Accuracy of Self-Checked Fecal Occult Blood Testing for Colorectal Cancer in Thai Patients

Purpose: Colorectal cancer (CRC) screening with fecal occult blood testing (FOBT) has been associatedwith a reduction in CRC incidence and CRC-related mortality. However, a conventional FOBT requires stoolcollection and handling, which may be inconvenient for participants. The EZ-DetectTM (Siam PharmaceuticalThailand) is a FDA-approved chromogen-substrate based FOBT which is basically a self-checked FOBT (nostool handling required). This study aimed to evaluate the accuracy of EZ-Detect for CRC detection. Methods:This prospective study was conducted in the Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand betweenNovember 2013 and May 2014. Some 96 patients with histologically-proven CRC and 101 patients with normalcolonoscopic findings were invited to perform self-checked FOBT according to the manufacturer’s instructions.Results were compared with endoscopic and pathologic findings. Sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) for CRC detection were calculated. Results: The present studyrevealed the sensitivity, specificity, PPV and NPV of this self-checked FOBT for CRC detection to be 41% (95%CI: 31-51), 97% (95% CI: 92-99), 93% (95% CI: 81-98) and 63% (95% CI: 55-70), respectively. The overallaccuracy of the self-checked FOBT for identifying CRC was 70%. The sensitivity for CRC detection based on7th AJCC staging was 29% for stage I, 32% for stage II and 50% for stage III/IV (P=0.19). The sensitivity was33% for proximal colon and 42% for distal colon and rectal cancer (P=0.76). Notably, none of nine infiltrativelesions gave a positive FOBT. Conclusions: The self-checked FOBT had an acceptable accuracy of CRC detectionexcept for infiltrative tumors. This home-administrated or ‘DIY’ do-it-yourself FOBT could be considered asone non-invasive and convenient tool for CRC screening.     

Detection Rate of Colorectal Adenoma or Cancer in Unselected Colonoscopy Patients: Indonesian Experience in a Private Hospital

Background: Colorectal cancer is currently the third most common cancer in Indonesia, yet colonoscopy - themost accepted mode of screening to date - is not done routinely and national data are still lacking. Objective: Todetermine the detection rate of colorectal cancers and adenomas in unselected patients undergoing colonoscopyfor various large bowel symptoms at the Digestive Disease and GI Oncology Centre, Medistra Hospital in Jakarta,Indonesia. Materials and Methods: Colonoscopy data from January 2009 to December 2012 were reviewed.New patients referred for colonoscopy were included. Data collected were patient demographic and significantcolonoscopy findings such as the presence of hemorrhoids, colonic polyps, colonic diverticula, inflammation,and tumor mass. Histopathological data were obtained for specimens taken by biopsy. Associations betweencategorical variables were analyzed using chi-square test, while mean differences were tested using the t-test.Results: A total of, 1659 cases were included in this study, 889 (53.6%) of them being men. Polyps or masses werefound in 495 (29.8%) patients while malignancy was confirmed in 74 (4.5%). Patients with a polyp or mass weresignificantly older (60.2 vs 50.8 years; p<0.001; t-test) and their presence was significantly associated with malegender (35.0% vs 23.9%; prevalent ratio [PR] 1.71; 95% confidence interval [CI] 1.38-2.12; p<0.001) and age>50 years (39.6% vs 16.6%; PR 3.29; 95% CI 2.59-4.12; p<0.001). Neoplastic lesions was found in 257 (16.1%),comprising 180 (11.3%) adenomas, 10 (0.6%) in situ carcinomas, and 67 (4.2%) carcinomas. Conclusions: Polypsor masses were found in 30% of colonoscopy patients and malignancies in 16.1%. These figures do not representthe nation-wide demographic status of colorectal cancer, but may reflect a potentially increasing major healthproblem with colorectal cancer in Indonesia.     

