Is "pelvic radiation disease" always the cause of bowel symptoms following prostate cancer intensity-modulated radiotherapy?

PubMed

Min, Myo; Chua, Benjamin; Guttner, Yvonne; Abraham, Ned; Aherne, Noel J; Hoffmann, Matthew; McKay, Michael J; Shakespeare, Thomas P

2014-02-01

Pelvic radiation disease (PRD) also widely known as "radiation proctopathy" is a well recognised late side-effect following conventional prostate radiotherapy. However, endoscopic evaluation and/or specialist referral for new or persistent post-prostate radiotherapy bowel symptoms is not routine and serious diagnoses may potentially be missed. Here we report a policy of endoscopic evaluation of bowel symptoms persisting >90 days post radiotherapy for prostate cancer. A consecutive series of 102 patients who had radical prostate intensity-modulated radiotherapy (IMRT)/image-guided radiotherapy (IGRT) and who had new or ongoing bowel symptoms or positive faecal occult blood tests (FOBT) on follow up visits more than three months after treatment, were referred for endoscopic examination. All but one (99%) had full colonoscopic investigation. Endoscopic findings included gastric/colonic/rectal polyps (56%), diverticular disease (49%), haemorrhoids (38%), radiation proctopathy (29%), gastritis/oesophagitis (8%) and rarer diagnoses, including bowel cancer which was found in 3%. Only four patients (4%) had radiation proctopathy without associated pathology and 65 patients (63%) had more than one diagnosis. If flexible sigmoidoscopy alone were used, 36.6% of patients and 46.6% patients with polyp(s) would have had their diagnoses missed. Our study has shown that bowel symptoms following prostate IMRT/IGRT are due to numerous diagnoses other than PRD, including malignancy. Routine referral pathways should be developed for endoscopic evaluation/specialist review for patients with new or persistent bowel symptoms (or positive FOBT) following prostate radiotherapy. This recommendation should be considered for incorporation into national guidelines. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A national cluster-randomised controlled trial to examine the effect of enhanced reminders on the socioeconomic gradient in uptake in bowel cancer screening.

PubMed

Raine, Rosalind; Moss, Sue M; von Wagner, Christian; Atkin, Wendy; Hans, Ines Kralj; Howe, Rosemary; Solmi, Francesca; Morris, Stephen; Counsell, Nicholas; Hackshaw, Allan; Halloran, Stephen; Handley, Graham; Logan, Richard F; Rainbow, Sandra; Smith, Steve; Snowball, Julia; Seaman, Helen; Thomas, Mary; Smith, Samuel G; McGregor, Lesley M; Vart, Gemma; Wardle, Jane; Duffy, Stephen W

2016-12-06

The NHS Bowel Cancer Screening Programme in England offers biennial guaiac faecal occult blood testing (gFOBt). There is a socioeconomic gradient in participation and socioeconomically disadvantaged groups have worse colorectal cancer survival than more advantaged groups. We compared the effectiveness and cost of an enhanced reminder letter with the usual reminder letter on overall uptake of gFOBt and the socioeconomic gradient in uptake. We enhanced the usual reminder by including a heading 'A reminder to you' and a short paragraph restating the offer of screening in simple language. We undertook a cluster-randomised trial of all 168 480 individuals who were due to receive a reminder over 20 days in 2013. Randomisation was based on the day of invitation. Blinding of individuals was not possible, but the possibility of bias was minimal owing to the lack of direct contact with participants. The enhanced reminder was sent to 78 067 individuals and 90 413 received the usual reminder. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation. Data were analysed by logistic regression with conservative variance estimates to take account of cluster randomisation. There was a small but statistically significant (P=0.001) increase in participation with the enhanced reminder (25.8% vs 25.1%). There was significant (P=0.005) heterogeneity of the effect by socioeconomic status with an 11% increase in the odds of participation in the most deprived quintile (from 13.3 to 14.1%) and no increase in the least deprived. We estimated that implementing the enhanced reminder nationally could result in up to 80 more people with high or intermediate risk colorectal adenomas and up to 30 more cancers detected each year if it were implemented nationally. The intervention incurred a small one-off cost of £78 000 to modify the reminder letter. The enhanced reminder increases overall uptake and reduces the

A national cluster-randomised controlled trial to examine the effect of enhanced reminders on the socioeconomic gradient in uptake in bowel cancer screening

PubMed Central

Raine, Rosalind; Moss, Sue M; von Wagner, Christian; Atkin, Wendy; Hans, Ines Kralj; Howe, Rosemary; Solmi, Francesca; Morris, Stephen; Counsell, Nicholas; Hackshaw, Allan; Halloran, Stephen; Handley, Graham; Logan, Richard F; Rainbow, Sandra; Smith, Steve; Snowball, Julia; Seaman, Helen; Thomas, Mary; Smith, Samuel G; McGregor, Lesley M; Vart, Gemma; Wardle, Jane; Duffy, Stephen W

2016-01-01

Background: The NHS Bowel Cancer Screening Programme in England offers biennial guaiac faecal occult blood testing (gFOBt). There is a socioeconomic gradient in participation and socioeconomically disadvantaged groups have worse colorectal cancer survival than more advantaged groups. We compared the effectiveness and cost of an enhanced reminder letter with the usual reminder letter on overall uptake of gFOBt and the socioeconomic gradient in uptake. Methods: We enhanced the usual reminder by including a heading ‘A reminder to you' and a short paragraph restating the offer of screening in simple language. We undertook a cluster-randomised trial of all 168 480 individuals who were due to receive a reminder over 20 days in 2013. Randomisation was based on the day of invitation. Blinding of individuals was not possible, but the possibility of bias was minimal owing to the lack of direct contact with participants. The enhanced reminder was sent to 78 067 individuals and 90 413 received the usual reminder. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation. Data were analysed by logistic regression with conservative variance estimates to take account of cluster randomisation. Results: There was a small but statistically significant (P=0.001) increase in participation with the enhanced reminder (25.8% vs 25.1%). There was significant (P=0.005) heterogeneity of the effect by socioeconomic status with an 11% increase in the odds of participation in the most deprived quintile (from 13.3 to 14.1%) and no increase in the least deprived. We estimated that implementing the enhanced reminder nationally could result in up to 80 more people with high or intermediate risk colorectal adenomas and up to 30 more cancers detected each year if it were implemented nationally. The intervention incurred a small one-off cost of £78 000 to modify the reminder letter. Conclusions: The enhanced reminder

When Good Evidence Is Not Enough: The Role of Context in Bowel Cancer Screening Policy in New Zealand

ERIC Educational Resources Information Center

Flitcroft, Kathy L.; Gillespie, James A.; Carter, Stacy M.; Trevena, Lyndal J.; Salkeld, Glenn P.

2011-01-01

Bowel cancer is a serious health problem in developed countries. Australia, the United Kingdom (UK) and New Zealand (NZ) reviewed the same randomised controlled trial evidence on the benefits and harms of population-based bowel cancer screening. Yet only NZ, with the highest age standardised rate of bowel cancer mortality, decided against…

Palliative surgery versus medical management for bowel obstruction in ovarian cancer

PubMed Central

Kucukmetin, Ali; Naik, Raj; Galaal, Khadra; Bryant, Andrew; Dickinson, Heather O

2014-01-01

Background Ovarian cancer is the sixth most common cancer among women and is usually diagnosed at an advanced stage. Bowel obstruction is a common feature of advanced or recurrent ovarian cancer. Patients with bowel obstruction are generally in poor physical condition with a limited life expectancy. Therefore, maintaining their QoL with effective symptom control is the main purpose of the management of bowel obstruction. Objectives To compare the effectiveness and safety of palliative surgery (surgery performed to control the cancer, reduce symptoms and improve quality of life for those whose cancer is not able to be entirely removed) and medical management for bowel obstruction in women with ovarian cancer. Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register, The Cochrane Central Register of Controlled trials (CENTRAL), Issue 1 2009, MEDLINE and EMBASE up to February 2009. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. Selection criteria Studies that compared palliative surgery and medical interventions, in adult women diagnosed with ovarian cancer who had either full or partial obstruction of the bowel. Randomised controlled trials (RCTs) and non-RCTs that used multivariable statistical adjustment for baseline case mix were eligible. Data collection and analysis Two review authors independently assessed whether potentially relevant studies met the inclusion criteria, abstracted data and assessed risk of bias. One non-randomised study was identified so no meta-analyses were performed. Main results The search strategy identified 183 unique references of which 22 were identified as being potentially eligible on the basis of title and abstract. Only one study met our inclusion criteria and was included in the review. It analysed retrospective data for 47 women who received either palliative surgery (n = 27) or medical management

Reasons for non-uptake and subsequent participation in the NHS Bowel Cancer Screening Programme: a qualitative study.

PubMed

Palmer, C K; Thomas, M C; von Wagner, C; Raine, R

2014-04-02

Screening for bowel cancer using the guaiac faecal occult blood test offered by the NHS Bowel Cancer Screening Programme (BCSP) is taken up by 54% of the eligible population. Uptake ranges from 35% in the most to 61% in the least deprived areas. This study explores reasons for non-uptake of bowel cancer screening, and examines reasons for subsequent uptake among participants who had initially not taken part in screening. Focus groups with a socio-economically diverse sample of participants were used to explore participants' experience of invitation to and non-uptake of bowel cancer screening. Participants described sampling faeces and storing faecal samples as broaching a cultural taboo, and causing shame. Completion of the test kit within the home rather than a formal health setting was considered unsettling and reduced perceived importance. Not knowing screening results was reported to be preferable to the implications of a positive screening result. Feeling well was associated with low perceived relevance of screening. Talking about bowel cancer screening with family and peers emerged as the key to subsequent participation in screening. Initiatives to normalise discussion about bowel cancer screening, to link the BCSP to general practice, and to simplify the test itself may lead to increased uptake across all social groups.

Octreotide as Palliative Therapy for Cancer-Related Bowel Obstruction That Cannot Be Removed by Surgery

ClinicalTrials.gov

2012-05-31

Colorectal Cancer; Constipation, Impaction, and Bowel Obstruction; Extrahepatic Bile Duct Cancer; Gastric Cancer; Gastrointestinal Stromal Tumor; Nausea and Vomiting; Ovarian Cancer; Pancreatic Cancer; Peritoneal Cavity Cancer; Small Intestine Cancer

Pharmacists' views on and experiences with bowel cancer screening kits in Auckland, New Zealand.

PubMed

Martini, Nataly; Basdew, Kamlika; Kammona, Ala; Shen, Amy; Taylor, Caragh; McIntosh, Timothy R; Barnes, Joanne

2014-08-01

To explore the views of New Zealand pharmacists on bowel cancer screening, particularly with regards to faecal occult blood testing (FOBT) kits, self-perceived knowledge on FOBT kits and barriers, motivators and experiences with selling and counselling consumers with respect to FOBT kits. Semi-structured interviews were conducted face to face or by telephone with 20 community pharmacists in the Auckland region. Interviews were recorded and transcribed verbatim and data were coded and analysed using NVivo software to identify key themes. Participant pharmacists believed that they were well placed to provide advice on FOBT kits to consumers. Barriers to selling the kits included cost and perceived lack of test sensitivity of the kits, poor consumer demand, pharmacists' lack of training and information, and a belief that selling FOBT kits was outside the pharmacists' scope of practice. Motivators to selling the kits included customer convenience, ease of use, confidence in the kits and embracing new roles for pharmacists. Pharmacists were concerned that use of the kits may increase the burden on the public health system through customer anxiety over test results; however, they agreed that there was a need for bowel cancer screening and awareness and that people concerned about bowel cancer should make visiting their general practitioner a priority. Pharmacists' views were mixed. Pharmacists' training and competence with respect to the provision of bowel cancer kits, and how a bowel cancer screening service can be developed to optimise public health outcomes, need to be addressed. © 2013 Royal Pharmaceutical Society.

Incidence, management, and course of cancer in patients with inflammatory bowel disease.

