Colorectal Cancer

Journal Information
ISSN / EISSN : 1758-194X / 1758-1958
Published by: Future Medicine Ltd (10.2217)
Total articles ≅ 322
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Mahdi Alemrajabi, , Esmail Amiri, Masoud Vahdani
Published: 1 December 2020
Colorectal Cancer, Volume 9; https://doi.org/10.2217/crc-2020-0014

Abstract:
After the outbreak of COVID-19, several issues in the field of general surgery have remained unknown. Here we present two consecutive patients operated on in a coronavirus center in February 2020, during the outbreak in Tehran, Iran. Moreover, we highlight some challenges surgeons face in the management of these patients during the outbreak. We suggest surgeons to perform the safest technique with the least risk. In borderline conditions, it is suggested to prefer stoma over anastomosis. This lessens the course of hospitalization and probable complication rates. We suggest establishing clean centers and prepare guidelines for the general surgery team members to lessen the risk for patients and healthcare providers.
Published: 1 September 2020
Colorectal Cancer, Volume 9; https://doi.org/10.2217/crc-2020-0007

Abstract:
Recently, there has been an unexpected trend toward increased incidence of colorectal cancer in younger individuals, particularly distal colon and rectal cancer in those under age 50. There is evidence to suggest that the human gut microbiome may play a role in carcinogenesis. The microbiome is dynamic and varies with age, geography, ethnicity and diet. Certain bacteria such as Fusobacterium nucleatum have been implicated in the development of colorectal and other gastrointestinal cancers. Recent data suggest that bacteria can alter the inflammatory and immune environment, influencing carcinogenesis, lack of treatment response and prognosis. Studies to date focus on older patients. Because the microbiome varies with age, it could be a potential explanation for the rise in early-onset colorectal cancer.
, Rebekah Anders, Patrick Blatchford, Amy Walde, Alexis Leal, Gentry King, Stephen Leong, Sarah Lindsey Davis, William T Purcell, Karyn A Goodman, et al.
Published: 1 September 2020
Colorectal Cancer, Volume 9; https://doi.org/10.2217/crc-2020-0012

Abstract:
Background: We examined characteristics of early-onset colorectal cancer (CRC) patients to identified factors, which may lead to earlier diagnosis. Materials & methods: This is a retrospective study with inclusion criteria: CRC diagnosed between 2012 and 2018 and age at diagnosis <50 years. Results: A total of 209 patients were included (mean age 41.8 years). Of those patients 42.5% had rectal cancer and 37.8% were stage IV at initial diagnosis. Of patients with data available for rectal bleeding history (n = 173), 50.8% presented with rectal bleeding and median time from onset of bleeding to diagnosis was 180 days (interquartile range 60–365), with longer duration noted in advanced cancer. Conclusion: Prolonged rectal bleeding history was noted in a significant proportion of early-onset CRC patients, with longer duration of rectal bleeding noted in stage IV patients. Patients and primary care physicians should be made aware of this finding in order to facilitate timely referral for diagnostic workup.
James V Tricoli
Published: 1 September 2020
Colorectal Cancer, Volume 9; https://doi.org/10.2217/crc-2020-0009

Abstract:
While the incidence of colorectal cancer (CRC) in the US has declined at a pace of 3% annually between 2003 and 2012, there has been an increase in the incidence of early-onset colorectal cancer (EOCRC). The reasons for this increase are unclear. Diet, the environment, the microbiome and alcohol consumption have all been proposed as contributing factors. There is the possibility that EOCRC has a unique biology. Overlapping with the EOCRC age range is CRC in adolescent and young adults (AYA) that share many molecular characteristics with EOCRC. The purpose of this review is to cover current progress in our understanding of the biology of CRC in the context of adolescent and young adult CRC and EOCRC and discuss future directions.
Laura Brockway-Lunardi, Stefanie Nelson, , James V Tricoli, , Anil Wali,
Published: 1 September 2020
Colorectal Cancer, Volume 9; https://doi.org/10.2217/crc-2020-0028

Abstract:
The incidence rates of sporadic early-onset colorectal cancer (EO-CRC) are increasing rapidly in the USA and globally. Birth cohort analyses strongly suggest that changes in early life exposures to known or unknown risk factors for CRC may be driving EO disease, but the etiology of EO-CRC remains poorly understood. To address the alarming rise in sporadic EO-CRC, the National Cancer Institute and National Institute of Environmental Health Sciences convened a virtual meeting that featured presentations and critical discussions from EO-CRC experts that examined emerging evidence on potential EO-CRC risk factors, mechanisms and translational opportunities in screening and treatment.
, Ajay Goel, Swati G Patel
Published: 1 September 2020
Colorectal Cancer, Volume 9; https://doi.org/10.2217/crc-2020-0005

Abstract:
Colorectal cancer (CRC) in individuals under the age of 50 is a problem that is increasing in USA and around the world. In this review, we discuss the degree to which early-onset (EO)CRC may be due to unsuspected Lynch syndrome or other inherited germline variants that predispose to cancer, describe the known somatic genetic alterations in EO tumors and discuss alterations in DNA methylation. Approximately 20% of EOCRCs can be attributed to identifiable germline mutations in genes that cause familial cancer syndromes. A variety of other genetic/epigenetic alterations have also been reported. We conclude that this is a heterogeneous problem, that requires a comprehensive analysis of genetic/epigenetic signatures to better understand EOCRC. Various subsets of EOCRCs must be analyzed individually for clues regarding the etiologies and possible specific therapies for this disease.
Jan T Lowery, Thomas K Weber, Dennis J Ahnen, Paul C Schroy Iii, Caleb L Levell, Robert A Smith
Published: 1 September 2020
Colorectal Cancer, Volume 9; https://doi.org/10.2217/crc-2020-0004

Abstract:
Aim: The National Colorectal Cancer Roundtable convened a national Summit to discuss the causes of early-onset colorectal cancer and clinical challenges to mitigating burden of this disease. Materials & methods: Information presented was synthesized through scientific consensus building to determine priorities for new research and practice change. Results: Research priorities include evaluating role of novel risk factors, understanding natural history and identifying ways to implement evidenced-based practices for identifying and managing at-risk persons. Practice change should focus on adoption of guidelines for collecting family history, screening in young adults at risk, provider and population awareness about risk and symptoms, and universal tumor testing. Conclusion: Successful implementation of strategies to address research and practice change will require collaboration from multiple partners.
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