Prevalence of Colorectal Cancer in Relatives of Iranian Patients Diagnosed with Colorectal Cancer

Background: A high rate of colorectal cancer occurrence is established in individuals with a positive familyhistory of this type of cancer. Objectives: The aim of this study was to investigate the prevalence of colorectalcancer in first degree and second degree relatives of colorectal cancer patients. Methods: Family medical historiesof 489 first degree relatives of colorectal cancer patients were obtained by a questionnaire. 249 average riskpatients with no family history of colorectal cancer were included as control patients. Results: In our study froma total of 489 case patients, 153 (31.3%) had at least one close relative affected by colon cancer. Case-controlanalysis showed an odd ratio of 3.1 (95% CI, 2.07 to 6.27) for one and 5.7 (CI, 2.39 to 13.56) for two affectedrelatives. Cases with a positive family history had a 3.006 times greater risk in developing colorectal cancer if afirst degree relative was affected comparing with a 4.898 time greater risk if a second degree family memberwas diagnosed with colorectal cancer .Our study indicated a higher risk for developing colorectal cancer in malefamily relatives 50 years and older. Rectal area was found the most tumor side affected in case and controlpatients. Conclusion: First-degree relatives of patients with colorectal cancer had an increased risk of developingthis type of cancer. The risk was greater when diagnosis was in male, elderly patients and other first-degreerelatives were affected.     

Colorectal Cancer Awareness and Screening Preference: A Survey during the Malaysian World Digestive Day Campaign

Background: Although the incidence of colorectal cancer in Malaysia is increasing, awareness of this cancer, including its symptoms, risk factors and screening methods, remains low among Malaysian populations. This survey was conducted with the aim of (i) ascertaining the awareness level regarding colorectal cancer symptoms, risk factors and its screening among the general populations and (ii) assessing the public preference and willingness to pay for colorectal cancer screening. Materials and Methods: The questionnaire was distributed in eight major cities in West Malaysia during the World Health Digestive Day (WDHD) campaign. Two thousand four hundred and eight respondents participated in this survey. Results: Generally, awareness of colorectal cancer was found to be relatively good. Symptoms such as change in bowel habit, blood in the stool, weight loss and abdominal pain were well recognized by 86.6%, 86.9%, 83.4% and 85.6% of the respondents, respectively. However, common risk factors such as positive family history, obesity and old age were acknowledged only by less than 70% of the respondents. Almost 80% of the respondents are willing to take the screening test even without any apparent symptoms. Colonoscopy is the preferred screening method, but only 37.5% were willing to pay from their own pocket to get early colonoscopy. Conclusions: Continous cancer education should be promoted with more involvement from healthcare providers in order to make future colorectal cancer screening programs successful.     

Continuity of Care and Colorectal Cancer Screening by Vietnamese American Patients

Background: Colorectal cancer (CRC) screening rates among Asian Americans are 30-50% lower than among Whites. Using practice management and electronic medical records data from a community health center, we examined the association of CRC screening with continuity of care and comorbidity. These variables have not previously been studied in Asian American and limited-English proficient populations. Methods: After obtaining IRB approval, we extracted data in 2009 on age-eligible Vietnamese patients who had one or more clinic visits in the prior 24 months. Our analysis examined associations between CRC screening (per current US Preventive Services Task Force guidelines) and clinic site, demographics, insurance status, continuity of care, comorbidities, and provider characteristics. Results: We identified a total of 1,016 eligible patients (604 at Clinic 1 and 412 at Clinic 2). Adherence to CRC screening was lower for patients who were male; lacked insurance; had only one medical visit in the past 12 months; and had no assigned primary care provider. Our multivariable models showed higher screening rates among patients who were female; had public health insurance; and had more than one medical visit in the past 12 months, regardless of “high” or “low” continuity of care. Conclusions: We found no association between higher continuity of care and CRC screening. Additional primary care systems research is needed to guide cancer screening interventions for limited-English proficient patients.     

