This study utilized data from two cohorts of the Nurses‘ Health Study involving nearly 159,000 women and 3.5 million person-years of follow-up. The investigators discovered
CRC
CRC
Being Breastfed Associated With Increased Risk of Colorectal Cancer
Most Patients Who Have Not Had Colorectal Cancer Screening Have Not Been Offered Screening
Previous studies have shown that most patients who had not undergone colorectal cancer (CRC) screening reportedly had not been offered screening by their primary care
Cancers Detected in Second-Round Fecal Immunochemical Test Screening Still Early Stage
The value of colorectal cancer (CRC) screening lies in CRC prevention through polyp detection and prevention of CRC mortality by early-stage CRC detection. Compared with
Delay in Colonoscopy After Positive FIT May Be Lethal, Particularly in 40- to 49-Year-Olds
These data are from a population-based Chinese screening program involving 595,180 persons aged 40 to 74 years with 16 years of follow-up. There were 42,353
Early-Onset Colon Cancers Have More Synchronous Advanced Adenomas
In a cross-sectional retrospective study at a single U.S. health care system, colonoscopic findings of 150 randomly selected patients with early-onset colorectal cancer (CRC) were
Monoallelic Variants in Recessive CRC Genes Not Associated With Increased CRC Risk
Increasingly, we are consulted on or asked to perform colonoscopies on patients who previously underwent multigene panel testing for oncogenes associated with colorectal cancer (CRC).
To Optimally Prevent Colorectal Cancer, We Need to Detect Both Adenomas and Serrated Lesions
Recent studies have found that significant fractions of colonoscopists possess adequate detection of conventional adenomas, as measured by adenoma detection rate (ADR), but low detection
About Half of Cancers in Serrated Polyposis Syndrome Arise Through the Adenoma-Carcinoma Sequence
The serrated pathway of colorectal cancer (CRC) is considered to account for about 20% of all CRCs. Patients with serrated polyposis syndrome (SPS) have higher
Declines in Colorectal Cancer Incidence in Older Persons Are Slowing
This study used SEER (Surveillance, Epidemiology, and End Results) data to update colorectal cancer (CRC) incidence and mortality trends from 1992 to 2019. The well-known
Changing Advanced/High-Risk Adenoma Definition Would Reduce Colonoscopies With Limited Delay in CRC Diagnoses
Patients with advanced or high-risk adenomas are recommended to undergo surveillance earlier than patients with low-risk adenomas. In the U.S., the traditional high-risk group classification
In U.S. Veterans, Advanced Adenomas, Not Nonadvanced Adenomas, Before Age 50 Associated With Higher CRC Risk
Adenomas are commonly diagnosed in patients younger than age 50 undergoing colonoscopy. Adenomas in young people often initiate surveillance at shorter than the recommended intervals,
Offering a Blood Test Increases CRC Screening in Patients Who Had Declined Colonoscopy and FIT
This was a randomized controlled trial in 359 veterans aged 50 to 75 years who had declined colonoscopy and a fecal immunochemical test (FIT) in
Colonoscopy Quality Appears To Be Good in U.S. Veterans Administration Hospitals
In a study of 29,877 patients with colorectal cancer (CRC) in the U.S. Veterans Affairs (VA) health care system, the rate of postcolonoscopy colorectal cancer
A New Treatment for Endoscopic Palliation of Colorectal Cancer
Patients with colorectal cancer (CRC) metastatic to the liver or lung often do not undergo surgical resection of their primary tumor. However, the primary tumor
Colonoscopy Screening at Intervals Longer Than 10 Years Is Feasible
Case-control studies and cohort studies have found that colonoscopy prevents colorectal cancer (CRC) for 15 to 20 years or more. However, only a few small
The Strongest Predictor of Colonoscopy Completion After a Positive Stool Test Is a Multitarget Stool DNA Test
It is well known that the rates of follow-up colonoscopy after a positive fecal screening test are suboptimal, and delays in colonoscopy versus prompt colonoscopy
Does Appendectomy Increase Risk of Colorectal Cancer?
This systematic review and meta-analysis identified 22 studies from 3 continents that addressed the risk of colorectal cancer (CRC) after appendectomy in the general population.
FIT-Fecal DNA Test Had High Positive Predictive Value in Second-Round Screening
This study examined the positive predictive value (PPV) of a second round of screening with a fecal immunochemical test (FIT)-fecal DNA test (Cologuard, Exact Sciences).
