Colorectal (Bowel) Cancer
Colorectal cancer (or bowel cancer) is one of the most common types of cancer in both men and women. Approximately four fifths of these cancers are found in the colon (large intestine), and one fifth in the rectum. Prevention and early detection of colorectal cancer is important. Some of most common symptoms include a change in bowel habit (eg. constipation, and bleeding), mucus discharge, and discomfort or pain in the lower abdomen. The vast majority of colon and rectum cancers are adenocarcinomas, around 10% of these are mucinous (protein contained in mucus). The median age at diagnosis is 70, age adjusted incidence rates are slightly higher in males compared to females. A substantial proportion of cases are in those with a genetic predisposition to colorectal cancer. Diet may also have an influence on the incidence of colorectal cancer, diatry fibre, retinoids, and calcium are thought to be protective, while high intake of animal fats may increases risk. Colorectal cancer may develop from benign polyps (a polyp is a tumour on a stem most commonly found on mucous membranes). World-wide about 782,000 people are diagnosed with colorectal cancer each year.
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Herdiatry Colorectal Cancers
Screening for Colorectal (Bowel) Cancer
Prevention of Colorectal (Bowel) Cancer
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MeSH term: Colorectal Neoplasms
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Herdiatry Colorectal Cancers (5 links)Between 15-20% of all colorectal cancers are thought to be familial. Some types of colon cancers and pre-disposing conditions are known to have an inherited element, in particular, Lynch Syndrome (hereditary non-polyposis colon cancer, HNPCC) and familial adenomatous polyposis (FAP).
This list of publications is regularly updated (Source: PubMed).
Colonic Schwannoma: A Case Study and Literature Review of a Rare Entity and Diagnostic Dilemma.
Am Surg. 2016; 82(12):1183-1186 [PubMed] Related Publications
Lymph Node Micrometastasis Cannot Be Considered as Positive Lymph Node in Nonmetastatic Colorectal Cancer.
Am Surg. 2017; 83(2):127-133 [PubMed] Related Publications
Differential expression of hENT1 and hENT2 in colon cancer cell lines.
Genet Mol Res. 2017; 16(1) [PubMed] Related Publications
Mutations in codons 12 and 13 of K-ras exon 2 in colorectal tumors of Saudi Arabian patients: frequency, clincopathological associations, and clinical outcomes.
Genet Mol Res. 2017; 16(1) [PubMed] Related Publications
Tumor-suppressive role of Kruppel-like factor 4 (KLF-4) in colorectal cancer.
Genet Mol Res. 2017; 16(1) [PubMed] Related Publications
The Ferguson Operating Anoscope for Resection of T1 Rectal Cancer.
Am Surg. 2016; 82(11):1105-1108 [PubMed] Related Publications
National Disparities in Surgical Approach to T1 Rectal Cancer and Impact on Outcomes.
Am Surg. 2016; 82(11):1080-1091 [PubMed] Related Publications
Paget's disease of the anus masking a mixed adenoneuroendocrine tumour of the rectum.
BMJ Case Rep. 2017; 2017 [PubMed] Related Publications
Expression Analysis of Previously Verified Fecal and Plasma Dow-regulated MicroRNAs (miR-4478, 1295-3p, 142-3p and 26a-5p), in FFPE Tissue Samples of CRC Patients.
Arch Iran Med. 2017; 20(2):92-95 [PubMed] Related Publications
METHODS: In this study, we evaluated the expression levels of miR-142-3p, miR-26a-5p (their reduced expression in plasma samples of CRC patients was previously confirmed), miR-4478 and miR-1295-3p (their reduced expression in stool samples of CRC patients was previously confirmed) in tissue samples of CRC patients in comparison to healthy subjects. To achieve this purpose, total RNA including small RNA was extracted from 53 CRC and 35 normal subjects' Formalin-fixed, Paraffin-embedded (FFPE) tissue samples using the miRNeasy FFPE Mini Kit. The expression levels of these four selected miRNAs were measured using quantitative Reverse Transcriptase Polymerase Chain Reaction (qRT-PCR).
RESULTS: We found that the expression levels of miR-4478 and miR-1295b-3p (two previously down-regulated fecal miRNAs) were significantly decreased in FFPE samples of CRC patients compared to healthy controls. On the other hand, no significant differences were seen in expression levels of miR-142-3p and miR-26a-5p (two previously down-regulated circulating miRNAs) in FFPE samples between these two groups.