PubMed

Algaba, Alicia; Guerra, Iván; Marín-Jiménez, Ignacio; Quintanilla, Elvira; López-Serrano, Pilar; García-Sánchez, María Concepción; Casis, Begoña; Taxonera, Carlos; Moral, Ignacio; Chaparro, María; Martín-Rodríguez, Daniel; Martín-Arranz, María Dolores; Manceñido, Noemí; Menchén, Luis; López-Sanromán, Antonio; Castaño, Ángel; Bermejo, Fernando

2015-04-01

Patients with inflammatory bowel disease [IBD] are at increased risk for developing some types of neoplasia. Our aims were to determin the risk for cancer in patients with IBD and to describe the relationship with immunosuppressive therapies and clinical management after tumor diagnosis. Retrospective, multicenter, observational, 5-year follow-up, cohort study. Relative risk [RR] of cancer in the IBD cohort and the background population, therapeutic strategies, and cancer evolution were analyzed. A total of 145 cancers were diagnosed in 133 of 9100 patients with IBD (global cumulative incidence 1.6% vs 2.4% in local population; RR = 0.67; 95% confidence interval [CI]: 0.57-0.78). Patients with IBD had a significantly increased RR of non-melanoma skin cancer [RR = 3.85; 2.53-5.80] and small bowel cancer [RR = 3.70; 1.23-11.13]. After cancer diagnosis, IBD treatment was maintained in 13 of 27 [48.1%] patients on thiopurines, in 2 of 3 on methotrexate [66.6%], none on anti-TNF-α monotherapy [n = 6] and 4 of 12 [33.3%] patients on combined therapy. Rate of death and cancer remission during follow-up did not differ [p > 0.05] between patients who maintained the treatment compared with patients who withdrew [5% vs 8% and 95% vs 74%, respectively]. An association between thiopurines [p = 0.20] or anti-TNF-α drugs [p = 0.77] and cancer was not found. Patients with IBD have an increased risk for non-melanoma skin cancer and small bowel cancer. Immunosuppresive therapy is not related to a higher overall risk for cancer or worse tumor evolution in patients who maintain these drugs after cancer diagnosis. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Bowel, Urinary, and Sexual Problems Among Long-Term Prostate Cancer Survivors: A Population-Based Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mols, Floortje; Comprehensive Cancer Centre South; Korfage, Ida J.

Purpose: To obtain insight into the long-term (5- to 10-year) effects of prostate cancer and treatment on bowel, urinary, and sexual function, we performed a population-based study. Prostate-specific function was compared with an age-matched normative population without prostate cancer. Methods and Materials: Through the population-based Eindhoven Cancer Registry, we selected all men diagnosed with prostate cancer between 1994 and 1998 in the southern Netherlands. In total, 964 patients, alive in November 2004, received questionnaire; 780 (81%) responded. Results: Urinary problems were most common after a prostatectomy; bowel problems were most common after radiotherapy. Compared with an age-matched normative population bothmore » urinary and bowel functioning and bother were significantly worse among survivors. Urinary incontinence was reported by 23-48% of survivors compared with 4% of the normative population. Bowel leakage occurred in 5-14% of patients compared with 2% of norms. Erection problems occurred in 40-74% of patients compared with 18% of norms. Conclusions: These results form an important contribution to the limited information available on prostate-specific problems in the growing group of long-term prostate cancer survivors. Bowel, urinary, and sexual problems occur more often among long-term survivors compared with a reference group and cannot be explained merely by age. Because these problems persist for many years, urologists should provide patients with adequate information before treatment. After treatment, there should be an appropriate focus on these problems.« less

Association of meat and coffee use with cancers of the large bowel, breast, and prostate among Seventh-Day Adventists: preliminary results.

PubMed

Phillips, R L; Snowdon, D A

1983-05-01

Deaths from cancers of the large bowel, breast, and prostate were ascertained over a 21-year period among 21,295 white California Adventists. Compared to non-Adventists, the age-sex-adjusted mortality for large bowel cancer was substantially reduced among Adventists. Adventists also showed a minimum reduction in mortality for breast and prostate cancer. Fatal large bowel cancer within the Adventist group was unrelated to meat use. However, coffee use showed a substantial positive association with fatal large bowel cancer. Although this association may be indirect or spurious, it deserves further investigation. Weak nonsignificant associations were observed between cancers of the breast and prostate and meat use.

Large bowel resection

MedlinePlus

... blockage in the intestine due to scar tissue Colon cancer Diverticular disease (disease of the large bowel) Other reasons for bowel resection are: Familial polyposis (polyps are growths on the lining of the colon or rectum) Injuries that damage the large bowel ...

Resistant starch: a promising dietary agent for the prevention/treatment of inflammatory bowel disease and bowel cancer.

PubMed

Higgins, Janine A; Brown, Ian L

2013-03-01

Resistant starch represents a diverse range of indigestible starch-based dietary carbohydrates. Resistant starch has been investigated in the past for its effects on bowel health (pH, epithelial thickness, and apoptosis of colorectal cancer cells); reduction in postprandial glycemia; increased insulin sensitivity; and effects on the gut microbiome. This review highlights advances as resistant starch gains clinical relevance as a potential treatment/preventive tool for diseases such as colorectal cancer (CRC) and diabetes. Recent articles have evaluated the comparative physiological effects of different types of resistant starch and investigated the effects of resistant starch on blood lipids, body weight, and defining resistant starch-induced changes to the micriobiome that may be important in health and disease. The most novel and relevant recent data describe a role for resistant starch in ameliorating inflammation; the use of resistant starch for optimal bowel health and prevention of CRC; and, further, that the systemic effects of resistant starch may be important for the treatment of other forms of cancer, such as breast cancer. This review describes advances in resistant starch research highlighting the gastrointestinal effects that are now being linked to systemic, whole body effects with clinical relevance. These effects have important implications for overall health and the prevention or amelioration of various chronic diseases.

Mouth cancer in inflammatory bowel diseases.

PubMed

Giagkou, E; Christodoulou, D K; Katsanos, K H

2016-05-01

Mouth cancer is a major health problem. Multiple risk factors for developing mouth cancer have been studied and include history of tobacco and alcohol abuse, age over 40, exposure to ultraviolet radiation, human papilloma virus infection (HPV), nutritional deficiencies, chronic irritation, and existence or oral potentially malignant lesions such as leukoplakia and lichen planus. An important risk factor for mouth cancer is chronic immunosuppression and has been extensively reported after solid organ transplantation as well as HIV-infected patients. Diagnosis of inflammatory bowel disease (IBD) is not yet considered as a risk factor for oral cancer development. However, a significant number of patients with IBD are receiving immunosuppressants and biological therapies which could represent potential oral oncogenic factors either by direct oncogenic effect or by continuous immunosuppression favoring carcinogenesis, especially in patients with HPV(+) IBD. Education on modifiable risk behaviors in patients with IBD is the cornerstone of prevention of mouth cancer. Oral screening should be performed for all patients with IBD, especially those who are about to start an immunosuppressant or a biologic. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Beliefs and Attitudes to Bowel Cancer Screening in Patients with CKD: A Semistructured Interview Study.

PubMed

James, Laura J; Wong, Germaine; Craig, Jonathan C; Ju, Angela; Williams, Narelle; Lim, Wai H; Cross, Nicholas; Tong, Allison

2017-04-03

Bowel cancer is a leading cause of cancer-related death in people with CKD. Shared decision making regarding cancer screening is particularly complex in CKD and requires an understanding of patients' values and priorities, which remain largely unknown. Our study aimed to describe the beliefs and attitudes to bowel cancer screening in patients with CKD. Face to face, semistructured interviews were conducted from April of 2014 to December of 2015 with 38 participants ages 39-78 years old with CKD stages 3-5, on dialysis, or transplant recipients from four renal units in Australia and New Zealand. Thematic analysis was used to analyze the transcripts. Five themes were identified: invisibility of cancer (unspoken stigma, ambiguity of risk, and absence of symptomatic prompting); prioritizing kidney disease (preserving the chance of transplantation, over-riding attention to kidney disease, protecting graft survival, and showing loyalty to the donor); preventing the crisis of cancer (evading severe consequences and cognizant of susceptibility); cognitive resistance (reluctance to perform a repulsive procedure, intensifying disease burden threshold, anxiety of a positive test, and accepting the inevitable); and pragmatic accessibility (negligible financial effect, convenience, and protecting anonymity). Patients with CKD understand the potential health benefits of bowel cancer screening, but they are primarily committed to their kidney health. Their decisions regarding screening revolve around their present health needs, priorities, and concerns. Explicit consideration of the potential practical and psychosocial burdens that bowel cancer screening may impose on patients in addition to kidney disease and current treatment is suggested to minimize decisional conflict and improve patient satisfaction and health care outcomes in CKD. Copyright © 2017 by the American Society of Nephrology.

Beliefs and Attitudes to Bowel Cancer Screening in Patients with CKD: A Semistructured Interview Study

PubMed Central

Wong, Germaine; Craig, Jonathan C.; Ju, Angela; Williams, Narelle; Lim, Wai H.; Cross, Nicholas; Tong, Allison

2017-01-01

Background and objectives Bowel cancer is a leading cause of cancer-related death in people with CKD. Shared decision making regarding cancer screening is particularly complex in CKD and requires an understanding of patients’ values and priorities, which remain largely unknown. Our study aimed to describe the beliefs and attitudes to bowel cancer screening in patients with CKD. Design, setting, participants, & measurements Face to face, semistructured interviews were conducted from April of 2014 to December of 2015 with 38 participants ages 39–78 years old with CKD stages 3–5, on dialysis, or transplant recipients from four renal units in Australia and New Zealand. Thematic analysis was used to analyze the transcripts. Results Five themes were identified: invisibility of cancer (unspoken stigma, ambiguity of risk, and absence of symptomatic prompting); prioritizing kidney disease (preserving the chance of transplantation, over-riding attention to kidney disease, protecting graft survival, and showing loyalty to the donor); preventing the crisis of cancer (evading severe consequences and cognizant of susceptibility); cognitive resistance (reluctance to perform a repulsive procedure, intensifying disease burden threshold, anxiety of a positive test, and accepting the inevitable); and pragmatic accessibility (negligible financial effect, convenience, and protecting anonymity). Conclusions Patients with CKD understand the potential health benefits of bowel cancer screening, but they are primarily committed to their kidney health. Their decisions regarding screening revolve around their present health needs, priorities, and concerns. Explicit consideration of the potential practical and psychosocial burdens that bowel cancer screening may impose on patients in addition to kidney disease and current treatment is suggested to minimize decisional conflict and improve patient satisfaction and health care outcomes in CKD. PMID:28153937

Small Bowel Dose Parameters Predicting Grade ≥3 Acute Toxicity in Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation: An Independent Validation Study Comparing Peritoneal Space Versus Small Bowel Loop Contouring Techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Banerjee, Robyn, E-mail: robynbanerjee@gmail.com; Chakraborty, Santam; Nygren, Ian

Purpose: To determine whether volumes based on contours of the peritoneal space can be used instead of individual small bowel loops to predict for grade ≥3 acute small bowel toxicity in patients with rectal cancer treated with neoadjuvant chemoradiation therapy. Methods and Materials: A standardized contouring method was developed for the peritoneal space and retrospectively applied to the radiation treatment plans of 67 patients treated with neoadjuvant chemoradiation therapy for rectal cancer. Dose-volume histogram (DVH) data were extracted and analyzed against patient toxicity. Receiver operating characteristic analysis and logistic regression were carried out for both contouring methods. Results: Grade ≥3more » small bowel toxicity occurred in 16% (11/67) of patients in the study. A highly significant dose-volume relationship between small bowel irradiation and acute small bowel toxicity was supported by the use of both small bowel loop and peritoneal space contouring techniques. Receiver operating characteristic analysis demonstrated that, for both contouring methods, the greatest sensitivity for predicting toxicity was associated with the volume receiving between 15 and 25 Gy. Conclusion: DVH analysis of peritoneal space volumes accurately predicts grade ≥3 small bowel toxicity in patients with rectal cancer receiving neoadjuvant chemoradiation therapy, suggesting that the contours of the peritoneal space provide a reasonable surrogate for the contours of individual small bowel loops. The study finds that a small bowel V15 less than 275 cc and a peritoneal space V15 less than 830 cc are associated with a less than 10% risk of grade ≥3 acute toxicity.« less

A Cross-Sectional Review of Reporting Variation in Postoperative Bowel Dysfunction After Rectal Cancer Surgery.

