information provides further support for
efforts to increase the use of colorectal cancer screening and
prevention services in adults older than 50 years.
13
UI - 12105867
AU - Bresalier RS
TI -
Primary chemoprevention of familial adenomatous polyposis with sulindac:
more questions than answers.
SO - Gastroenterology 2002 Jul;123(1):379-81
14
UI - 11940085
AU - Cappelli M; Hunter AG; Stern H; Humphreys L; Van Houten L; O'Rourke K;
TI -
Viertelhausen S; Perras H; Lagarde AE
Participation rates of Ashkenazi Jews in a colon cancer community-based
screening/prevention study.
SO - Clin Genet 2002 Feb;61(2):104-14
AD - Psychology, Children's Hospital of Eastern Ontario (CHEO), Ottawa,
Canada. cappelli@cheo.on.ca
In a recent colon cancer risk study, genetic assessment and colonoscopy
were offered to virtually all of the adult Ashkenazi Jews in an urban
community. The present study was designed to examine factors influencing
participation and response in the initial study and to suggest
strategies for improving participation in future health promotion
programs. The study comprised a random sample of three groups of
individuals who had been targeted for participation in the previous
study: those who had (a) agreed to participate (n = 234); (b) declined
participation (n = 179); and (c) failed to respond to a mailed
recruitment package (n = 128). All participants completed a brief
telephone survey. Key multivariate predictors of both response and
participation were individuals' perceptions of the drawbacks of
participating in colon cancer screening research and the degree of
decisional conflict they experienced. Response was further predicted by
the influence of spouses, family history of colon cancer, past knowledge
of genetic testing for colon cancer, and education level. Participation
was predicted by awareness that the study was supported by the Ashkenazi
Jewish community, past experience with genetic testing, individuals'
perceptions of the benefits of participating, and whether or not they
had children. The degree to which individuals understand the purpose and
nature of genetic screening research, along with their levels of
decisional conflict and other psychosocial factors, may influence the
likelihood of their participation in such research. Results of this
study suggest a number of possible strategies for improving
participation and response rates in disease prevention and detection
studies.
15
UI - 11728233
AU - Anderson MR; Jankowski JA
TI -
The treatment, management and prevention of oesophageal cancer.
SO - Expert Opin Biol Ther 2001 Nov;1(6):1017-28
AD - Epithelial Laboratory, Division of Medical Sciences, University of
Birmingham, Edgbaston, B15 2TH, UK.
The combination of a rising incidence and a poor survival rate makes
oesophageal cancer a major health issue. Adenocarcinoma of the
oesophagus is associated with one of the commonest pre-malignant lesions
recognised, Barrett's metaplasia. This provides a focus for early
detection and intervention. The subjects of acid suppression, bile
reflux, COX-2 inhibition and ablation therapy will be discussed
herewith. Established carcinoma is now rarely treated by surgery alone
and this review discusses the benefits of multimodality therapy combined
with more accurate staging techniques. Finally an emerging understanding
of the molecular events that characterise the transition to carcinoma
may provide novel targets in cancer therapy such as epidermal growth
factor receptor (EGFR) and TNF-alpha. This review will focus on some of
the future developments in the treatment of oesophageal cancer.
16
UI - 12078915
AU - Stark AH; Madar Z
TI -
Olive oil as a functional food: epidemiology and nutritional approaches.
SO - Nutr Rev 2002 Jun;60(6):170-6
AD - The Hebrew University of Jerusalem, Faculty of Agricultural, Food and
Environmental Quality Sciences, Rehovot, Israel.
Olive oil is an integral ingredient of the Mediterranean diet and
accumulating evidence suggests that it may have health benefits that
include reduction of risk factors of coronary heart disease, prevention
of several varieties of cancers, and modification of immune and
inflammatory responses. Olive oil appears to be an example of a
functional food, with varied components that may contribute to its
overall therapeutic characteristics. Olive oil is known for its high
levels of monounsaturated fatty acids and is also a good source of
phytochemicals including polyphenolic compounds, squalene, and
alpha-tocopherol.
17
UI - 12165642
AU - Anderson KE; Johnson TW; Lazovich D; Folsom AR
TI -
Association between nonsteroidal anti-inflammatory drug use and the
incidence of pancreatic cancer.
SO - J Natl Cancer Inst 2002 Aug 7;94(15):1168-71
AD - Division of Epidemiology, School of Public Health, University of
Minnesota, Minneapolis 55454, USA. andeson_k@epi.umn.edu
Laboratory studies indicate that nonsteroidal anti-inflammatory drugs
(NSAIDs) may inhibit pancreatic cancer, but epidemiologic data to
support this finding are limited. We conducted a prospective study from
1992 through 1999 among 28 283 postmenopausal women who lived in Iowa to
examine the association between the self-reported use of aspirin and
other NSAIDs and the incidence of pancreatic cancer. Eighty incident
cases of pancreatic cancer were identified during 7 years of follow-up.
The multivariate-adjusted relative risk of pancreatic cancer associated
with any current use of aspirin versus no use was 0.57 (95% confidence
interval = 0.36 to 0.90). There was a trend of decreasing risk of
pancreatic cancer incidence with increasing frequency of aspirin use per
week (P(trend) =.005). Nonaspirin NSAID use was not associated with
incident pancreatic cancer. These data indicate that aspirin might be
chemopreventive for pancreatic cancer.
18
UI - 11913651
AU - Frontin KM
TI -
Colon cancer.
SO - Ethn Dis 2002 Winter;12(1):S2-66-7
19
UI - 12192027
AU - Levy R
TI -
Sulindac in familial adenomatous polyposis.
SO - N Engl J Med 2002 Aug 22;347(8):615
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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