CONCLUSION: Regarding current findings, it may be concluded that to diagnose CRC patients based on the miRNAs approach, stool samples are more likely preferable to plasma samples; nevertheless, additional studies with more samples are needed to confirm the results.
Prevalence and Anatomic Distribution of Serrated and Adenomatous Lesions in Patients with Inflammatory Bowel Disease.
Can J Gastroenterol Hepatol. 2017; 2017:5490803 [PubMed] Free Access to Full Article Related Publications
Accuracy of FDG-PET/CT in Colorectal Peritoneal Carcinomatosis: Potential Tool for Evaluation of Chemotherapeutic Response.
Anticancer Res. 2017; 37(2):929-934 [PubMed] Related Publications
PATIENTS AND METHODS: This retrospective study compared the performance of FDG-PET/CT for PC diagnosis in 26 patients with CRC with histopathologically-confirmed PC with a control group of 26 patients. An FDG-PET/CT score established for each patient diagnosed with PC was compared with the peritoneal cancer index (PCI) performed during surgery.
RESULTS: The sensitivity and specificity of FDG-PET/CT for PC detection were 85% (22/26) and 88% (23/26), respectively. The most scored quadrant by FDG-PET/CT corresponded to the most scored quadrant at surgery in 77.3%.
CONCLUSION: FDG-PET/CT may represent a useful tool for evaluating response to neoadjuvant chemotherapy in patients with PC of CRC origin.
Factors Associated with the Lack of Adjuvant Chemotherapy Following Curative Surgery for Stage II and III Colon Cancer: A Korean National Cohort Study.
Anticancer Res. 2017; 37(2):915-922 [PubMed] Related Publications
PATIENTS AND METHODS: A total of 8,412 patients diagnosed with stage II or III disease who underwent curative resection were included.
RESULTS: Adjuvant chemotherapy was not administered in 3,057 cases (36.34%). Factors associated with the lack of chemotherapy were older age [hazard ratio (HR)=1.50 in patients 65-74 years and 5.23 in patients ≥75 years of age], female sex (HR=1.15), tumor-node-metastasis (TNM) stage II (HR=4.28), emergency surgery (HR=1.45), American Society of Anesthesiologists (ASA) score of 3 or higher (HR=1.62), fewer than 12 lymph nodes examined (HR=1.19), a greater quantity of transfusion (HR=1.08), and hospital type (tertiary referral center) (HR=1.62).
CONCLUSION: Patient-related (older age, female sex, and ASA score of 3 or higher) and treatment-related factors (TNM stage II, emergency surgery, fewer than 12 lymph nodes examined, a greater quantity of transfusion, and hospital type) influenced the lack of adjuvant chemotherapy. Given that the use of adjuvant chemotherapy improves overall survival, physicians should make an effort to increase the proportion of patients receiving chemotherapy after surgery.
Carbohydrate Antigen 19-9 Predicts Synchronous Peritoneal Carcinomatosis in Patients with Colorectal Cancer.
Anticancer Res. 2017; 37(2):865-870 [PubMed] Related Publications
PATIENTS AND METHODS: The cases of 395 CRC patients who underwent primary lesion resection were retrospectively reviewed. Risk factors were evaluated by uni- and multivariate analyses from clinicopathological data.
RESULTS: In the univariate analysis, tumor invasion (p<0.001), lymph node and hematogenous metastases (p=0.037 and p<0.001, respectively), and elevated preoperative serum CA19-9 level (p<0.001) were associated with synchronous PC, and multiple regression analysis revealed that an elevated preoperative serum CA19-9 level was an independent risk factor for PC (odds ratio=5.03, 95% confidence interval=1.29-19.60, p=0.020).
CONCLUSION: Elevated preoperative serum CA 19-9 level may be useful in predicting synchronous PC in patients with CRC.
Correlation of Blood T-Cells to Intratumoural Density and Location of CD3(+) and CD8(+) T-Cells in Colorectal Cancer.
Anticancer Res. 2017; 37(2):675-683 [PubMed] Related Publications
MATERIALS AND METHODS: A total of 18 patients with stage I-III colorectal cancer (CRC) were included. Blood was analyzed for T-cell type (CD3(+), CD4(+) and CD8(+)) and count using flow cytometry. Intratumoural T-cells were stained using immunohistochemistry and quantified by digital pathology. Tumour location was defined as invasive front (IF) or tumour center (TC).