PubMed

Chapman, Stephen J; Bolton, William S; Corrigan, Neil; Young, Neville; Jayne, David G

2017-02-01

Postoperative bowel dysfunction affects quality of life after sphincter-preserving rectal cancer surgery, but the extent of the problem is not clearly defined because of inconsistent outcome measures used to characterize the condition. The purpose of this study was to assess variation in the reporting of postoperative bowel dysfunction and to make recommendations for standardization in future studies. If possible, a quantitative synthesis of bowel dysfunction symptoms was planned. MEDLINE and EMBASE databases, as well as the Cochrane Library, were queried systematically between 2004 and 2015. The studies selected reported at least 1 component of bowel dysfunction after resection of rectal cancer. The main outcome measures were reporting, measurement, and definition of postoperative bowel dysfunction. Of 5428 studies identified, 234 met inclusion criteria. Widely reported components of bowel dysfunction were incontinence to stool (227/234 (97.0%)), frequency (168/234 (71.8%)), and incontinence to flatus (158/234 (67.5%)). Urgency and stool clustering were reported less commonly, with rates of 106 (45.3%) of 234 and 61 (26.1%) of 234. Bowel dysfunction measured as a primary outcome was associated with better reporting (OR = 3.49 (95% CI, 1.99-6.23); p < 0.001). Less than half of the outcomes were assessed using a dedicated research tool (337/720 (46.8%)), and the remaining descriptive measures were infrequently defined (56/383 (14.6%)). Heterogeneity in the reporting, measurement, and definition of postoperative bowel dysfunction precluded pooling of results and limited interpretation. Considerable variation exists in the reporting, measurement, and definition of postoperative bowel dysfunction. These inconsistencies preclude reliable estimates of incidence and meta-analysis. A broadly accepted outcome measure may address this deficit in future studies.

Perceived Threat and Internet Use Predict Intentions to Get Bowel Cancer Screening (Colonoscopy): Longitudinal Questionnaire Study

PubMed Central

Grapendorf, Johannes; Greving, Hannah; Sassenberg, Kai

2018-01-01

Background Many people use the Internet for health-related information search, which is known to help regulate their emotional state. However, not much is known yet about how Web-based information search together with negative emotional states (ie, threat of cancer diagnosis) relate to preventive medical treatment decisions (ie, colonoscopy intentions). Objective The aim of this study was to investigate how frequency of health-related Internet use together with perceived threat of a possible (bowel) cancer diagnosis influences intentions to get a colonoscopy. Previous research has shown that people who experience threat preferentially process positive information in an attempt to downregulate the aversive emotional state. The Internet can facilitate this regulatory strategy through allowing self-directed, unrestricted, and thus biased information search. In the context of threat regarding a possible bowel cancer diagnosis, feelings of threat can still be effectively reduced through cancer screening (ie, colonoscopy). We, therefore, predict that in that particular context, feelings of threat should be related to stronger colonoscopy intentions, and that this relationship should be enhanced for people who use the Internet often. Methods A longitudinal questionnaire study was conducted among healthy participants who were approaching or just entering the bowel cancer risk group (aged 45-55 years). Perceived threat of a possible (bowel) cancer diagnosis, frequency of health-related Internet use, and intentions to have a colonoscopy were assessed at 2 time points (6-month time lag between the 2 measurement points T1 and T2). Multiple regression analyses were conducted to test whether threat and Internet use at T1 together predicted colonoscopy intentions at T2. Results In line with our predictions, we found that the threat of a possible (bowel) cancer diagnosis interacted with the frequency of Internet use (both T1) to predict colonoscopy intentions (T2; B=.23, standard

Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: a modelling study.

PubMed

Lew, Jie-Bin; St John, D James B; Xu, Xiang-Ming; Greuter, Marjolein J E; Caruana, Michael; Cenin, Dayna R; He, Emily; Saville, Marion; Grogan, Paul; Coupé, Veerle M H; Canfell, Karen

2017-07-01

No assessment of the National Bowel Screening Program (NBCSP) in Australia, which considers all downstream benefits, costs, and harms, has been done. We aimed to use a comprehensive natural history model and the most recent information about cancer treatment costs to estimate long-term benefits, costs, and harms of the NBCSP (2 yearly immunochemical faecal occult blood testing screening at age 50-74 years) and evaluate the incremental effect of improved screening participation under different scenarios. In this modelling study, a microsimulation model, Policy1-Bowel, which simulates the development of colorectal cancer via both the conventional adenoma-carcinoma and serrated pathways was used to simulate the NBCSP in 2006-40, taking into account the gradual rollout of NBCSP in 2006-20. The base-case scenario assumed 40% screening participation (currently observed behaviour) and two alternative scenarios assuming 50% and 60% participation by 2020 were modelled. Aggregate year-by-year screening, diagnosis, treatment and surveillance-related costs, resource utilisation (number of screening tests and colonoscopies), and health outcomes (incident colorectal cancer cases and colorectal cancer deaths) were estimated, as was the cost-effectiveness of the NBCSP. With current levels of participation (40%), the NBCSP is expected to prevent 92 200 cancer cases and 59 000 deaths over the period 2015-40; an additional 24 300 and 37 300 cases and 16 800 and 24 800 deaths would be prevented if participation was increased to 50% and 60%, respectively. In 2020, an estimated 101 000 programme-related colonoscopies will be done, associated with about 270 adverse events; an additional 32 500 and 49 800 colonoscopies and 88 and 134 adverse events would occur if participation was increased to 50% and 60%, respectively. The overall number needed to screen (NNS) is 647-788 per death prevented, with 52-59 colonoscopies per death prevented. The programme is cost

Small bowel perforation secondary to metastatic non-small cell lung cancer. A rare entity with a dismal prognosis.

PubMed

Salemis, Nikolaos S; Nikou, Efstathios; Liatsos, Christos; Gakis, Christos; Karagkiouzis, Grigorios; Gourgiotis, Stavros

2012-09-01

The incidence of gastrointestinal metastases from lung cancer is higher than previously thought as they have been reported in 2-14% of the cases in autopsy studies. However, clinically significant metastases are rare. Small bowel perforation secondary to metastatic non-small cell lung cancer is a very rare clinical entity. The aim of this study is to describe a case of ileal perforation in a patient with intestinal metastases of a non-small cell lung cancer, along with a review of the literature. A 57-year-old male with a history of non-small cell lung cancer was referred to our emergency department with signs and symptoms of acute surgical abdomen. A computed tomography scan demonstrated dilated small bowel loops, liver deposits, and signs of perforation of an intra-abdominal hollow viscus. Emergency exploratory laparotomy revealed diffuse purulent peritonitis and a perforated ileal tumor. A segmental small bowel resection and primary anastomosis were performed. Histological and immunohistochemical findings were consistent with a metastatic non-small cell lung carcinoma. Additional evaluation revealed widespread metastatic disease. Unfortunately, despite adjuvant treatment, the patient died of progressive disease 2 months after surgery. Small bowel perforation due to metastatic non-small cell lung cancer is a very rare clinical entity. The possibility of small bowel metastases should be kept in mind in patients with lung cancer presenting with an acute abdomen. Intestinal perforation occurs in advanced stages and is usually a sign of widespread disease. Aggressive surgery can provide effective palliation and may improve short-term survival. The prognosis is however dismal.

Increasing participation of people with learning disabilities in bowel screening.

PubMed

Gray, Jonathan

2018-03-08

Learning disability nurses have a key role in addressing the health inequalities experienced by people with learning disabilities. People with learning disabilities are less likely to participate in bowel screening than other sectors of the population, despite there being evidence of this population being at an increased risk of developing bowel cancer. There are a range of barriers at individual and systemic levels that impact on participation in bowel screening by people with learning disabilities. Actions to address these barriers have been identified in the literature and learning disability nurses are a key agent of change in enabling people with learning disabilities to participate in the national screening programmes.

Identification of Small Ligands Targeting Breast Cancer by In Vivo Screening of Peptide Libraries in Breast Cancer Patients

DTIC Science & Technology

2000-09-01

safety of IV injection of filamentous phage in humans, including the use of filamentous phage as an effective vaccine vehicle and also as a vehicle...Society National Surgical Adjuvant Breast and Bowel Project New England Cancer Society Society of Surgical Oncology Vermont Cancer Center...PROFESSIONAL SOCIETY COMMITTEES National Surgical Adjuvant Breast and Bowel Project 1991 -Present Principal Investigator for clinical trials, University of

Small bowel obstruction from distant metastasis of primary breast cancer: a case report.

PubMed

Oh, Seung Jae; Park, Seon Young; Kim, Ji Young; Yim, Hyunee; Jung, Yongsik; Han, Sae Hwan

2018-02-01

Gastrointestinal (GI) tract metastasis of primary breast cancer is very rare. We present a patient with small bowel obstruction from distant metastasis of primary breast cancer. Each characteristic features of concern of GI tract distant metastasis from many pervious studies has been reported differently. We should remember that GI tract metastasis may coexist when patients with breast cancer have intermittent or recurrent abdominal pain with or without obstructive symptoms.

Inflammatory bowel disease and cancer response due to anti-CTLA-4: is it in the flora?

PubMed

Carbonnel, Franck; Soularue, Emilie; Coutzac, Clélia; Chaput, Nathalie; Mateus, Christine; Lepage, Patricia; Robert, Caroline

2017-04-01

Checkpoint inhibitors blocking CTLA-4 (ipilimumab) and PD-1 (nivolumab, pembrolizumab) have transfigured our cancer treatment paradigm. However, these drugs can induce immune-related adverse events that share clinical and pathological characteristics with immune-mediated diseases. One of the most severe immune-related adverse event observed with anti-CTLA-4 is an enterocolitis that mirrors naturally occurring inflammatory bowel disease. This paper reviews the clinical, immunological, and microbiota data associated with the immune-related enterocolitis induced by the cancer immunotherapy blocking CTLA-4, ipilimumab. A parallel analysis of the mechanisms underlying inflammatory bowel diseases on the one hand, and anti-CTLA-4-induced colitis on the other hand, stresses the crucial role of the gut microbiota and of resident T reg in the genesis of both iatrogenic and spontaneous inflammatory bowel diseases.

Revisiting the potential signs of colorectal cancer on contrast-enhanced computed tomography without bowel preparation.

PubMed

Naqvi, Jawad; Hosmane, Sharath; Lapsia, Snehal

2015-10-01

Colorectal cancer (CRC) is the second most common cause of cancer death in the US. Earlier detection can allow treatment with curative intent and improve prognosis. Optical and virtual colonoscopy are widely used in screening for colonic polyps and in the investigation of suspected CRC. However, contrast-enhanced computed tomography (CT) is still performed to investigate various non-specific abdominal complaints. Hence, a significant number of CRC are identified on contrast-enhanced CT without bowel preparation. We describe several signs, which when present in tandem, raise suspicion of CRC, and may warrant further investigation with optical colonoscopy. These include an intraluminal mass, eccentric or circumferential wall thickening >3 mm, focal wall enhancement, pericolic fat stranding, a cluster of >3 local lymph nodes, and enlarged lymph nodes >10 mm in short axis. Multiplanar evaluation of the bowel should be performed on all CT abdominal studies, including those without bowel preparation, to identify subtle features of CRC.

Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survviors

PubMed Central

Sun, Virginia; Grant, Marcia; Wendel, Christopher S.; McMullen, Carmit K.; Bulkley, Joanna E.; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M.; Herrinton, Lisa J.; Hornbrook, Mark C.; Krouse, Robert S.

2015-01-01

BACKGROUND Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors’ health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. METHODS This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N=856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high versus low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. RESULTS CRC survivors made substantial, permanent dietary and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CONCLUSIONS CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship. PMID:26159443

Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors.

PubMed

Sun, Virginia; Grant, Marcia; Wendel, Christopher S; McMullen, Carmit K; Bulkley, Joanna E; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M; Herrinton, Lisa J; Hornbrook, Mark C; Krouse, Robert S

2015-12-01

Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors' health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N = 856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high vs. low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. CRC survivors made substantial, permanent dietary, and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship.

Irritable bowel syndrome.

PubMed

Malone, Michael A

2011-09-01

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that leads to crampy pain, gassiness, bloating, and changes in bowel habits in the absence of any currently identifiable organic disorder. Patients with IBS may be classified by their predominant bowel habit: diarrhea-predominant, constipation-predominant, or IBS with alternating bowel movements. IBS is often associated with stress or anxiety. Although IBS can be frustrating and concerning to patients with this disorder, it does not cause permanent harm to the intestines and does not lead to a serious disease such as cancer. Although treatments exist for its symptoms, there is no known cure. Copyright © 2011 Elsevier Inc. All rights reserved.