Perceived Deterrence Towards Colonoscopy for Colorectal Cancer Screening among Northern Malaysia Population: A Qualitative Study

Background: Patients with positive immunochemical faecal occult blood test results were found to have poor compliance for a subsequent colonoscopy procedure. This study was conducted to explore patients’ perceived deterrence for colonoscopy following a positive stool test. Methods: Using qualitative study method, a phone interview was conducted with 16 patients to elicit their views on the reasons for failure to attend the colonoscopy procedure following a positive stool test. The interviews were audio recorded, transcribed verbatim and translated before proceeded with the data analysis. Content analysis was made on the translated interview, followed by systematic classification of data by major themes. Results: Reasons for nonattendance were categorized under five main themes; unnecessary test, fear of the procedure, logistic obstacles (subthemes; time constraint, transportation problem), social influences, and having other health priority. Lacking in information about the procedure during the referral process was identified to cause misperception and unnecessary worry towards colonoscopy. Fear of the procedure was commonly cited by female respondents while logistic issues pertaining to time constraint were raised by working respondents. Conclusions: More effective communication between patients and health care providers are warranted to avoid misconception regarding colonoscopy procedure. Support from primary care doctors, customer-friendly appointment system, use of educational aids and better involvement from family members were among the strategies to increase colonoscopy compliance.     

Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran,Iran between 2008 and 2013

Background: Colorectal cancer (CRC) is one of the prime causes of mortality around the globe, with asignificantly rising incidence in the Middle East region in recent decades. Since detection of CRC in the earlystages is an important issue, and also since to date there are no comprehensive epidemiologic studies depictingthe Middle East region with special attention to the average risk group, further investigation is of significantnecessity in this regard. Aim: Our aim was to investigate the prevalence of preneoplastic and neoplastic lesionsof the colon in an average risk population. Materials and Methods: A total of 1,208 eligible asymptomatic,average- risk adults older than 40 years of age, referred to Firuzgar Hospotal in the years 2008-2012, wereenrolled. They underwent colonoscopy screening and all polypoid lesions were removed and examined by anexpert gastrointestinal pathologist. The lesions were classified by size, location, numbers and pathologic findings.Size of lesions was measured objectively by endoscopists. Results: The mean age of participants was 56.5 ± 9.59and 51.6% were male. The overall polyp detection rate was 199/1208 (16.5 %), 26 subjects having non-neoplasticpolyps, including hyperplastic lesions, and 173/1208 (14.3%) having neoplastic polyps, of which 26 (2.15%) wereadvanced neoplasms .The prevalence of colorectal neoplasia was more common among the 50-59 age group.Advanced adenoma was more frequent among the 60-69 age group. The majority of adenomas were detectedin the distal colon, but a quarter of advanced adenomas were found in the proximal colon; advance age andmale gender was associated with the presence of adenoma. Conclusions: It seems that CRC screening amongaverage-risk population might be recommended in countries such as Iran. However, sigmioidoscopy alone wouldmiss many colorectal adenomas. Furthermore, the 50-59 age group could be considered as an appropriate targetpopulation for this purpose in Iran.     

C-myc在结直肠癌和息肉中的表达及其意义

[目的]探讨c-myc在结直肠癌发生、发展中的作用及其与临床病理特征的相关性。[方法]采用免疫组织化学SP法检测60例结直肠癌组织、60例结直肠息肉组织、30例结直肠癌旁组织中c-myc蛋白表达。[结果]结直肠癌、结直肠腺瘤性息肉组织中c-myc蛋白表达阳性率明显高于结直肠增生性息肉及癌旁黏膜组织。c-myc蛋白高表达与结肠癌发病部位、肿瘤分化程度、Dukes分期、淋巴结转移有关（P均〈0.05）。c-myc蛋白高表达与结直肠腺瘤性息肉大小以及息肉有蒂或无蒂相关（P〈0.05）。[结论]c-myc表达与结直肠癌发生、发展有关。主题词：结直肠息肉;结直肠肿瘤;c-myc;免疫组织化学     

564例大肠癌结肠镜资料分析

目的对564例大肠癌结肠镜检查结果进行总结分析。方法回顾564例经结肠镜检查及病理确诊的大肠癌患者，就性别、年龄、病变部位、结肠镜检查及病理特征进行分析。结果9151例接受结肠镜检查者中，共发现大肠癌患者564例，检出率为6．16％。男女比例为1．4：1；≥50岁为高发年龄（占70．39％）；直肠病变占多数，乙状结肠其次，分别为52．01％和15．24％，右半结肠癌占25．91％；腺癌仍为大肠癌最常见的病理类型（94．25％），鳞癌及腺鳞癌各有1例和2例，腺瘤性息肉癌变48例，占8．36％。结论≥50岁为大肠癌高发年龄，直肠和乙状结肠为大肠癌的高发部位，全结肠镜检查是筛查和诊断大肠癌的有效手段。     