RESULTS: The number of CD3(+) and CD4(+) T-cells in pre-surgical blood samples correlated with the number of CD3(+) T-cells found in the IF (Spearman ϱ=0.558, p<0.05 and 0.598, p<0.01 respectively) and CD3(+) in the TC (ϱ=0.496, p<0.05, and ϱ=0.637, p<0.01, respectively). A strong correlation was found between CD4(+) cells in blood and CD8(+) T-cells found in the TC and IF (ϱ=0.602 and ϱ=0.591, p<0.01).
CONCLUSION: There is a correlation between blood CD3(+) and CD4(+) T-cells and the T-cells found at the TC and IF.
Clinical Significance of Methylation and Reduced Expression of the Quaking Gene in Colorectal Cancer.
Anticancer Res. 2017; 37(2):489-498 [PubMed] Related Publications
MATERIALS AND METHODS: Oligonucleotide microarray expression profiling was carried out on a panel of primary CRC specimens (n=17) and CRC cell lines (n=5), followed by methylation analysis using methylation-specific polymerase chain reaction. QKI expression levels were assessed in 156 primary CRCs by qRT-PCR and immunohistochemistry.
RESULTS: Low QKI expression was observed in 47.7% in CRCs. QKI promoter methylation was detected in 32.1% of patients with CRC, and in these patients mRNA expression in tumor tissue was significantly down-regulated compared to matched normal tissues (p=0.049). There was a significant relationship between low QKI expression and recurrence after surgery (p=0.004). Low QKI expression was an independent risk factor for recurrence after surgery in 153 patients with CRC without distant metastases (p=0.036).
CONCLUSION: Patients with tumors expressing low levels of QKI experienced significantly higher rates of tumor recurrence after curative surgery and worse prognoses. Methylation of the QKI promoter and concomitant reduced expression of QKI mRNA may be important for CRC initiation and progression. Loew QKI expression may be a useful clinical biomarker for predicting recurrence and prognosis.
Salinomycin Abolished STAT3 and STAT1 Interactions and Reduced Telomerase Activity in Colorectal Cancer Cells.
Anticancer Res. 2017; 37(2):445-453 [PubMed] Related Publications
MATERIALS AND METHODS: Co-immunoprecipitation was performed to examine STAT3-STAT1 protein interactions. Telomerase activity was measured by polymerase chain reaction (PCR) and ELISA assays. Apoptosis and cell stress arrays were analyzed to identify key proteins responding to salinomycin treatments.
RESULTS: IL-6 and TNF-α induced STAT3 and STAT1 interactions, however the interactions were abolished by salinomycin challenge. Salinomycin reduced cancer stem cell phenotype and decreased telomerase activity of colorectal cancer cells.
CONCLUSION: Our work uncovers a new mechanism through which salinomycin inhibits cancer stemness suggesting a novel targeted-therapy for metastatic colorectal cancer.
Systematic Review of Pelvic Exenteration With En Bloc Sacrectomy for Recurrent Rectal Adenocarcinoma: R0 Resection Predicts Disease-free Survival.
Dis Colon Rectum. 2017; 60(3):346-352 [PubMed] Related Publications
OBJECTIVE: The purpose of this study was to evaluate clinical outcome measures and complication rates following sacrectomy for recurrent rectal cancer.
DATA SOURCES: A search was conducted on Pub Med for English language articles relevant to sacrectomy for recurrent rectal cancer with no time limitations.
STUDY SELECTION: Studies reported sacrectomy with survival data for recurrent rectal adenocarcinoma.
MAIN OUTCOME MEASURE: Disease-free survival following sacrectomy for recurrent rectal cancer was the main outcome measured.
RESULTS: A total of 220 patients with recurrent rectal cancer were included from 7 studies, of which 160 were men and 60 were women. Overall median operative time was 717 (570-992) minutes and blood loss was 3.7 (1.7-6.2) L. An R0 (>1-mm resection margin) resection was achieved in 78% of patients. Disease-free survival associated with R0 resection was 55% at a median follow-up period of 33 (17-60) months; however, none of the patients with R1 (<1-mm resection margin) survived this period. Postoperative complication rates and median length of stay were found to decrease with more distal sacral transection levels. In contrast, R1 resection rates increased with more distal transection.
LIMITATION: The studies assessed by this review were retrospective case series and thus are subject to significant bias.
CONCLUSION: Sacrectomy performed for patients with recurrent rectal cancer is associated with significant postoperative morbidity. Morbidity and postoperative length of stay increase with the level of sacral transection. Nevertheless, approximately half of patients eligible for rectal excision with en bloc sacrectomy may benefit from disease-free survival for up to 33 months, with R0 resection predicting disease-free survival in the medium term.
