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National Cancer Institute®
Ultima Vez Modificado: 1 de agosto del 2002
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.
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. firstname.lastname@example.org
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.
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.
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
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.
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.
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.
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. email@example.com
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.
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.firstname.lastname@example.org
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. email@example.com
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
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. firstname.lastname@example.org
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.
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. email@example.com
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.
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.
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.
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. firstname.lastname@example.org
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.
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