High resolution colonoscopy in a bowel cancer screening program improves polyp detection

PubMed Central

Banks, Matthew R; Haidry, Rehan; Butt, M Adil; Whitley, Lisa; Stein, Judith; Langmead, Louise; Bloom, Stuart L; O’Bichere, Austin; McCartney, Sara; Basherdas, Kalpesh; Rodriguez-Justo, Manuel; Lovat, Laurence B

2011-01-01

AIM: To compare high resolution colonoscopy (Olympus Lucera) with a megapixel high resolution system (Pentax HiLine) as an in-service evaluation. METHODS: Polyp detection rates and measures of performance were collected for 269 colonoscopy procedures. Five colonoscopists conducted the study over a three month period, as part of the United Kingdom bowel cancer screening program. RESULTS:There were no differences in procedure duration (χ2 P = 0.98), caecal intubation rates (χ2 P = 0.67), or depth of sedation (χ2 P = 0.64). Mild discomfort was more common in the Pentax group (χ2 P = 0.036). Adenoma detection rate was significantly higher in the Pentax group (χ2 test for trend P = 0.01). Most of the extra polyps detected were flat or sessile adenomas. CONCLUSION: Megapixel definition colonoscopes improve adenoma detection without compromising other measures of endoscope performance. Increased polyp detection rates may improve future outcomes in bowel cancer screening programs. PMID:22090787

A theoretical framework to guide a study of patients' bowel symptoms and self-care strategies following sphincter-saving surgery for rectal cancer.

PubMed

Landers, Margaret; McCarthy, Geraldine; Savage, Eileen

2013-08-01

A paucity of research is available on patients' bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer. Most research undertaken to date on patients' bowel symptoms following surgery for rectal cancer has been largely atheoretical. The purpose of this paper is to describe the process of choosing a theoretical framework to guide a study of patients' bowel symptoms and self-care strategies following sphincter-saving surgery for rectal cancer. As a result of a thorough literature review, we determined that the Symptom Management Theory provided the most comprehensive framework to guide our research. Copyright © 2013 Elsevier Inc. All rights reserved.

Previous Cancer/Lymphoma and Refractory Inflammatory Bowel Disease.

PubMed

Bernheim, Oren; Axelrad, Jordan; Itzkowitz, Steven H; Colombel, Jean-Frederic

2015-09-14

Immunomodulators and biologic agents are effective in treating inflammatory bowel diseases (IBDs), and recent evidence supports their introduction earlier in the disease course. An important concern to both patients and physicians considering immunosuppression (IS) for the treatment of IBD is the potential associated cancer risk. Several important clinical questions deserve attention with respect to IBD therapy and cancer. First, does medical therapy for IBD predispose to developing cancer? Second, in an IBD patient with a history of cancer, does IBD therapy impact cancer recurrence? Third, once cancer develops in an IBD patient, is the cancer outcome different? Finally, in an IBD patient with current cancer, does the cancer therapy affect IBD outcomes? In a recent multicentric study, patients were identified based on a diagnosis of IBD and cancer with subsequent exposure to anti-tumor necrosis factor α (anti-TNFα arm), thiopurines or methotrexate (antimetabolite arm) or without subsequent IS exposure (control arm). Two hundred and fifty-five patients met the inclusion criteria. Prior cancers included 121 solid, 62 gastrointestinal, 55 dermatologic and 17 hematologic malignancies. During the follow-up period, 75 (29.4%) patients developed incident cancer: 36 (14.1%) a new cancer, 33 (12.9%) a recurrent cancer and 6 (2.4%) a new and recurrent cancer. Incident cancer rate per 100 person-years for patients exposed to anti-TNFα, anti-metabolites and controls was 2.6 with 795 person-years of follow-up, 14.8 with 122 person-years of follow-up and 8.52 with 422 person-years of follow-up, respectively. In this series of IBD patients with a history of cancer, exposure to IS following a cancer diagnosis was not associated with an increased risk of incident cancer compared to patients who did not receive these agents. Prospective data are needed to confirm these findings. © 2015 S. Karger AG, Basel.

Recommendations on rectal surveillance for colorectal cancer after subtotal colectomy in patients with inflammatory bowel disease.

PubMed

Derikx, Lauranne A A P; de Jong, Michiel E; Hoentjen, Frank

2018-05-17

Approximately 30% of patients with ulcerative colitis require a colectomy during their disease course. This substantially reduces colorectal cancer risk, although it is still possible to develop colorectal neoplasia in the remaining rectum. Although clear and well-accepted surveillance guidelines exist for patients with inflammatory bowel disease with an intact colon, specific surveillance recommendations following colectomy are less clear. Here, we aim to summarize the prevalence, incidence, and risk factors for developing colorectal cancer in patients with inflammatory bowel disease who underwent subtotal colectomy with a permanent end ileostomy and rectal stump, or with ileorectal anastomosis. Subsequently, gained insights are integrated into a proposed endoscopic surveillance strategy of the residual rectum.

Costs and cost-effectiveness of full implementation of a biennial faecal occult blood test screening program for bowel cancer in Australia.

PubMed

Pignone, Michael P; Flitcroft, Kathy L; Howard, Kirsten; Trevena, Lyndal J; Salkeld, Glenn P; St John, D James B

2011-02-21

To examine the costs and cost-effectiveness of full implementation of biennial bowel cancer screening for Australian residents aged 50-74 years. Identification of existing economic models from 1993 to 2010 through searches of PubMed and economic analysis databases, and by seeking expert advice; and additional modelling to determine the costs and cost-effectiveness of full implementation of biennial faecal occult blood test screening for the five million adults in Australia aged 50-74 years. Estimated number of deaths from bowel cancer prevented, costs, and cost-effectiveness (cost per life-year gained [LYG]) of biennial bowel cancer screening. We identified six relevant economic analyses, all of which found colorectal cancer (CRC) screening to be very cost-effective, with costs per LYG under $55,000 per year in 2010 Australian dollars. Based on our additional modelling, we conservatively estimate that full implementation of biennial screening for people aged 50-74 years would have gross costs of $150 million, reduce CRC mortality by 15%-25%, prevent 300-500 deaths from bowel cancer, and save 3600-6000 life-years annually, for an undiscounted cost per LYG of $25,000-$41,667, compared with no screening, and not taking cost savings as a result of treatment into consideration. The additional expenditure required, after accounting for reductions in CRC incidence, savings in CRC treatment costs, and existing ad-hoc colonoscopy use, is likely to be less than $50 million annually. Full implementation of biennial faecal occult blood test screening in Australia can reduce bowel cancer mortality, and is an efficient use of health resources that would require modest additional government investment.

Impact of non-clinical community-based promotional campaigns on bowel cancer screening engagement: An integrative literature review.

PubMed

Martini, Angelita; Morris, Julia N; Preen, David

2016-10-01

This paper reviewed the relationship between non-clinical, client-oriented promotional campaigns to raise bowel cancer awareness and screening engagement. An integrative literature review using predefined search terms was conducted to summarise the accumulated knowledge. Data was analysed by coding and categorising, then synthesized through development of themes. Eighteen of 116 studies met inclusion criteria. Promotional campaigns had varying impact on screening uptake for bowel cancer. Mass media was found to moderately increase screening, predominately amongst "worried well". Small media used in conjunction with other promotional activities, thus its effect on screening behaviours was unclear. One-on-one education was less effective and less feasible than group education in increasing intention to screen. Financial support was ineffective in increasing screening rates when compared to other promotional activities. Screening engagement increased because of special events and celebrity endorsement. Non-clinical promotional campaigns did impact uptake of bowel cancer screening engagement. However, little is evident on the effect of single types of promotion and most research is based on clinician-directed campaigns. Cancer awareness and screening promotions should be implemented at community and clinical level to maximize effectiveness. Such an approach will ensure promotional activities are targeting consumers, thus strengthening screening engagement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of Acupuncture for Early Recovery of Bowel Function in Cancer: A Systematic Review and Meta-Analysis.

PubMed

Liu, Yi-Hua; Dong, Guang-Tong; Ye, Yang; Zheng, Jia-Bin; Zhang, Ying; Lin, Hong-Sheng; Wang, Xue-Qian

2017-01-01

The aim of this study was to evaluate the effects of acupuncture therapy to reduce the duration of postoperative ileus (POI) and to enhance bowel function in cancer patients. A systematic search of electronic databases for studies published from inception until January 2017 was carried out from six databases. Randomized controlled trials (RCTs) involving the use of acupuncture and acupressure for POI and bowel function in cancer patients were identified. Outcomes were extracted from each study and pooled to determine the risk ratio and standardized mean difference. 10 RCTs involving 776 cancer patients were included. Compared with control groups (no acupuncture, sham acupuncture, and other active therapies), acupuncture was associated with shorter time to first flatus and time to first defecation. A subgroup analysis revealed that manual acupuncture was more effective on the time to first flatus and the time to first defecation; electroacupuncture was better in reducing the length of hospital stay. Compared with control groups (sham or no acupressure), acupressure was associated with shorter time to first flatus. However, GRADE approach indicated a low quality of evidence. Acupuncture and acupressure showed large effect size with significantly poor or inferior quality of included trials for enhancing bowel function in cancer patients after surgery. Further well-powered evidence is needed.

Risk of cancer in patients with irritable bowel syndrome: a nationwide population-based study.

PubMed

Hu, Li-Yu; Ku, Fan-Chen; Lu, Ti; Shen, Cheng-Che; Hu, Yu-Wen; Yeh, Chiu-Mei; Tzeng, Cheng-Hwai; Chen, Tzeng-Ji; Chen, Pan-Ming; Liu, Chia-Jen

2015-12-01

The aim of our study was to evaluate the overall cancer risk among patients with the irritable bowel syndrome (IBS) by using a nationwide population-based data set. We obtained data on newly diagnosed IBS patients (age ≥ 20 years) without antecedent cancer from the Taiwan National Health Insurance Research Database for the period between 2000 and 2010. Standardized incidence ratios (SIRs) were calculated for various types of cancer in the IBS patients. A total of 1,043 people among the 29,838 IBS patients had developed cancer, and the follow-up was 139,185 person-years (median, 4.56 years), leading to a significantly increased SIR (1.18; 95% confidence interval [CI]) = 1.11-1.26) among all cancer types. However, after excluding cancer that developed within the first year after IBS diagnosis, the increased SIR of overall cancer was nonsignificant. In particular, the IBS patients exhibited an increased risk of cancers of the colon and rectum (SIR = 1.51; 95% CI = 1.31-1.73), liver and biliary tract (SIR = 1.40; 95% CI = 1.21-1.62), pancreas (SIR = 1.56; 95% CI = 1.02-2.28), and kidney (SIR = 1.56; 95% CI = 1.10-2.15). An increased SIR in IBS patients was observed only within the first year of IBS diagnosis. The findings of this study might have resulted from detection bias, localized symptoms, or paraneoplastic syndromes associated with IBS-like symptoms. Additional prospective studies are necessary to confirm these findings. Copyright © 2015 Elsevier Inc. All rights reserved.

Views of supervisors of colonoscopy training on quality issues for the national bowel cancer screening program in Australia.

PubMed

Pentti, Marita; Muller, Jennifer; Janda, Monika; Newman, Beth

2009-02-01

To describe the views of supervisors of colonoscopy training in regard to colonoscopy training capacity and quality in Australia. Anonymous postal surveys from March to May 2007 were posted to 127 colonoscopy training supervisors (30.2% estimated response rate). The surveys queried colonoscopy training capacity and quality, supervisors' views and opinions on innovative approaches to colonoscopy training, number of colonoscopies and time required by trainees to gain competence in colonoscopy. Approximately 50% of trainers agreed and 27% disagreed that current numbers of training places were adequate to maintain a skilled colonoscopy workforce in preparation for the National Bowel Cancer Screening Program (NBCSP). A collaborative approach with the private sector was seen as beneficial by 65%. Non-gastroenterologists (non-GEs) were more likely than gastroenterologists (GEs) to be of the opinion that simulators are beneficial for colonoscopy training (chi(2)-test = 5.55, P = 0.026). The majority of trainers did not support training either nurses (73%) or general practitioners (GPs) in colonoscopy (71%). Approximately 60% of trainers considered that the current requirements for recognition of training in colonoscopy could be insufficient for trainees to gain competence and 80% of those indicated that > or = 200 colonoscopies were needed. Colonoscopy training in Australia has traditionally followed the apprenticeship model. Projected increases in demand for colonoscopy with the introduction of the NBCSP may require additional training places and new and innovative approaches to training in order to ensure the provision of high-quality colonoscopy services under the NBCSP.

Safety and efficacy of self-expandable metal stents for obstructive proximal and distal large bowel cancer.

PubMed

Mitra, V; Hu, M; Majumdar, D; Krishnan, V; Chaudhury, B; Hancock, J; Dwarakanath, D

2017-03-01

Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction). The majority (88%) had self-expanded metal stents inserted for palliation. Technical and clinical success rates were 98.7% and 91.2%, respectively. One patient had stent-related perforation; there was no procedure-related mortality. Conclusion This study shows that self-expanded metal stent insertion in malignant colorectal obstruction is safe and effective and can be successfully delivered in a district general hospital with high technical and clinical success rates.