Outcome and Salvage Surgery Following "Watch and Wait" for Rectal Cancer after Neoadjuvant Therapy: A Systematic Review.
Dis Colon Rectum. 2017; 60(3):335-345 [PubMed] Related Publications
OBJECTIVE: The aim of this study is to assess the rate of salvage surgery and associated oncological outcomes for patients who develop a tumor regrowth with the "watch and wait" approach.
DATA SOURCES: Relevant studies were identified through PubMed, Embase, and Google Scholar search.
STUDY SELECTION: A systematic review was undertaken of studies assessing patients selected for the "watch and wait" approach according to PRISMA guidelines.
MAIN OUTCOME MEASURES: The associated tumor regrowth, salvage surgery, and disease-free and overall survival rates were assessed.
RESULTS: Five retrospective and 4 prospective observational studies were included into the analysis, with a total of 370 patients in the "watch and wait" group, of which 256 (69.2%) had persistent clinical complete response. Of those who had tumor regrowth, salvage surgery was possible in 83.8%. There was no difference in overall survival and disease-free survival between patients who received immediate surgery and the "watch and wait" group.
LIMITATIONS: The limitations of this study include its retrospective nature and small sample size. Furthermore, there is significant heterogeneity between study protocols, including the short median follow-up, given that tumor regrowth and distant metastasis may manifest at a later time point.
CONCLUSION: The majority of patients with tumor regrowth can be salvaged with definite surgery after "watch and wait." However, there is insufficient evidence to draw firm conclusions on the oncological safety of this approach; therefore, it is currently not the standard of care for locally advanced rectal cancer.
Early Postoperative Decrease of Serum Albumin Predicts Surgical Outcome in Patients Undergoing Colorectal Resection.
Dis Colon Rectum. 2017; 60(3):326-334 [PubMed] Related Publications
OBJECTIVE: The purpose of this study was to evaluate whether the reduction in serum albumin within 2 postoperative days compared with the preoperative level could serve as an independent predictor of postoperative complications after colorectal surgery.
DESIGN: This was a retrospective study from a single institution.
SETTINGS: The study was conducted in a tertiary referral hospital.
PATIENTS: A total of 626 patients undergoing major colorectal surgery between December 2012 and January 2016 were eligible for this study.
MAIN OUTCOME MEASURES: Univariate and multivariate analyses were performed to identify risk factors for postoperative complications and to identify the factors associated with Δalbumin. Receiver operating characteristic curves were developed to examine the cutoff value of the change in albumin in predicting postoperative complications.
RESULTS: Among all of the patients, the median Δalbumin after surgery was 15%. ΔAlbumin was an independent risk factor for overall complications (p < 0.01). The cutoff value was 15%, and an increased area under the curve compared with C-reactive protein occurred on postoperative day 3 or 4. Patients with a Δalbumin ≥15% experienced more postoperative major complications, a higher comprehensive complication index, a longer postoperative stay, and increased surgical site infections (p < 0.05) than those <15%. ΔAlbumin correlated with sex, type of surgery, stoma creation, C-reactive protein on postoperative day 3 or 4, and intraoperative blood transfusion. Postoperative C-reactive protein remained independently associated with Δalbumin (p < 0.01).
LIMITATIONS: The study was limited by its retrospective nature.
CONCLUSIONS: A cutoff value of a 15% reduction in serum albumin within 2 postoperative days could help to identify patients with a high probability of postoperative complications and permit safe and early discharge after colorectal surgery.
Short- and Long-term Outcomes of Laparoscopic Total Mesenteric Excision for Neuroendocrine Tumors of the Rectum.
Dis Colon Rectum. 2017; 60(3):284-289 [PubMed] Related Publications
OBJECTIVE: The purpose of this study was to investigate the short- and long-term outcomes of patients who underwent laparoscopic rectal resection plus total mesenteric excision for rectal neuroendocrine tumors at our institution.
DESIGN: This was a single center, retrospective study.
SETTINGS: The study was conducted at a tertiary care facility.
PATIENTS: Eight-two patients with neuroendocrine tumors who underwent rectal resection with total mesenteric excision, 77 laparoscopically, between June 2005 and August 2015 were included.
INTERVENTIONS: Laparoscopic rectal resection and total mesenteric excision were the study interventions.
MAIN OUTCOME MEASURES: Demographic characteristics and surgical and postoperative outcomes were measured.