Colorectal Cancer Screening Rates Increased During the COVID Pandemic, but With Stool-based Tests, Not Colonoscopy
This report is from the National Health Interview Survey, an annual survey of U.S. households covering a wide range of health topics. Response rates were
Is There an Increased Risk of Proximal Gastrointestinal Cancer After a Positive Fecal Immunochemical Test?
The fecal immunochemical test (FIT) is a simple, noninvasive, at-home study that detects blood in the stool and is used for colon cancer (CRC) screening
Metabolic Syndrome Increases All-Cause and Disease-Specific Mortality in Colorectal Cancer
Metabolic syndrome (MS), diabetes mellitus, and obesity are all associated with an increased prevalence of precancerous colorectal polyps and incidence of colorectal cancer (CRC). This
Prediagnosis Obesity Eliminates Survival Advantage Associated With Aspirin Use in Stage IV Colorectal Cancer
This study divided 656 participants with stage IV colorectal cancer (CRC) into groups according to their prediagnosis body mass index (BMI): normal (38.3%), overweight (36.3%),
Fifteen-Year Benefits of Screening Sigmoidoscopy, Based on Pooled Results of 4 Randomized Controlled Trials
This is a pooled analysis of 4 randomized controlled trials of one-time sigmoidoscopy screening in patients aged 55 to 64 years. The trials were conducted
Review Indicates Colorectal Cancer Screening Guidelines Have Inadequate Reporting and Discussion of Screening Harms
Cancer screening can lead to patient-level harms from screening tests, diagnostic follow-up, and cancer treatment. This review examined U.S. screening guidelines on breast, cervical, colorectal,
First Randomized Controlled Trial Comparing Colonoscopy With No Screening Finds Less Benefit Than Expected for Colonoscopy
In the first report of incidence and mortality results from a randomized controlled trial (RCT) comparing colonoscopy with no screening, 84,585 previously unscreened persons aged
Dutch Describe Impact of Their National Biennial Fecal Immunochemical Test Screening Program
In 2014, the Netherlands instituted a national program of every-other-year fecal immunochemical test (FIT) screening for colorectal cancer (CRC). Since the start of screening, within
Risk-Stratified CRC Screening Using Fecal Immunochemical Test and Stool DNA
This is a post hoc analysis of a risk-stratification screening strategy based on the Asia-Pacific Colorectal Screening (APCS) scoring system. This score ranks patients as
Substantial Risk of Advanced Adenomas but No Colorectal Cancer in a Cohort of Patients With CDH1 Mutations
CDH1 mutations are associated with a very high risk of gastric cancer, early age of onset of gastric cancer, and a high risk of breast cancer
Global Trends in Colorectal Cancer
Data on colorectal cancer (CRC) incidence and deaths were extracted from the GLOBOCAN database for 2020, and projections were made for 2040. Some of the
Interval Cancers Are More Deadly Than Screen-Detected Cancers but Are Not Different in Molecular Features
Previous studies have found that interval or postcolonoscopy cancers have molecular profiles that differ somewhat from those of cancers detected at a baseline colonoscopy, including
Do Patients With Young-Onset Colorectal Cancer Require More Frequent Surveillance Colonoscopy?
Current recommendations for sporadic colorectal cancer (CRC) are to perform surveillance colonoscopy 1 year after surgical resection, then at 3 years, and then at 5-year
Colonoscopy Every 10 Years Starting at Age 40 Modeled as Cost-Effective for Men With Body Mass Index ≥35
Obesity is a known risk factor for colorectal cancer (CRC) in both men and women. A previously developed decision analytic was used to model the
Liquid Biopsy Shows Promise for Early-Onset Colorectal Cancer
Early-onset colorectal cancer (EOCRC), or CRC occurring before age 50, is associated with advanced tumor stage at diagnosis, distal colon location, and signet ring histology.
Breath Test for Colon Cancer Shows Promise
Patients with certain cancers expel volatile organic compounds (VOCs). VOCs are the basis of previous reports in which dogs were trained to identify patients with
12 of 12 Patients With Mismatch Repair-Deficient, Locally Advanced Rectal Cancer Had Complete Response to Dostarlimab Alone
It is well known that mismatch repair-deficient colorectal cancer (CRC), also called microsatellite instability (MSI)-high CRC, fails to respond to traditional fluorouracil-based chemotherapy but has
Liquid Biopsy After Resection of Stage II Colon Cancer Reduced the Need for Adjuvant Chemotherapy
Patients with stage III (node-positive) colorectal cancer (CRC) benefit from adjuvant chemotherapy. Patients with stage II (invading muscularis propia or deeper and node-negative) CRC typically
Actual Impact of COVID-19 on CRC (8.7% Reduction) and Advanced Adenoma (26.9% Reduction) Diagnoses in a U.S. Health Care System
This study utilized the Kaiser Permanente Northern California (KPNC) health care system to evaluate the actual impact of the COVID-19 pandemic on colorectal cancer (CRC).