Pelvic floor muscle training for bowel dysfunction following colorectal cancer surgery: A systematic review.

PubMed

Lin, Kuan-Yin; Granger, Catherine L; Denehy, Linda; Frawley, Helena C

2015-11-01

To identify, evaluate and synthesize the evidence examining the effectiveness of pelvic floor muscle training (PFMT) on bowel dysfunction in patients who have undergone colorectal cancer surgery. Eight electronic databases (MEDLINE 1950-2014; CINAHL 1982-2014; EMBASE 1980-2014; Scopus 1823-2014; PsycINFO 1806-2014; Web of Science 1970-2014; Cochrane Library 2014; PEDro 1999-2014) were systematically searched in March 2014. Reference lists of identified articles were cross referenced and hand searched. Randomized controlled trials, cohort studies and case series were included if they investigated the effects of conservative treatments, including PFMT on bowel function in patients with colorectal cancer following surgery. Two reviewers independently assessed the risk of bias of studies using the Newcastle-Ottawa Scale (NOS). Six prospective non-randomized studies and two retrospective studies were included. The mean (SD) NOS risk of bias score was 4.9 (1.2) out of 9; studies were limited by a lack of non-exposed cohort, lack of independent blinded assessment, heterogeneous treatment protocols, and lack of long-term follow-up. The majority of studies reported significant improvements in stool frequency, incontinence episodes, severity of fecal incontinence, and health-related quality of life (HRQoL) after PFMT. Meta-analysis was not possible due to lack of randomized controlled trials. Pelvic floor muscle training for patients following surgery for colorectal cancer appears to be associated with improvements in bowel function and HRQoL. Results from non-randomized studies are promising but randomized controlled trials with sufficient power are needed to confirm the effectiveness of PFMT in this population. © 2014 Wiley Periodicals, Inc.

Fecal hydroxysteroid dehydrogenase activities in vegetarian Seventh-Day Adventists, control subjects, and bowel cancer patients.

PubMed

Macdonald, I A; Webb, G R; Mahony, D E

1978-10-01

Cell-free extracts were prepared from mixed fecal anaerobic bacteria grown from stools of 14 vegetarian Seventh-Day Adventists, 16 omnivorous control subjects, and eight patients recently diagnosed with cancer of the large bowel. Preparations were assayed for NAD- and NADP-dependent 3alpha-, 7alpha- and 12alpha-hydroxysteroid dehydrogenases with bile salts and androsterone as substrates (eight substrate-cofactor combinations were tested). A significant intergroup difference was observed in the amounts of NAD- and NADP-dependent 7alpha-hydroxysteroid dehydrogenase produced: bowel cancer patients exceeded controls, and controls exceeded Seventh-Day Adventists. Other enzyme activity comparisons were not significant. The pH values of the stools were significantly higher in cancer patients compared to Seventh-Day Adventists; values were 7.03 +/- 0.60 and 6.46 +/- 0.58 respectively. The pH value for controls was 6.66 +/- 0.62. A plot of pH value versus NADP-dependent 7alpha-hydroxysteroid dehydrogenase tended to separate the cancer patients from the other groups. Comparative data suggest that much of the 3alpha-hydroxysteroid dehydrogenase active against bile salt is also active against androsterone.

Nationwide bowel cancer screening programme in England: cohort study of lifestyle factors affecting participation and outcomes in women

PubMed Central

Blanks, R G; Benson, V S; Alison, R; Brown, A; Reeves, G K; Beral, V; Patnick, J; Green, J

2015-01-01

Background: In 2006, the National Health Service Bowel Cancer Screening Programme in England (NHSBCSP) began offering routine population-based biennial faecal occult blood testing (FOBt) at ages 60–69. There is, however, limited information on how characteristics of individuals affect participation and outcomes of screening, and we studied this association by linking NHSBCSP data to a large prospective cohort of women. Methods: Electronic linkage of the NHSBCSP and Million Women Study records identified 899 166 women in the study cohort with at least one invitation for screening. NHSBCSP provided information on screening acceptance, FOBt results, screen-detected colorectal cancer and other outcomes. The Million Women Study provided prospectively collected information on personal and lifestyle factors. Multiple regression was used to estimate relative risks (RRs) of factors associated with acceptance and outcomes of screening. Results: Overall, 70% of women (628 976/899 166) accepted their first invitation for bowel cancer screening, of whom 9133 (1.5%) were FOBt-positive, 743 (0.1%) had screen-detected colorectal cancer and 3056 (0.5%) had screen-detected colorectal adenoma. Acceptance was lower in women from the most than the least deprived tertile, in South Asians and in Blacks than in Whites, in current than in never smokers and in obese than in normal weight women: adjusted RRs (95% confidence interval) for acceptance vs not, 0.90 (0.90–0.90); 0.77 (0.75–79); 0.94 (0.92–0.96); 0.78 (0.77–0.78); and 0.88 (0.88–0.89), respectively: P<0.001 for each. These factors were also associated with an increased risk of being FOBt-positive and of having screen-detected adenoma, but were not strongly associated with the risk of screen-detected colorectal cancer. Relative risks for screen-detected adenoma were 1.22 (1.12–1.34), 2.46 (1.75–3.45), 1.61 (1.05–2.48), 1.53 (1.38–1.68) and 1.77 (1.60–1.95), respectively (P<0.001 for all, except for

Association of bowel habits with lower urinary tract symptoms in men: findings from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Survey.

PubMed

Thurmon, Kerri L; Breyer, Benjamin N; Erickson, Bradley A

2013-04-01

We examine the association between self-reported lower urinary tract symptoms and bowel habits in men in a large, cross-sectional, population based cohort study. The study included 3,077 men participating in the 2005-2006 or 2007-2008 cycles of the NHANES (National Health and Nutrition Examination Survey) who were 40 years old or older and without a history of prostate cancer. Men were considered to have lower urinary tract symptoms if they reported nocturia, urinary hesitancy and/or incomplete bladder emptying. Bowel habits were characterized by frequency of bowel movements per week and stool consistency based on the Bristol Stool Form Scale. Weighted associations between bowel habits and lower urinary tract symptoms were determined using univariate and multivariate techniques, adjusting for age, race, body mass index, diabetes, alcohol intake, activity level and smoking. The prevalence of lower urinary tract symptoms was 37%, with 4% reporting all 3 symptoms. Reporting 3 or fewer bowel movements per week was associated with nocturia (OR 1.67, 95% CI 1.21-2.30), incomplete bladder emptying (OR 2.14, 95% CI 1.06-4.31) and urinary hesitancy (OR 2.06, 95% CI 1.06-4.02). Reporting more than 10 bowel movements per week was associated with nocturia only (OR 1.42, 95% CI 1.01-1.55). Hard (OR 1.76, 95% CI 1.31-2.37) and loose (OR 1.25, 95% CI 1.01-1.55) stool consistency increased the odds of reporting nocturia. Lower urinary tract symptoms in the adult male were independently associated with low stool frequency, hard stool type and loose stool type. These data suggest causality or a common pathophysiology of lower urinary tract symptoms and abnormalities of bowel habits. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Outcomes of the Bowel Cancer Screening Programme (BCSP) in England after the first 1 million tests

PubMed Central

Patnick, Julietta; Nickerson, Claire; Coleman, Lynn; Rutter, Matt D; von Wagner, Christian

2012-01-01

Introduction The Bowel Cancer Screening Programme in England began operating in 2006 with the aim of full roll out across England by December 2009. Subjects aged 60–69 are being invited to complete three guaiac faecal occult blood tests (6 windows) every 2 years. The programme aims to reduce mortality from colorectal cancer by 16% in those invited for screening. Methods All subjects eligible for screening in the National Health Service in England are included on one database, which is populated from National Health Service registration data covering about 98% of the population of England. This analysis is only of subjects invited to participate in the first (prevalent) round of screening. Results By October 2008 almost 2.1 million had been invited to participate, with tests being returned by 49.6% of men and 54.4% of women invited. Uptake ranged between 55–60% across the four provincial hubs which administer the programme but was lower in the London hub (40%). Of the 1.08 million returning tests 2.5% of men and 1.5% of women had an abnormal test. 17 518 (10 608 M, 6910 F) underwent investigation, with 98% having a colonoscopy as their first investigation. Cancer (n=1772) and higher risk adenomas (n=6543) were found in 11.6% and 43% of men and 7.8% and 29% of women investigated, respectively. 71% of cancers were ‘early’ (10% polyp cancer, 32% Dukes A, 30% Dukes B) and 77% were left-sided (29% rectal, 45% sigmoid) with only 14% being right-sided compared with expected figures of 67% and 24% for left and right side from UK cancer registration. Conclusion In this first round of screening in England uptake and fecal occult blood test positivity was in line with that from the pilot and the original European trials. Although there was the expected improvement in cancer stage at diagnosis, the proportion with left-sided cancers was higher than expected. PMID:22156981

[Early detection of bowel cancer in occupational surveillance examinations: switching from a guaiak-based to an immunochemical fecal occult blood test].

PubMed

Webendörfer, S; Riemann, J F

2014-01-01

If the diagnosis is made early the cure rate of bowel cancer is more than 90 %. Occupational preventative medical care required by law and carried out by company physicians can be supplemented by a medical consultation and by simple screenings to interest employees in cancer prevention and refer them to registered general practitioners and specialist doctors for further diagnosis and treatment. Since 2001, BASF SE in Ludwigshafen, Germany offers its employees aged 45 and more a program to detect intestinal cancer early. The employees receive personal invitations for this program once a year. The participants answer a standard questionnaire about risk factors for bowel cancer and an endoscopic diagnosis, if this has already been carried out, and receive a FOBT. Since 2010 an immunological test system was used. We compare the results from two consecutive years with a Guajacum test system (g-FOBT) and an immunological test (i-FOBT). The German Association of Digestive and Metabolic Diseases, DGVS, recommends a colonoscopy if test results are positive or a family member has suffered from bowel cancer. Between 2008 and 2011, a total of 52,797 invitations were sent to employees aged 45 and over. Overall, 16,730 men (37.7 % of 46,245) and 1,585 women (24.4 % of 6,552) took part (in some cases more than once). The return rate of the FOBT increased from 66.7 % in 2008 to 79.5 % in 2011. Due to positive results and/or suspicious information in the questionnaire, 2,441 colonoscopies were recommended, 849 of them because of a positive FOBT. The medical department was informed of 224 endoscopy diagnoses. In 8 cases, manifested cancer (6 × colon, 2 × rectum) and in 57 cases adenomatous polyps were diagnosed as preliminary stages of cancer. Most of these diagnoses were made using the i-FOBT, the simultaneous increase in positive test results and therefore more frequent recommendations for a colonoscopy. The additional offer of a program for early detection of bowel

The Dose-Volume Relationship of Small Bowel Irradiation and Acute Grade 3 Diarrhea During Chemoradiotherapy for Rectal Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robertson, John M.; Lockman, David; Yan Di

Purpose: Previous work has found a highly significant relationship between the irradiated small-bowel volume and development of Grade 3 small-bowel toxicity in patients with rectal cancer. This study tested the previously defined parameters in a much larger group of patients. Methods and Materials: A total of 96 consecutive patients receiving pelvic radiation therapy for rectal cancer had treatment planning computed tomographic scans with small-bowel contrast that allowed the small bowel to be outlined with calculation of a small-bowel dose-volume histogram for the initial intended pelvic treatment to 45 Gy. Patients with at least one parameter above the previously determined dose-volumemore » parameters were considered high risk, whereas those with all parameters below these levels were low risk. The grade of diarrhea and presence of liquid stool was determined prospectively. Results: There was a highly significant association with small-bowel dose-volume and Grade 3 diarrhea (p {<=} 0.008). The high-risk and low-risk parameters were predictive with Grade 3 diarrhea in 16 of 51 high-risk patients and in 4 of 45 low-risk patients (p = 0.01). Patients who had undergone irradiation preoperatively had a lower incidence of Grade 3 diarrhea than those treated postoperatively (18% vs. 28%; p = 0.31); however, the predictive ability of the high-risk/low-risk parameters was better for preoperatively (p = 0.03) than for postoperatively treated patients (p = 0.15). Revised risk parameters were derived that improved the overall predictive ability (p = 0.004). Conclusions: The highly significant dose-volume relationship and validity of the high-risk and low-risk parameters were confirmed in a large group of patients. The risk parameters provided better modeling for the preoperative patients than for the postoperative patients.« less

Is there a role for prophylactic colectomy in Lynch syndrome patients with inflammatory bowel disease?