RESULTS: Median tumor size was 8.8 mm (range, 3.0-35.0 mm); 63.6% of tumors were located in the lower rectum, with the median distance from the tumor to the anal verge being 50.0 mm (range, 20.0-130.0 mm). Anal preservation was achieved in all of the patients. Anastomotic leakage occurred in 5 patients (6.5%), but there were no deaths. Seventy-one patients (92.2%) had tumor invasion confined to the submucosa. Lymph node metastasis was present in 29 patients (37.7%), including 26 (33.8%) with perirectal and 5 (6.5%) with lateral lymph node metastasis. The median follow-up period in 59 patients was 42 months (range, 11-113 months), and the 3-year overall survival rate was 97.8%.
LIMITATIONS: The study was limited by its single-center, retrospective analysis.
CONCLUSIONS: Laparoscopic rectal resection with total mesenteric excision is safe in patients with rectal neuroendocrine tumors, with good short- and long-term outcomes. Because rectal neuroendocrine tumors are smaller and show superficial invasion, the rate of anal preservation may be high.
Accuracy of MRI in Restaging Locally Advanced Rectal Cancer After Preoperative Chemoradiation.
Dis Colon Rectum. 2017; 60(3):274-283 [PubMed] Related Publications
OBJECTIVE: The purpose of this study was to determine the accuracy of MRI in restaging locally advanced rectal cancer after preoperative chemoradiation.
DESIGN: This was a retrospective study.
SETTINGS: The study was conducted in a Dutch high-volume rectal cancer center.
PATIENTS: A consecutive cohort of 48 patients with locally advanced rectal cancer treated with a curative intent was identified.
MAIN OUTCOME MEASURES: Three readers independently evaluated the MRI both for primary staging and for restaging after preoperative chemoradiation and were blinded to results from the other readers as well as histological results. Interobserver variability was determined. Accuracy of the restaging MRI was assessed through the comparison of tumor characteristics on MRI with histopathologic outcomes.
RESULTS: T stage was correctly predicted by the 3 readers in 47% to 68% and N stage in 68% to 70%. Overstaging was more common than understaging. Positive predictive values (PPV) among the 3 readers for T0 were 0%, and negative predictive values (NPVs) varied from 84% to 85%. For T1/2, PPVs and NPVs were 50% to 67% and 72% to 90%, and for T3/4 they were 54% to 62% and 33% to 78%. PPVs and NPVs for N0 stage were 81% to 95% and 58% to 73%. Tumor regression grade on MRI did not correspond with histopathologic tumor regression grade; PPVs for good response (tumor regression grade on MRI 1-2) were 48% to 61%, and NPVs were 42% to 58%. Interobserver agreement was fair to moderate for T stage, N stage, and tumor response (κ = 0.20-0.41) and fair to substantial for the relation with the mesorectal fascia (κ = 0.33-0.77). In none of the patients was the surgical plan changed after the restaging MRI.
LIMITATIONS: This study was limited by its small sample size and retrospective nature.
CONCLUSIONS: MRI has low accuracy for restaging locally advanced rectal cancer after preoperative chemoradiation, and the interobserver variability is significant.
Robotic Resection is a Good Prognostic Factor in Rectal Cancer Compared with Laparoscopic Resection: Long-term Survival Analysis Using Propensity Score Matching.
Dis Colon Rectum. 2017; 60(3):266-273 [PubMed] Related Publications
OBJECTIVE: The aim of this study is to evaluate long-term oncologic outcomes of robotic total mesorectal excision compared with laparoscopic total mesorectal excision.
DESIGN: This was a retrospective study.
SETTINGS: This study was conducted in a tertiary referral hospital.
PATIENTS: A total of 732 patients who underwent totally robotic (n = 272) and laparoscopic (n = 460) total mesorectal excision for rectal cancer were included in this study.
MAIN OUTCOME MEASURES: We compared clinicopathologic outcomes of patients. In addition, short- and long-term outcomes and prognostic factors for survival were evaluated in the matched robotic and laparoscopic total mesorectal excision groups (224 matched pairs by propensity score).
RESULTS: Before case matching, patients in the robotic group were younger, more likely to have undergone preoperative chemoradiation, and had a lower tumor location than those in the laparoscopic group. After case matching most clinicopathologic outcomes were similar between the groups, but operative time was longer and postoperative ileus was more frequent in the robotic group. In the matched patients excluding stage IV, the overall survival, cancer-specific survival, and disease-free survival were better in the robotic group, but did not reach statistical significance. The 5-year survival rates for robotic and laparoscopic total mesorectal excision were 90.5% and 78.0% for overall survival, 90.5% and 79.5% for cancer-specific survival, and 72.6% and 68.0% for disease-free survival. In multivariate analysis, robotic surgery was a significant prognostic factor for overall survival and cancer-specific survival (p = 0.0040, HR = 0.333; p = 0.0161, HR = 0.367).