Endoscopic Submucosal Dissection for Early Colorectal Cancer and High-Risk Surgery: Okay to Not Operate
This study investigated outcomes in patients who underwent endoscopic submucosal dissection (ESD) for T1 colorectal cancer (CRC) and then had adverse histologic features that predict
Cancer Risk in Serrated Polyposis Syndrome and Sporadic Sessile Serrated Lesion Patients and Their Relatives
This study used the Utah Cancer Registry to examine cancer risk in patients with serrated polyposis syndrome (SPS) and their relatives as well as patients
Asking Patients With Colorectal Cancer to Help Get Their Siblings Screened Is Not That Helpful
We often tell our patients with colorectal cancer (CRC) or advanced adenomas that guidelines indicate their siblings are at increased risk of developing CRC or
U.S. Multi-Society Task Force Endorses Colorectal Cancer Screening in Average-Risk Persons at Age 45
In a recommendation characterized as “weak recommendation; low-quality evidence,” the U.S. Multi-Society Task Force on Colorectal Cancer (MSTF) now recommends initiating screening for colorectal cancer
There Are Now 5 Randomized Controlled Trials of Flexible Sigmoidoscopy Screening, and They All Show It Works
Four previous randomized controlled trials of flexible sigmoidoscopy (FS) have shown reductions in at least distal colorectal cancer (CRC) incidence and mortality after FS screening.
Birth Cohort Effects in Colorectal Cancer Impacting 50- to 54-Year-Olds
As birth cohorts younger than age 50 become progressively younger, the relative increase in colorectal cancer (CRC) risk compared to past decades becomes progressively greater.
Constipation Is Not a Risk Factor for Colorectal Cancer
Patients are often concerned that chronic constipation will put them at risk for colorectal cancer (CRC), and previous data on this topic have been mixed.
Sessile Serrated Lesions, Unspecified Serrated Polyps, and Colorectal Cancer Risk
This study examined the risk of colorectal cancer (CRC) associated with serrated polyp subtypes in patients undergoing their first colonoscopy between 2006 and 2016. There
Summary of Evidence: Overweight and Obesity Are Both Associated With Early-Onset Colorectal Cancer Incidence
Intense ongoing investigation has suggested a number of risk factors for early-onset colorectal cancer (EOCRC), defined as CRC in persons younger than aged 50 years
Patients Live a Healthier Lifestyle After Endoscopic Screening
Previous studies have been inconclusive as to whether endoscopic screening contributes to patients leading a healthier or unhealthier lifestyle. For example, patients with normal examinations
Protein Assays Added to the Fecal Immunochemical Test Improve Sensitivity for Advanced Adenomas
The fecal immunochemical test (FIT) is widely chosen by organized colorectal cancer (CRC) screening programs as the screening test of choice. FIT detects about 80%
Low Vitamin D Intake Associated With Early Onset Colorectal Cancer in Nurses’ Health Study
Many investigators are trying to understand the increasing risk of colorectal cancer (CRC) developing before age 50, or so-called early-onset CRC. The Nurses’ Health Study
Strong Evidence That Long-Term Proton Pump Inhibitor Use Increases Colorectal Cancer Risk
Data vary regarding whether hypergastrinemia and proton pump inhibitor (PPI) use increase adenoma progression and risk of colorectal cancer (CRC). The current study from the
Updated Colorectal Cancer Screening Recommendations From the U.S. Preventive Services Task Force: Some of the Details
The U.S. Preventive Services Task Force (USPSTF) recommendations are key for screening because they influence the policies of the Centers for Medicare and Medicaid Services
Colonoscopy More Effective Than the Fecal Immunochemical Test in Case-Control Study
Randomized controlled trials comparing the use of colonoscopy to the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening are underway. A case-control study from
Germline Testing for Cancer Genes in Everyone With Colorectal Cancer?