PubMed

McNamara, Kate L; Aronson, Melyssa D; Cohen, Zane

2016-01-01

Lynch syndrome and chronic inflammatory bowel disease are two important risk factors for colorectal cancer. It is unclear whether Lynch syndrome patients with inflammatory bowel disease are at sufficiently increased risk for colorectal cancer to warrant prophylactic colectomy. This study aims to identify all cases of Lynch syndrome and concurrent inflammatory bowel disease in a large familial gastrointestinal cancer registry, define incidence of colorectal cancer, and characterize mismatch repair protein gene mutation status and inflammatory bowel disease-associated colorectal cancer risk factors. We retrospectively identified and collected clinical data for all cases with confirmed diagnoses of Lynch syndrome and inflammatory bowel disease in the Familial Gastrointestinal Cancer Registry at Mount Sinai Hospital in Toronto, Canada. Twelve cases of confirmed Lynch syndrome, and concurrent inflammatory bowel disease were identified. Four cases developed colorectal cancer. An additional five cases had colectomy; one was performed for severe colitis, and four were performed for low-grade dysplasia. None of these surgical specimens contained malignancy or high-grade dysplasia. The presentation of Lynch syndrome with inflammatory bowel disease is uncommon and not well described in the literature. This small but important series of twelve cases is the largest reported to date. In this series, patients with Lynch syndrome and concurrent inflammatory bowel disease do not appear to have sufficiently increased risk for colorectal cancer to recommend prophylactic surgery. Therefore, the decision to surgery should continue to be guided by surgical indications for each disease. Further evaluation of this important area will require multi-institutional input.

The impact of type and number of bowel resections on anastomotic leakage risk in advanced ovarian cancer surgery.

PubMed

Grimm, Christoph; Harter, Philipp; Alesina, Pier F; Prader, Sonia; Schneider, Stephanie; Ataseven, Beyhan; Meier, Beate; Brunkhorst, Violetta; Hinrichs, Jakob; Kurzeder, Christian; Heitz, Florian; Kahl, Annett; Traut, Alexander; Groeben, Harald T; Walz, Martin; du Bois, Andreas

2017-09-01

To identify risk factors for anastomotic leakage (AL) in patients undergoing primary advanced ovarian cancer surgery and to evaluate the prognostic implication of AL on overall survival in these patients. We analyzed our institutional database for primary EOC and included all consecutive patients treated by debulking surgery including any type of full circumferential bowel resection beyond appendectomy between 1999 and 2015. We performed logistic regression models to identify risk factors for AL and log-rank tests and Cox proportional hazards models to evaluate the association between AL and survival. AL occurred in 36/800 (4.5%; 95% confidence interval [3%-6%]) of all patients with advanced ovarian cancer and 36/518 (6.9% [5%-9%]) patients undergoing bowel resection during debulking surgery. One hundred fifty-six (30.1%) patients had multiple bowel resections. In these patients, AL rate per patient was only slightly higher (9.0% [5%-13%]) than in patients with rectosigmoid resection only (6.9% [4%-10%]), despite the higher number of anastomosis. No independent predictive factors for AL were identified. AL was independently associated with shortened overall survival (HR 1.9 [1.2-3.4], p=0.01). In the present study, no predictive pre- and/or intraoperative risk factors for AL were identified. AL rate was mainly influenced by rectosigmoid resection and only marginally increased by additional bowel resections. Copyright © 2017 Elsevier Inc. All rights reserved.

Positive detection of exfoliated colon cancer cells on linear stapler cartridges was associated with depth of tumor invasion and preoperative bowel preparation in colon cancer.

PubMed

Ikehara, Kishiko; Endo, Shungo; Kumamoto, Kensuke; Hidaka, Eiji; Ishida, Fumio; Tanaka, Jun-Ichi; Kudo, Shin-Ei

2016-08-31

The aim of this study was to investigate exfoliated cancer cells (ECCs) on linear stapler cartridges used for anastomotic sites in colon cancer. We prospectively analyzed ECCs on linear stapler cartridges used for anastomosis in 100 colon cancer patients who underwent colectomy. Having completed the functional end-to-end anastomosis, the linear stapler cartridges were irrigated with saline, which was collected for cytological examination and cytological diagnoses were made by board-certified pathologists based on Papanicolaou staining. The detection rate of ECCs on the linear stapler cartridges was 20 %. Positive detection of ECCs was significantly associated with depth of tumor invasion (p = 0.012) and preoperative bowel preparation (p = 0.003). There were no marked differences between ECC-positive and ECC-negative groups in terms of the operation methods, tumor location, histopathological classification, and surgical margins. Since ECCs were identified on the cartridge of the linear stapler used for anastomosis, preoperative mechanical bowel preparation using polyethylene glycol solution and cleansing at anastomotic sites using tumoricidal agents before anastomosis may be necessary to decrease ECCs in advanced colon cancer.

A comparison of sennosides-based bowel protocols with and without docusate in hospitalized patients with cancer.

PubMed

Hawley, Philippa Helen; Byeon, Jai Jun

2008-05-01

Constipation is a common and distressing condition in patients with cancer, especially those taking opioid analgesics. Many institutions prevent and treat constipation with titrated laxatives, which is known as a bowel protocol. An effective and well-tolerated bowel protocol is a very important component of cancer care, and there is little evidence on which to base selection of the most appropriate agents. This study compares a protocol of the stimulant laxative sennosides alone with a protocol of sennosides plus the stool softener docusate, in hospitalized patients at an oncology center. The docusate-containing protocol had an initial docusate-only step for patients not taking opioids, and four to six 100-mg capsules of docusate sodium in addition to the sennosides for the rest of the protocol. Thirty patients received the sennosides-only (S) protocol and 30 the sennosides plus docusate (DS) protocol. The efficacy and adverse effects of the protocols were monitored for 5-12 days. The two protocols were used sequentially, creating two cohorts, one on each protocol. Eighty percent of patients were taking oral opioids and 72% were admitted for symptom control/supportive care. Over a total of 488 days of observation it was found that the S protocol produced more bowel movements than the DS protocol, and in the symptom control/supportive care patients this difference was statistically significant (p < 0.05). In the S group admitted for symptom control/supportive care 62.5% had a bowel movement more than 50% of days, as compared with 32% in those receiving the DS protocol. Fifty-seven percent of the DS group required additional interventions (lactulose, suppositories or enemas) compared to 40% in the S group. Cramps were reported equally by 3 (10%) patients in each group. Eight patients (27%) experienced diarrhea in the S group compared to 4 (13%) in the DS group. The addition of the initial docusate-only step and adding docusate 400-600 mg/d to the sennosides did not

Bowel symptoms and self-care strategies of survivors in the process of restoration after low anterior resection of rectal cancer.

PubMed

Yin, Lishi; Fan, Ling; Tan, Renfu; Yang, Guangjing; Jiang, Fenglin; Zhang, Chao; Ma, Jun; Yan, Yang; Zou, Yanhong; Zhang, Yaowen; Wang, Yamei; Zhang, Guifang

2018-06-04

The purpose of this research is to identify the bowel symptoms and self-care strategies for rectal cancer survivors during the recovery process following low anterior resection surgery. A total of 100 participants were investigated under the structured interview guide based on the dimensions of "symptom management theory". 92% of participants reported changes in bowel habits, the most common being the frequent bowel movements and narrower stools, which we named it finger-shaped consistency stools. The 6 most frequently reported bowel symptoms were excessive flatus (93%), clustering (86%), urgency (77%), straining (62%), bowel frequency (57%) and anal pendant expansion (53%). Periodic bowel movements occurred in 19% participants. For a group of 79 participants at 6 to 24 months post-operation, 86.1% reported a significant improvement of bowel symptoms. Among 68 participants of this subgroup with significant improvements, 70.5% participants reported the length of time it took was at least 6 months. Self-care strategies adopted by participants included diet, bowel medications, practice management and exercise. It is necessary to educate patients on the symptoms experienced following low anterior resection surgery. Through the process of trial and error, participants have acquired self-care strategies. Healthcare professionals should learn knowledge of such strategies and help them build effective interventions.

Abdominal emergency in elderly: a case of small bowel obstruction and ischemia caused by bulky IA ovarian cancer.

PubMed

Assenza, M; Campana, G; Centonze, L; Simonelli, L; Romeo, V; Marchese, S; Andreoli, C; Modini, C

2013-01-01

Bowel obstruction resulting from colorectal and ovarian cancer is a serious and distressing complication of these malignancies. This may be caused by diffuse peritoneal carcinomatosis, bulky masses filling the pelvis and abdomen or postoperative adhesions, and should be carefully worked out by pre-operative imaging. We report the case of a small bowel obstruction and intestinal ischemia caused by a bulky (20x40 cm in diameter) cystic ovarian neoplasm that was found to be a stage IA G2 cystadenocarcinoma, successfully managed by uterus-sparing surgery.

German Bowel Cancer Center: An Attempt to Improve Treatment Quality

PubMed Central

Jannasch, Olof; Udelnow, Andrej; Wolff, Stefanie; Lippert, Hans; Mroczkowski, Pawel

2015-01-01

Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC) are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010. We compared cohorts treated in certified and noncertified hospitals regarding preoperative variables and perioperative outcomes. Outcomes were verified by matched-pair analysis. Results. Patients of noncertified hospitals had higher ASA-scores, higher prevalence of risk factors, more distant metastases, lower tumour localization, lower frequency of pelvic MRI, and higher frequencies of missing values and undetermined TNM classifications (significant differences only). Outcome analysis revealed more general complications in certified hospitals (20.3% versus 17.4%, p = 0.03). Both cohorts did not differ significantly in percentage of R0-resections, intraoperative complications, anastomotic leakage, in-hospital death, and abdominal wall dehiscence. Conclusions. The concept of BCC is a step towards improving the structural and procedural quality. This is a good basis for improving outcome quality but cannot replace it. For a primary surgical disease like rectal cancer a specific, surgery-targeted program is still needed. PMID:26064091

Pediatric Inflammatory Bowel Disease.

PubMed

Kapoor, Akshay; Bhatia, Vidyut; Sibal, Anupam

2016-11-15

The incidence of inflammatory bowel disease is increasing in the pediatric population worldwide. There is paucity of high quality scientific data regarding pediatric inflammatory bowel disease. Most of the guidelines are offshoots of work done in adults, which have been adapted over time to diagnose and treat pediatric patients. This is in part related to the small numbers in pediatric inflammatory bowel disease and less extensive collaboration for multicentric trials both nationally and internationally. A literature search was performed using electronic databases i.e. Pubmed and OVID, using keywords: pediatric, inflammatory bowel disease, Crohns disease, Ulcerative colitis, epidemiology and guidelines. This article amalgamates the broad principles of diagnosing and managing a child with suspected inflammatory bowel disease. 25% of the patients with inflammatory bowel disease are children and and young adolescents. The primary concern is its impact on growth velocity, puberty and quality of life, including psychosocial issues. Treatment guidelines are being re-defined as the drug armamentarium is increasing. The emphasis will be to achieve mucosal healing and normal growth velocity with minimal drug toxicity.

Cancer in inflammatory bowel disease 15 years after diagnosis in a population-based European Collaborative follow-up study.

PubMed

Katsanos, Konstantinos H; Tatsioni, Athina; Pedersen, Natalia; Shuhaibar, Mary; Ramirez, Vicent Hernandez; Politi, Patrizia; Rombrechts, Evelien; Pierik, Marieke; Clofent, Juan; Beltrami, Marina; Bodini, Paolo; Freitas, Joao; Mouzas, Ioannis; Fornaciari, Giovanni; Moum, Bjorn; Lakatos, Peter Laszlo; Vermeire, Severine; Langholz, Ebbe; Odes, Selwyn; Morain, Colm O'; Stockbrügger, Reinhold; Munkholm, Pia; Tsianos, Epameinondas V

2011-10-01

To determine the occurrence of intestinal and extraintestinal cancers in the 1993-2009 prospective European Collaborative Inflammatory Bowel Disease (EC-IBD) Study Group cohort. A physician per patient form was completed for 681 inflammatory bowel disease patients (445UC/236CD) from 9 centers (7 countries) derived from the original EC-IBD cohort. For the 15-year follow up period, rates of detection of intestinal and extraintestinal cancers were computed. Patient follow-up time was fifteen years. In total 62/681 patients (9.1%) [41 with ulcerative colitis/21 with Crohn's disease, 36 males/26 females] were diagnosed with sixty-six cancers (four patients with double cancers). Colorectal cancer was diagnosed in 9/681 patients [1.3%] (1 Crohn's disease and 8 ulcerative colitis). The remaining 53 cancers were extraintestinal. There was a higher prevalence of intestinal cancer in the Northern centers compared to Southern centers [p=NS]. Southern centers had more cases of extraintestinal cancer compared to Northern centers [p=NS]. The frequency of all observed types of cancers in Northern and in Southern centers did not differ compared to the expected one in the background population. In the fifteen-year follow up of the EC-IBD Study Group cohort the prevalence of cancer was 9.1% with most patients having a single neoplasm and an extraintestinal neoplasm. In Northern centers there were more intestinal cancers while in Southern centers there were more extraintestinal cancers compared to Northern centers. In this IBD cohort the frequency of observed cancers was not different from that expected in the background population. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

A Formal Palliative Care Service Improves the Quality of Care in Patients with Stage IV Cancer and Bowel Obstruction.