The Optimal Cut-Off Level of The Fecal Immunochemical Test For Colorectal Cancer Screening in a Country with Limited Colonoscopy Resources: A Multi-Center Study from Thailand

Background: Selecting the cut-off point for the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening programs is of prime importance. The balance between the test performance for detecting advanced neoplasia and the available colonoscopy resources should be considered. We aimed to identify the optimal cut-off of FIT for advanced neoplasia in order to minimize colonoscopy burden. Methods: We conducted a multi-center study in 6 hospitals from diverse regions of Thailand. Asymptomatic participants, aged 50-75 years, were tested with one-time quantitative FIT (OC-SENSOR, Eiken Chemical Co.,Ltd., Tokyo, Japan) and all participants underwent colonoscopy. We assessed test performance in detecting advanced neoplasia (advanced adenoma and CRC) and measured the burden of colonoscopy with different cut-offs [25 (FIT25), 50 (FIT50), 100 (FIT100), 150 (FIT150), and 200 (FIT200)ng/ml]. Results: Among 1,479 participants, advanced neoplasia and CRC were found in 137 (9.3%) and 14 (0.9%), respectively. From FIT25 to FIT200, the positivity rate decreased from 18% to 4.9%. For advanced neoplasia, an increased cut-off decreased sensitivity from 42.3% to 16.8% but increased specificity from 84.2% to 96.3%. The increased cut-off increased the positive predictive value (PPV) from 21.5% to 31.5%. However, all cut-off points provided a high negative predictive value (NPV) (>90%). For CRC, the miss rate for FIT25 to FIT 150 was the same (n=3, 21%), whereas that with FIT200 increased to 35% (n=5). Conclusions: In a country with limited-colonoscopy resources, using FIT150 may be preferred because it offers both high PPV and NPV for advanced neoplasia detection. It could also decrease colonoscopy workload, while maintaining a CRC miss rate similar to those with lower cut-offs.     

南昌地区2 889例大肠息肉的临床病理分析

目的：了解南昌为主要区域的大肠息肉的临床病理特点及其变化趋势。方法：回顾性调查我院1990年1月至2004年12月15年间行结肠镜检查确诊的大肠息肉患者，分析其临床病理特点及其变化趋势。结果：15年来共行结肠镜检21853例．确诊的大肠息肉共2889例，大肠息肉患者的检出率为13．2％，平均发病年龄为46．6±16．5岁男女比例为1.8：1，男性患者平均年龄大于女性（47．1±17．5与45．5±14．5，P〈0．05）。直肠是大肠息肉的最常见部位．占41％，然后为乙状结肠27．7％，左半结肠息肉多于右半结肠息肉（35．8％与23．1％，P〈0．05）。腺瘤型息肉是最常见的息肉类型（67％）。幼年型息肉患者平均年龄最小（12．0~4．8岁，P〈O．05）．腺瘤型息肉患者的平均年龄最大（52．0±14．0岁，P〈0．05），结肠息肉病占息肉患者的1．2％，伴癌发生的息肉占6．1％。比较15年来息肉的临床病理特点发现．近年来大肠息肉的检出率明显增加：患者的平均年龄增加：腺瘤性息肉增多而炎性息肉、潴留性息肉减少。结论：大肠息肉是大肠的常见疾病，男性发病率多于女性；直肠和乙状结肠是息肉的最常见发生部位；少儿主要是潴留型息肉、幼年型息肉，成年主要是腺瘤型息肉．近年来南昌地区大肠息肉的检出率明显增加；患者的平均年龄增加：腺瘤性息肉增多而炎性息肉、潴留性息肉减少。     