LIMITATIONS: This study has the potential for selection bias and limited generalizability.
CONCLUSIONS: Robotic total mesorectal excision for rectal cancer showed long-term survival comparable to laparoscopic total mesorectal excision in this study. Robotic surgery was a good prognostic factor for overall survival and cancer-specific survival, suggesting potential oncologic benefits.
Quality of Life and Functional Outcome After Transanal Abdominal Transanal Proctectomy for Low Rectal Cancer.
Dis Colon Rectum. 2017; 60(3):258-265 [PubMed] Related Publications
OBJECTIVE: The purpose of this study was to evaluate the quality of life and functional outcomes of patients after transanal abdominal transanal proctectomy.
DESIGN: This is a cross-sectional study.
SETTINGS: The study was conducted at a tertiary referral colorectal center.
PATIENTS: Patients who underwent transanal abdominal transanal proctectomy were included and surveyed using the Fecal Incontinence Quality of Life Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, the Quality of Life Questionnaire CR38 module, and a questionnaire designed by the authors to assess satisfaction with quality of life.
MAIN OUTCOME MEASURES: Quality of life, functional outcomes, and patient satisfaction were measured and compared by age, tumor level, and stage of the disease.
RESULTS: A total of 133 surveys were mailed, and 90 patients responded and were included in the study. Patient quality of life was not significantly different after surgery. Patients with more proximal tumors had better lifestyle, physical, and emotional scores. Older patients performed better on multiple levels, including coping, emotional, body image, future perspective, and digestive. Stage of disease had no impact on quality of life. Compared with reference values, patients who underwent transanal abdominal transanal proctectomy performed better on most of the components. All of patients preferred transanal abdominal transanal proctectomy over having a stoma based on their current anal sphincter function, and >97% of patients preferred transanal abdominal transanal proctectomy based on their current quality of life, sexual function, and level of activities.
LIMITATIONS: This study is limited by the lack of a comparison group and a potential selection bias.
CONCLUSIONS: Satisfaction with quality of life and functional outcomes is high after transanal abdominal transanal proctectomy. Older patients and those with more proximal tumors performed better. This patient population clearly preferred a sphincter-preserving option for treatment of their rectal cancer.
The lncRNA H19 Promotes Cell Proliferation by Competitively Binding to miR-200a and Derepressing β-Catenin Expression in Colorectal Cancer.
Biomed Res Int. 2017; 2017:2767484 [PubMed] Free Access to Full Article Related Publications
Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria.
Pan Afr Med J. 2016; 24:333 [PubMed] Free Access to Full Article Related Publications
METHODS: This is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 -July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria.
RESULTS: A total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%). The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis.
CONCLUSION: The study supports the present wisdom that polyps are clearly less prevalent in our environment when compared to the Western world. The increased prevalence with advancing age, in male subjects and of left sided lesions, is also in keeping with previous results from our environment. A case is also advanced for the increased deployment of endoscopy as a tool for the detection of these polyps and ultimately, the reduction of colorectal cancer in our population.
Pancreatic Metastasis from Rectal Cancer that was Diagnosed by Endoscopic Ultrasonography-guided Fine Needle Aspiration (EUS-FNA).
Intern Med. 2017; 56(3):301-305 [PubMed] Related Publications
The Features of Colorectal Tumors in a Patient with Li-Fraumeni Syndrome.
Intern Med. 2017; 56(3):295-300 [PubMed] Related Publications
Rectal Neuroendocrine Tumor G1 with a Solitary Hepatic Metastatic Lesion.
Intern Med. 2017; 56(3):289-293 [PubMed] Related Publications
Desmin detection by facile prepared carbon quantum dots for early screening of colorectal cancer.
Medicine (Baltimore). 2017; 96(5):e5521 [PubMed] Free Access to Full Article Related Publications
What Can We Learn from Epidemiological Studies in Inflammatory Bowel Disease?
Dig Dis. 2017; 35(1-2):69-73 [PubMed] Related Publications
CONCLUSIONS: The surgery rate in CD has decreased over the time period. The evidence on colectomy rate in UC is less conclusive. The RR of CRC in UC and CD is approximately doubled compared to that of the background population, but it seems to be decreasing in more recent cohorts.