PubMed

Gabriel, Emmanuel; Kukar, Moshim; Groman, Adrienne; Alvarez-Perez, Amy; Schneider, Jaclyn; Francescutti, Valerie

2017-02-01

Patients with stage IV cancer and bowel obstruction present a complicated management problem. The aim of this study was to evaluate the role of the palliative care service (PC) in the management of this complex disease process. A retrospective analysis was conducted of all patients admitted to Roswell Park Cancer Institute with stage IV cancer and bowel obstruction from 2009 to 2012 after the institution of a formal PC. This cohort was matched to similar patients from 2005 to 2008 (no palliative care service or NPC). Patient characteristics and outcomes included baseline demographics, comorbid conditions, do-not-resuscitate (DNR) status, laboratory parameters, medical and surgical management, length of stay, symptom relief, and disposition status. A total of 19 patients were identified in the PC group. Based on the PC group baseline characteristics, 19 patients were identified for the NPC group using matched values. Regarding outcomes, there were significant differences in the medication regimens (narcotics, octreotide, and Decadron) between the 2 groups. In the PC group, 14 of 19 patients showed improvement compared to 9 of 19 in the NPC group. Nearly 60% of patients in the PC group had a formal DNR order versus 10.5% in NPC ( P = .002). A significantly higher percentage of patients were discharged to hospice in the PC group (47.4% vs 0.0%, P = .006). Palliative care consultation improves the quality of care for patients with stage IV cancer and bowel obstruction, with particular benefits in symptom management, end-of-life discussion, and disposition to hospice.

Frequent Bowel Movements

MedlinePlus

... bowel disease (IBD). Centers for Disease Control and Prevention. https://www.cdc.gov/ibd/what-is-IBD.htm. Accessed Nov. 15, 2017. Hyperthyroidism (Overactive thyroid). National Institute of Diabetes and Digestive ...

Impact of general practice endorsement on the social gradient in uptake in bowel cancer screening

PubMed Central

Raine, Rosalind; Duffy, Stephen W; Wardle, Jane; Solmi, Francesca; Morris, Stephen; Howe, Rosemary; Kralj-Hans, Ines; Snowball, Julia; Counsell, Nicholas; Moss, Sue; Hackshaw, Allan; von Wagner, Christian; Vart, Gemma; McGregor, Lesley M; Smith, Samuel G; Halloran, Stephen; Handley, Graham; Logan, Richard F; Rainbow, Sandra; Smith, Steve; Thomas, Mary C; Atkin, Wendy

2016-01-01

Background: There is a socioeconomic gradient in the uptake of screening in the English NHS Bowel Cancer Screening Programme (BCSP), potentially leading to inequalities in outcomes. We tested whether endorsement of bowel cancer screening by an individual's general practice (GP endorsement; GPE) reduced this gradient. Methods: A cluster-randomised controlled trial. Over 20 days, individuals eligible for screening in England from 6480 participating general practices were randomly allocated to receive a GP-endorsed or the standard invitation letter. The primary outcome was the proportion of people adequately screened and its variation by quintile of Index of Multiple Deprivation. Results: We enrolled 265 434 individuals. Uptake was 58.2% in the intervention arm and 57.5% in the control arm. After adjusting for age, sex, hub and screening episode, GPE increased the overall odds of uptake (OR=1.07, 95% CI 1.04–1.10), but did not affect its socioeconomic gradient. We estimated that implementing GPE could result in up to 165 more people with high or intermediate risk colorectal adenomas and 61 cancers detected, and a small one-off cost to modify the standard invitation (£78 000). Conclusions: Although GPE did not improve its socioeconomic gradient, it offers a low-cost approach to enhancing overall screening uptake within the NHS BCSP. PMID:26742011

Evidence-based recommendations for bowel cleansing before colonoscopy in children: a report from a national working group.

PubMed

Turner, D; Levine, A; Weiss, B; Hirsh, A; Shamir, R; Shaoul, R; Berkowitz, D; Bujanover, Y; Cohen, S; Eshach-Adiv, O; Jamal, Gera; Kori, M; Lerner, A; On, A; Rachman, L; Rosenbach, Y; Shamaly, H; Shteyer, E; Silbermintz, A; Yerushalmi, B

2010-12-01

There are no current recommendations for bowel cleansing before colonoscopy in children. The Israeli Society of Pediatric Gastroenterology and Nutrition (ISPGAN) established an iterative working group to formulate evidence-based guidelines for bowel cleansing in children prior to colonoscopy. Data were collected by systematic review of the literature and via a national-based survey of all endoscopy units in Israel. Based on the strength of evidence, the Committee reached consensus on six recommended protocols in children. Guidelines were finalized after an open audit of ISPGAN members. Data on 900 colonoscopies per year were accrued, which represents all annual pediatric colonoscopies performed in Israel. Based on the literature review, the national survey, and the open audit, several age-stratified pediatric cleansing protocols were proposed: two PEG-ELS protocols (polyethylene-glycol with electrolyte solution); Picolax-based protocol (sodium picosulphate with magnesium citrate); sodium phosphate protocol (only in children over the age of 12 years who are at low risk for renal damage); stimulant laxative-based protocol (e. g. bisacodyl); and a PEG 3350-based protocol. A population-based analysis estimated that the acute toxicity rate of oral sodium phosphate is at most 3/7320 colonoscopies (0.041 %). Recommendations on diet and enema use are provided in relation to each proposed protocol. There is no ideal bowel cleansing regimen and, thus, various protocols are in use. We propose several evidence-based protocols to optimize bowel cleansing in children prior to colonoscopy and minimize adverse events. © Georg Thieme Verlag KG Stuttgart · New York.

Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: prospective randomized trial.

PubMed

Sadahiro, Sotaro; Suzuki, Toshiyuki; Tanaka, Akira; Okada, Kazutake; Kamata, Hiroko; Ozaki, Toru; Koga, Yasuhiro

2014-03-01

We have already reported that, for patients undergoing elective colon cancer operations, perioperative infection can be prevented by a single intravenous dose of an antibiotic given immediately beforehand if mechanical bowel preparation and the administration of oral antibiotics are implemented. Synbiotics has been reported to reduce the rate of infection in patients after pancreatic cancer operations. The effectiveness of oral antibiotics and probiotics in preventing postoperative infection in elective colon cancer procedures was examined in a randomized controlled trial. Three hundred ten patients with colon cancer randomly were assigned to one of three groups. All patients underwent mechanical bowel preparation and received a single intravenous dose of flomoxef immediately before operation. Probiotics were administered in Group A; oral antibiotics were administered in Group B; and neither probiotics nor oral antibiotics were administered in Group C. Stool samples were collected 9 and 2 days before and 7 and 14 days after the procedure. Clostridium difficile toxin and the number of bacteria in the intestine were determined. The rates of incisional surgical-site infection were 18.0%, 6.1%, and 17.9% in Groups A, B, and C, and the rates of leakage were 12.0%, 1.0%, and 7.4% in Groups A, B, and C, respectively, indicating that both rates were lesser in Group B than in Groups A and C (P = .014 and P = .004, respectively). The detection rates of C. difficile toxin were not changed among the three groups. We recommend oral antibiotics, rather than probiotics, as bowel preparation for elective colon cancer procedures to prevent surgical-site infections. Copyright © 2014 Mosby, Inc. All rights reserved.

Dysplasia and cancer in inflammatory bowel disease 10 years after diagnosis: results of a population-based European collaborative follow-up study.

PubMed

Katsanos, K H; Vermeire, S; Christodoulou, D K; Riis, L; Wolters, F; Odes, S; Freitas, J; Hoie, Ole; Beltrami, Marina; Fornaciari, G; Clofent, J; Bodini, P; Vatn, M; Nunes, Paula Borralho; Moum, B; Munkholm, P; Limonard, C; Stockbrugger, R; Rutgeerts, P; Tsianos, E V

2007-01-01

To determine dysplasia and cancer in the 1991-2004 European Collaborative Inflammatory Bowel Disease (EC-IBD) Study Group cohort. A patient questionnaire and a physician per patient form were completed for each of the 1,141 inflammatory bowel disease patients (776 ulcerative colitis/365 Crohn's disease) from 9 centers (7 countries) derived from the EC-IBD cohort. Rates of detection of intestinal cancer and dysplasia as well as extra-intestinal neoplasms were computed. Patient follow-up time was 10.3 +/- 0.8 (range 9.4-11) years. The mean age of the whole group of IBD patients was 37.8 +/- 11.3 (range 16-76) years. Thirty-eight patients (3.3%; 26 with ulcerative colitis/12 with Crohn's disease, 21 males/17 females, aged 61.3 +/- 13.4, range 33-77 years), were diagnosed with 42 cancers. Cancers occurred 5.4 +/- 3.3 (range 0-11) years after inflammatory bowel disease diagnosis. Colorectal cancer was diagnosed in 8 (1 Crohn's disease and 7 ulcerative colitis patients--0.3 and 0.9% of the Crohn's disease and ulcerative colitis cohort, respectively) of 38 patients and 30 cancers were extra-intestinal. Four of 38 patients (10.5%) were diagnosed as having 2 cancers and they were younger compared to patients with one cancer (p = 0.0008). There was a trend for a higher prevalence of intestinal cancer in the northern centers (0.9%) compared to southern centers (0.3%, p = NS). Southern centers had more cases of extra-intestinal cancer compared to northern centers (2 vs. 3.8%, p = 0.08). Ten patients (0.9%; 8 with ulcerative colitis/2 with Crohn's disease, 8 males, aged 62.3 +/- 14.1 years) had colorectal dysplasia. In the first decade of the EC-IBD Study Group cohort follow-up study, the prevalence of cancer was as expected with most patients having a single neoplasm and an extra-intestinal neoplasm. In northern centers there was a trend for more intestinal cancers, while in southern centers there was a trend for more extra-intestinal cancers compared to northern centers. 2007

Optimizing bowel preparation for colonoscopy: a guide to enhance quality of visualization

PubMed Central

Bechtold, Matthew L.; Mir, Fazia; Puli, Srinivas R.; Nguyen, Douglas L.

2016-01-01

Colonoscopy is an important screening and therapeutic modality for colorectal cancer. Unlike other screening tests, colonoscopy is dependent on pre-procedure bowel preparation. If the bowel preparation is poor, significant pathology may be missed. Many factors are known to improve bowel preparation. This review will highlight those factors that may optimize the bowel preparation, including choice of bowel preparation, grading or scoring of the bowel preparation, special factors that influence preparation, and diet prior to colonoscopy that affects bowel preparation. The aim of the review is to offer suggestions and guide endoscopists on how to optimize the bowel preparation for the patients undergoing colonoscopy. PMID:27065725

Lack of influence of cytokeratin-positive mini micrometastases in "Negative Node" patients with colorectal cancer: findings from the national surgical adjuvant breast and bowel projects protocols R-01 and C-01.