Clinicopathological Patterns of Colorectal Cancer in Tunisia

Introduction: Colorectal cancer is the third most commonly diagnosed cancer worldwide. Design: In orderto review the clinical and pathological features of colorectal cancer in Tunisia, a retrospective study was carriedout on 1,443 cancer cases diagnosed in the Pathology Department, Farhet Hached University Hospital of Sousse,for a 15-year period (1993-2007). Results: The median age was 61 years. Adenocarcinoma was the most frequent(90.9%) with moderately differentiated tumors accounting for 76.7% of cases. Only eighty patients were identifiedas being in early stages (0 and A) and 85.8% in advanced stages (B-D). Over time, we observed a significantdecrease of stage B (p=0.02) and a significant increase of stage D (p=0.002). The tumor size was larger than 5cm in 67.5% of cases. Conclusion: The large proportion of patients presented at advanced stages, compared toonly 5.5% of patients at early stages, emphasizes the need to plan and develop a screening program for the earlydetection of this cancer and its precursor lesions in Tunisia.     

Implementation of Screening Colonoscopy amongst First-Degree Relatives of Patients with Colorectal Cancer in Turkey: a Cross-Sectional Questionnaire Based Survey

Objective: To evaluate the implementation of screening colonoscopy amongst first-degree relatives (FDRs)of patients with colorectal cancer (CRC) in Turkey. Materials and Methods: A total of 400 first-degree relatives(mean(SD)age: 42.5(12.7) years, 55.5% were male) of 136 CRC patients were included in this cross-sectionalquestionnaire based survey. Data on demographic characteristics, relationship to patient and family history formalignancy other than the index case were evaluated in the FDRs of patients as were the data on knowledge aboutand characteristics related to the implementation of screening colonoscopy using a standardized questionnaireform. Results: The mean(SD) age at diagnosis of CRC in the index patients was 60.0(14.0) years, while mean(SD)age of first degree relatives was 42.5(12.7) years. Overall 36.3% of relatives were determined to have knowledgeabout colonoscopy. Physicians (66.9%) were the major source of information. Screening colonoscopy wasrecommended to 19.5% (n=78) of patient relatives, while 48.7% (n=38) of individuals participated in colonoscopyprocedures, mostly (57.9%) one year after the index diagnosis. Screening colonoscopy revealed normal findingsin 25 of 38 (65.8%) cases, while precancerous lesions were detected in 26.3% of screened individuals. In 19.0% ofFDRs of patients, there was a detected risk for Lynch syndrome related cancer. Conclusions: In conclusion, ourfindings revealed that less than 20% of FDRs of patients had received a screening colonoscopy recommendation;only 48.7% participated in the procedure with detection of precancerous lesions in 26.3%. Rise of awarenessabout screening colonoscopy amongst patients with CRC and first degree relatives of patients and motivationof physicians for targeted screening would improve the participation rate in screening colonoscopy by FDRs ofpatients with CRC in Turkey.     

Preferences and Acceptance of Colorectal Cancer Screening in Thailand

Colorectal cancer (CRC) is now common in Thailand with an increase in incidence over time. Health authoritiesare planning to implement a nationwide CRC screening program using fecal immunochemical test (FIT) as aprimary screening tool. This study aimed to estimate preferences and acceptance of FIT and colonoscopy, explorefactors influencing the acceptance, and investigate reasons behind choosing and rejecting to screen before theprogram was implemented. Patients aged 50-69, visiting the primary care unit during the study period, wereinvited to join this study. Patients with a history of cancer or past CRC screening were excluded. Face-to-faceinterviews were conducted. Subjects were informed about CRC and the screening tests: FIT and colonoscopy.Then, they were asked for their opinions regarding the screening. The total number of subjects was 437 (86.7%response rate). Fifty-eight percent were females. The median age was 58 years. FIT was accepted by 74.1% ofsubjects compared to 55.6% for colonoscopy. The acceptance of colonoscopy was associated with perceivedsusceptibility to CRC and family history of cancer. No symptoms, unwilling to screen, healthy, too busy and anxiousabout diagnosis were reasons for refusing to screen. FIT was preferred for its simplicity and non-invasivenesscompared with colonoscopy. Those rejecting FIT expressed a strong preference for colonoscopy. Subjects chosecolonoscopy because of its accuracy; it was refused for the process and complications. If the screening programis implemented for the entire target population in Thailand, we estimate that 106,546 will have a positive FIT,between 8,618 and 12,749 identified with advanced adenoma and between 2,645 and 3,912 identified with CRCin the first round of the program.     