Current guidelines recommend universal screening of patients with newly diagnosed colorectal cancer (CRC) for tumor features of Lynch syndrome. This is usually done by immunohistocompatibility
Liquid Biopsy Assay Predicts Lymph Node Metastases in T1 Colorectal Cancer
When patients have T1 colorectal cancer (CRC) resected, histologic features, such as deep submucosal invasion, poor differentiation, lymphovascular invasion, and high-grade tumor budding, are used
Selective Serotonin Reuptake Inhibitors Reduce Colorectal Cancer Risk, and the Effect Is Additive to Aspirin
In a nationwide Swedish registry study, 24,786 colorectal cancer (CRC) cases and 74,358 randomly matched controls for birth year and sex were evaluated to determine
Brits Evaluate Their New Postpolypectomy Surveillance Guidelines
The UK revised its postpolypectomy surveillance guidelines to reduce the use of surveillance colonoscopy. According to the guidelines, patients considered to be high risk for
Patients With Multifocal Cancer: Evidence for Intraluminal Spread of Tumor
In various series, 2% to 7% of patients with colorectal cancer (CRC) have either synchronous or metachronous second cancer. Second CRCs have generally been considered
Non-White Race and Low Socioeconomic Status Associated With Longer Wait for Treatment After Colorectal Cancer Diagnosis
The time between diagnosis of colorectal cancer (CRC) and initiation of treatment is associated with mortality. In this study of 330,988 CRC cases in the
Artificial Intelligence System Outperforms Guideline Predictive Criteria for Lymph Node Metastasis in T1 Cancers
In a study from 7 centers in Japan, a deep learning artificial intelligence (AI) program trained on 3134 T1 colorectal cancers (CRCs) from 6 Japanese
Monoallelic NTHL1 Loss of Function Not Associated With Colorectal Cancer
NTHL1 encodes endonuclease III-like protein 1, an enzyme involved in base-excision repair that identifies and removes oxidized pyrimidines. Biallelic loss-of-function mutations of base-excision repair genes, such
Most Primary Care Physicians Not Following the American Cancer Society’s Recommendation to Screen at Age 45
The American Cancer Society (ACS) recommended in 2018 that all Americans should undergo colorectal cancer (CRC) screening beginning at age 45. Thus far, other major
Low Incidence of Colorectal Cancer After Endoscopic Dysplasia Resection in Patients With IBD
Given the paucity of high-quality outcome data, the optimal management of polypoid and/or nonpolypoid colonic lesions in IBD is an ongoing debate. Guidelines recommend that
Early Colorectal Cancer Screening in African Americans: High Uptake and High Yield
Recommendations from GI societies to screen African Americans for colorectal cancer (CRC) starting at age 45 were based largely on age-related incidence and mortality data
Adenomas in the Young: What Do They Mean?
The incidence of colorectal cancer (CRC) is increasing in persons under age 50 in much of the world. Endoscopists commonly encounter sporadic adenomas when performing
Negative Colonoscopy Predicts Reduced Risk of Colon Cancer for 17 Years
Previous studies in symptomatic populations have found that a negative colonoscopy predicts a reduction in colorectal cancer (CRC) incidence for greater than 20 years. The
Malpractice Trends in Colon Cancer
This study identified 240 malpractice cases related to colorectal cancer (CRC) between 1988 and 2018 by using a legal database called VerdictSearch. This database is
Predicting CRC in Unscreened Populations by CBC
About one-third of the U.S. population is unscreened for colorectal cancer (CRC). One approach to early detection in this population is to screen health care
Randomized Colorectal Cancer Screening Trial Includes Risk-Stratified Arm
Colorectal cancer (CRC) screening can be offered to patients as a menu of screening options; sequential testing (colonoscopy offered first with another testing option offered
Molecular Markers Predict Prognosis in Colorectal Cancer
Douglas K. Rex, MD, FASGE, reviewing Phipps AI, et al. Gastroenterology 2020 Feb 20. Current recommendations from the U.S. Multi-Society Task Force recommend that all
Improving ADR Shown Again to Save Lives
Douglas K. Rex, MD, FASGE, reviewing Lam AY, et al. Gastrointest Endosc 2020 Feb 21. A 2017 study from the Polish screening colonoscopy program showed
Polygenic Risk Score Has Predictive Value for Early Onset Colorectal Cancer
Douglas K. Rex, MD, FASGE reviewing Archambault AN, et al. Gastroenterology 2019 Dec 19. Everyone wants to understand the underlying drivers for why early-onset colorectal
WASP classification – optical diagnosis of polyps <10mm
Recently sessile serrated lesions (SSLs) have been recognized as another important precursor lesion to CRC. SSLs are thought be responsible for 15–30% of colorectal cancer.