Poor Knowledge of Colorectal Cancer in Brunei Darussalam

Background: Colorectal cancer (CRC) is the most common gastrointestinal cancer and the incidence isincreasing in many developing countries. While it can be detected early and even prevented through screeningand removal of premalignant lesions, there are barriers to screening which include low level of knowledge andawareness of CRC. This study assessed the level of knowledge of CRC in Brunei Darussalam. Materials andMethods: A total of 431 (262 male and 161 female) subjects participated in this questionnaire study. Subjectswere scored on their knowledge of signs/symptoms (maximum 10 correct answers) and known risk factors forCRC (maximum 10 correct answers) and were categorised into poor (0-2), moderate (3-4) and satisfactory (5-10).Comparisons were made between the various patient factors. Results: Overall, 54.1% could not name any CRCsigns/symptoms or associated risk factors. Most were not aware of any screening modalities. The overall scoresfor CRC signs/symptoms and risk factors were 1.3±1.39 (range 0-6) and 0.6±1.05 (range 0-5) respectively. Overall,the breakdown of scores was: poor (78.1%), moderate (20.3%) and satisfactory (6.2%) for signs/symptoms andpoor (93.2%), moderate (6.2%) and satisfactory (0.7%) for risk factors. Higher level of education, female genderand non-Malay race were associated with higher scores for both signs/symptoms and knowledge of screeningmodality; however the overall scores were low. Conclusions: Our study showed that the general knowledge ofCRC in Brunei Darussalam is poor. Being female, with higher levels of education and non-Malay race wereassociated with higher scores, but they were still generally poor. More needs to be done to increase the publicknowledge and awareness of CRC.     

Motivating Underserved Vietnamese Americans to Obtain Colorectal Cancer Screening: Evaluation of a Culturally Tailored DVD Intervention

Background: Colorectal cancer (CRC) is a leading cause of cancer death among Vietnamese Americans, yetscreening remains underutilized. We investigated the effectiveness of a culturally tailored DVD intervention inpromoting CRC screening among unscreened Vietnamese Americans age 50 and over. Materials and Methods:Using a community-based participatory research approach, we conducted a trial comparing twenty-eightsubjects who received a mailed DVD in Vietnamese, with twenty-eight subjects who received a mailed brochurein Vietnamese. Subjects completed telephone surveys at baseline, One-month, and one-year. The primaryoutcome was receipt of screening. Secondary measures were participants’ knowledge, attitudes, and beliefs aboutCRC screening. Two focus groups explored the intervention’s acceptability and effectiveness. Results: At oneyear, CRC screening rates of 57.1% and 42.9% were observed in experimental and control group respectively(p=0.42), Subjects in both groups showed increased knowledge about CRC after one month. Focus group findingsrevealed that the DVD was an effective method of communicating information and would help promote screening.Conclusions: The findings suggest that culturally tailored, linguistically appropriate content is more importantthan the type of media used. This relatively low intensity, low cost intervention utilizing a DVD can be anotheruseful method for outreach to the often hard-to-reach unscreened population.     

Main Risk Factors Association with Proto-Oncogene Mutations in Colorectal Cancer

Objective: Although several factors have been shown to have etiological roles in colorectal cancer, few investigationshave addressed how and to what extent these factors affect the genetics and pathology of the disease. Precise relationshipswith specific genetic mutations that could alter signaling pathways involved in colorectal cancer remain unknown.We therefore aimed to investigate possible links between lifestyle, dietary habits, and socioeconomic factors and specificmutations that are common in colorectal cancers. Methods: Data were retrieved from a baseline survey of lifestyle factors,dietary behavior, and SES, as well as anthropometric evaluations during a physical examination, for 100 confirmedprimary sporadic colorectal cancer patients from Northwest Iran. Results: High socioeconomic status was significantlyassociated with higher likelihood of a KRAS gene mutation (P < 0.05) (odds ratio: 3.01; 95% CI: 0.69–13.02). Consumingcarbohydrates and alcohol, working less, and having a sedentary lifestyle also increased the odds of having a KRASmutation. Conclusion: Although research has not yet described the exact relationships among genetic mutations withdifferent known risk factors in colorectal cancer, examples of the latter may have an impact on KRAS gene mutations.     

The Accuracy of Fecal Immunochemical Test in Colorectal Cancer Screening: A Meta-Analysis

Objective: To investigate the accuracy of OC-Sensor and colorectal cancer screening in a population-based randomized controlled trial at Khon Kaen province, Thailand. Methods: The MOOSE Guidelines for Systematic Reviews and Meta-Analyses of Observational Studies was applied. Eligibility criteria were English language, hand searching was conducted using Medline databases from 2010 to 2021 for identify literatures reviews of OC-Sensor and colorectal cancer screening. The initials screen based on the research titles and abstracts, final screenings based on full-text reports. Synthesis the results with meta-analysis using fixed effect model, random effect model, determined statistically significant with p-value < 0.05.  Confirmed the pooled effect sizes of high heterogeneity by meta-regression including tested precision of each estimates by bubble plot using STATA version 14. Results: Meta-regression showed sensitivity of OC- sensor = 72.54% (95% CI: 65.82-79.25), and specificity of OC- sensor = 89.59% (95% CI: 87.23-91.95). Conclusions: Sample size and cut-off of fecal hemoglobin concentration in each study were differed but sub-group analysis and sensitivity analysis were not considered for this analysis because population, setting and location for detected cancer of included study are not differences.     

Knowledge of Colorectal Cancer Screening among YoungMalaysians

The objective of this study was to determine the knowledge and associated factors regarding colorectal cancerscreening among university students in Malaysia. The questionnaire consisted of three parts: socio-demographiccharacteristics, lifestyle practice and knowledge of colorectal screening. A cross-sectional study was conductedamong 300 students (21.3±1.4 years old). The majority of the participants were Malay with a monthly familyincome of less than 5,000 Ringgit Malaysia (equal to 1,700 USD) (67.0% and 76.0%, respectively). Regardingtheir lifestyle practices, the majority were non-smokers and had never consumed alcohol (83.7%, and 88.0%,respectively). The majority of the participants had no knowledge of digital rectal examination, colonoscopy,barium enema and fecal occult blood screening (63.3%, 60.7%, 74.0% and 62.3%, respectively). Univariate andmultivariate analysis revealed that their age and the discipline which the students were studying significantlyinfluenced their level of knowledge about colorectal screening. The present study results indicate that educationcampaigns about colorectal cancer should be promoted.     

Presence of Human Papillomavirus DNA in Colorectal Cancer Tissues in Shiraz,Southwest Iran

Background: Colorectal cancer is one of the most common cancers worldwide. Viruses including human papillomavirus (HPV) have been reported to be associated with different cancers but any association with colorectal cancers remains controversial. Aim: To evaluate any association between HPV infection and adenocarcinoma of the colon and adenomatous polyps. Materials and Methods: Paraffin-embedded tissue specimens of 70 colorectal adenocarcinomas, 70 colorectal adenomatous polyps, and 70 colorectal normal tissues were subjected to DNA extraction. The quality of the extracted DNA was confirmed by amplification of a β-globin fragment using polymerase chain reaction (PCR). PCR using specific primers were performed to detect HPV DNA. Specific primers targeting the E6 region of the HPVs 16 and 18 were used for genotyping. Results: HPV DNA was detected in 2 (2.85%) out of 70 adenocarcinoma colorectal tissues and 4 (5.71 %) out of 70 adenomatous colorectal tissues. All normal colorectal tissues were negative for HPV DNA. HPV-16 was the most predominant genotype (5 sample) followed by HPV-18 (4 sample). Despite the above observations, statistical analyses indicated no significant differences in the frequencies of HPV positive subjects between the cancerous and normal samples. Conclusions: Although the differences observed in the frequencies of HPV positive cases in our study was not significant relative to those of control subjects, the fact of 6 positive samples among cancerous tissues, may still suggest a role of HPV in colorectal carcinogenesis. The study collectively indicated that some colorectal cancerous tissues are infected with high risk HPV genotype. The findings merit more investigation.