PubMed

Fisher, Edwin R; Colangelo, Linda; Wieand, Samuel; Fisher, Bernard; Wolmark, Norman

2003-08-01

Results of the few extant reports concerning the clinical significance of so-called "occult micrometastases" of lymph nodes of patients with Dukes A and B colorectal cancer have been variable. We examined the presumably negative nodes of a larger cohort of such patients who were enrolled in the National Surgical Adjuvant Breast and Bowel Project clinical trials R-01 and C-01 for the influence of what we preferably designate as nodal mini micrometastases on parameters of survival. Mini micrometastases were detected by immunohistochemical staining of the original lymph node sections with anticytokeratin A1/A3 in a total of 241 Dukes A and B patients with rectal and 158 with colonic cancers. Their frequency, as well as that of nuclear and histologic grades, and an estimation of their relationship to relative risks were correlated with overall and recurrence-free survival by univariate and multivariate analyses. Nodal mini micrometastases were detected in 73 of 399 (18.3 percent) patients of this cohort. They failed to exhibit any significant relationship to overall or recurrence-free survival. No association between the assessments of tumor differentiation and mini micrometastases was found. Nuclear and histologic grades also failed to further discriminate overall or recurrence-free survival in patients with A or B stages of colonic or rectal cancers in this cohort. The immunohistochemical demonstration of nodal mini micrometastases failed to discriminate high- and low-risk groups of patients with colorectal cancer who were designated as being node-negative after routine pathologic examination.

The Experience of Extended Bowel Resection in Individuals With a High Metachronous Colorectal Cancer Risk: A Qualitative Study.

PubMed

Steel, Emma J; Trainer, Alison H; Heriot, Alexander G; Lynch, Craig; Parry, Susan; Win, Aung K; Keogh, Louise A

2016-07-01

To ascertain individual experiences of extended bowel resection as treatment for colorectal cancer (CRC) in those with a high metachronous CRC risk, including the self-reported adequacy of information received at different time points of treatment and recovery.
. Qualitative.
. Participants were recruited through the Australasian Colorectal Cancer Family Registry and two hospitals in Melbourne, Australia.
. 18 individuals with a high metachronous CRC risk who had an extended bowel resection from 6-12 months ago.
. Semistructured interviews. Data were analyzed thematically.
. In most cases, the treating surgeon decided on the best option regarding surgical treatment. Participants felt well informed about the surgical procedure. Information related to surgical outcomes, recovery, and lifestyle adjustment from surgery was not always adequate. Many participants described ongoing worry about developing another cancer. 
. Patients undergoing an extended resection to reduce metachronous CRC risk require detailed information delivered at more than one time point and relating to several different aspects of the surgical procedure and its outcomes.
. An increased emphasis should be given to the provision of patient information on surgical outcomes, recovery, and lifestyle adjustment. Colorectal nurses could provide support for some of the reported unmet needs.

Emotional predictors of bowel screening: the avoidance-promoting role of fear, embarrassment, and disgust.

PubMed

Reynolds, Lisa M; Bissett, Ian P; Consedine, Nathan S

2018-05-03

Despite considerable efforts to address practical barriers, colorectal cancer screening numbers are often low. People do not always act rationally, and investigating emotions may offer insight into the avoidance of screening. The current work assessed whether fear, embarrassment, and disgust predicted colorectal cancer screening avoidance. A community sample (N = 306) aged 45+ completed a questionnaire assessing colorectal cancer screening history and the extent that perceptions of cancer risk, colorectal cancer knowledge, doctor discussions, and a specifically developed scale, the Emotional Barriers to Bowel Screening (EBBS), were associated with previous screening behaviours and anticipated bowel health decision-making. Step-wise logistic regression models revealed that a decision to delay seeking healthcare in the hypothetical presence of bowel symptoms was less likely in people who had discussed risk with their doctor, whereas greater colorectal cancer knowledge and greater fear of a negative outcome predicted greater likelihood of delay. Having previously provided a faecal sample was predicted by discussions about risk with a doctor, older age, and greater embarrassment, whereas perceptions of lower risk predicted a lower likelihood. Likewise, greater insertion disgust predicted a lower likelihood of having had an invasive bowel screening test in the previous 5 years. Alongside medical and demographic factors, fear, embarrassment and disgust are worthy of consideration in colorectal cancer screening. Understanding how specific emotions impact screening decisions and behaviour is an important direction for future work and has potential to inform screening development and communications in bowel health.

Surgical treatment of complex small bowel Crohn disease.

PubMed

Michelassi, Fabrizio; Sultan, Samuel

2014-08-01

The clinical presentations of Crohn disease of the small bowel vary from low to high complexity. Understanding the complexity of Crohn disease of the small bowel is important for the surgeon and the gastroenterologist caring for the patient and may be relevant for clinical research as a way to compare outcomes. Here, we present a categorization of complex small bowel Crohn disease and review its surgical treatment as a potential initial step toward the establishment of a definition of complex disease. The complexity of small bowel Crohn disease can be sorted into several categories: technical challenges, namely, fistulae, abscesses, bowel or ureteral obstruction, hemorrhage, cancer and thickened mesentery; extensive disease; the presence of short gut; a history of prolonged use of medications, particularly steroids, immunomodulators, and biological agents; and a high risk of recurrence. Although the principles of modern surgical treatment of Crohn disease have evolved to bowel conservation such as strictureplasty techniques and limited resection margins, such practices by themselves are often not sufficient for the management of complex small bowel Crohn disease. This manuscript reviews each category of complex small bowel Crohn disease, with special emphasis on appropriate surgical strategy.

Bowel Retraining: Strategies for Establishing Bowel Control

MedlinePlus

... Us Search Bowel Retraining: Strategies for Establishing Bowel Control Home Bowel Retraining Details Treatment Last Updated: 29 ... help people with bowel disorders establish or reestablish control. Individuals with symptoms of inability to control bowel ...

The impact of bowel preparation on the severity of anastomotic leak in colon cancer patients.

PubMed

Haskins, Ivy N; Fleshman, James W; Amdur, Richard L; Agarwal, Samir

2016-12-01

The routine use of preoperative bowel preparation (BP) is heavily debated in the colorectal surgery literature. To date, no study has investigated the effect preoperative BP has on patients with an established anastomotic leak. We therefore seek to compare the severity of patient morbidity and mortality in patients with a known anastomotic leak based on type of preoperative BP using the Targeted Colectomy American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP). All elective colon cancer operations performed with primary anastomosis were identified within the targeted colectomy database from 2012 to 2013. Patients who experienced a postoperative anastomotic leak were identified and stratified based on preoperative BP. Variables that had an association with mechanical BP at P < 0.10 were included in a multivariate logistic regression model to determine if BP was independently associated with postoperative morbidity and mortality. A total of 6,297 patients underwent elective colon resection with primary anastomosis for colon cancer. Two hundred and nineteen (3.5%) patients experienced an anastomotic leak. Thirty-day wound morbidity and mortality was not worse in patients who underwent preoperative BP. BP is not associated with worse patients outcomes in those patients with an established anastomotic leak following elective colon research with primary anastomosis. J. Surg. Oncol. 2016;114:810-813. © 2016 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Diarrhea and flatulence are major bowel disorders after radical cystectomy: Results from a cross-sectional study in bladder cancer patients.

PubMed

Hupe, Marie C; Vahlensieck, Winfried; Ozimek, Tomasz; Struck, Julian P; Hennig, Martin J P; Tezval, Hossein; von Klot, Christoph A; Merseburger, Axel S; Kuczyk, Markus A; Kramer, Mario W

2018-05-01

We had previously demonstrated changes in defecation after radical cystectomy (RC). Reports addressing long-term bowel disorders following RC are rare. This cross-sectional study evaluates long-term bowel issues in a large cohort. A questionnaire assessing changes in bowel function (diarrhea, constipation, urge to defecate, sensation of incomplete defecation, and flatulence) and its effect on quality of life was developed based on the gastrointestinal quality of life index and distributed in collaboration with the German bladder cancer support group. There were 431 evaluable questionnaires. For the analyses, we focused on patients that had the RC>1 year ago (n = 324). Current bowel problems were reported by 42.6% of patients. The most frequent bowel problems were flatulence (48.8%), diarrhea (29.6%), and sensation of incomplete defecation (22.5%). In cases of bowel problems, 39.7% and 59.8% of the patients indicated life restriction and dissatisfaction, respectively. Prevalence of diarrhea and flatulence were significantly higher>12 (vs. ≤12) months following RC. Both symptoms significantly correlated with younger age at RC, life restriction, lower quality of life, lower health state, and lower energy level. Additionally, diarrhea significantly correlated with pouches as urinary diversion (vs. ileal conduit or ureterocutaneostomy) and higher dissatisfaction level. To our knowledge this is the largest cohort evaluating long-term bowel symptoms after RC. Diarrhea is a prominent symptom after RC with a high impact on daily life that leads to dissatisfaction. A better understanding of long-term bowel symptoms could be translated into optimized surgical procedures, postoperative medication/nutrition, and patient education. Copyright © 2018 Elsevier Inc. All rights reserved.

The Experience of Extended Bowel Resection in Individuals With a High Metachronous Colorectal Cancer Risk: A Qualitative Study

PubMed Central

Steel, Emma J.; Trainer, Alison H.; Heriot, Alexander G.; Lynch, Craig; Parry, Susan; Win, Aung K.; Keogh, Louise A.

2016-01-01

Purpose/Objectives To ascertain individual experiences of extended bowel resection as treatment for colorectal cancer (CRC) in those with a high metachronous CRC risk, including the self-reported adequacy of information received at different time points of treatment and recovery. Research Approach Qualitative. Setting Participants were recruited through the Australasian Colorectal Cancer Family Registry and two hospitals in Melbourne, Australia. Participants 18 individuals with a high metachronous CRC risk who had an extended bowel resection from 6–12 months ago. Methodologic Approach Semistructured interviews. Data were analyzed thematically. Findings In most cases, the treating surgeon decided on the best option regarding surgical treatment. Participants felt well informed about the surgical procedure. Information related to surgical outcomes, recovery, and lifestyle adjustment from surgery was not always adequate. Many participants described ongoing worry about developing another cancer. Conclusions Patients undergoing an extended resection to reduce metachronous CRC risk require detailed information delivered at more than one time point and relating to several different aspects of the surgical procedure and its outcomes. Interpretation An increased emphasis should be given to the provision of patient information on surgical outcomes, recovery, and lifestyle adjustment. Colorectal nurses could provide support for some of the reported unmet needs. PMID:27314187

Capecitabine and Oxaliplatin in the Preoperative Multimodality Treatment of Rectal Cancer: Surgical End Points From National Surgical Adjuvant Breast and Bowel Project Trial R-04

PubMed Central

O'Connell, Michael J.; Colangelo, Linda H.; Beart, Robert W.; Petrelli, Nicholas J.; Allegra, Carmen J.; Sharif, Saima; Pitot, Henry C.; Shields, Anthony F.; Landry, Jerome C.; Ryan, David P.; Parda, David S.; Mohiuddin, Mohammed; Arora, Amit; Evans, Lisa S.; Bahary, Nathan; Soori, Gamini S.; Eakle, Janice; Robertson, John M.; Moore, Dennis F.; Mullane, Michael R.; Marchello, Benjamin T.; Ward, Patrick J.; Wozniak, Timothy F.; Roh, Mark S.; Yothers, Greg; Wolmark, Norman

2014-01-01

Purpose The optimal chemotherapy regimen administered concurrently with preoperative radiation therapy (RT) for patients with rectal cancer is unknown. National Surgical Adjuvant Breast and Bowel Project trial R-04 compared four chemotherapy regimens administered concomitantly with RT. Patients and Methods Patients with clinical stage II or III rectal cancer who were undergoing preoperative RT (45 Gy in 25 fractions over 5 weeks plus a boost of 5.4 Gy to 10.8 Gy in three to six daily fractions) were randomly assigned to one of the following chemotherapy regimens: continuous intravenous infusional fluorouracil (CVI FU; 225 mg/m2, 5 days per week), with or without intravenous oxaliplatin (50 mg/m2 once per week for 5 weeks) or oral capecitabine (825 mg/m2 twice per day, 5 days per week), with or without oxaliplatin (50 mg/m2 once per week for 5 weeks). Before random assignment, the surgeon indicated whether the patient was eligible for sphincter-sparing surgery based on clinical staging. The surgical end points were complete pathologic response (pCR), sphincter-sparing surgery, and surgical downstaging (conversion to sphincter-sparing surgery). Results From September 2004 to August 2010, 1,608 patients were randomly assigned. No significant differences in the rates of pCR, sphincter-sparing surgery, or surgical downstaging were identified between the CVI FU and capecitabine regimens or between the two regimens with or without oxaliplatin. Patients treated with oxaliplatin experienced significantly more grade 3 or 4 diarrhea (P < .001). Conclusion Administering capecitabine with preoperative RT achieved similar rates of pCR, sphincter-sparing surgery, and surgical downstaging compared with CVI FU. Adding oxaliplatin did not improve surgical outcomes but added significant toxicity. The definitive analysis of local tumor control, disease-free survival, and overall survival will be performed when the protocol-specified number of events has occurred. PMID:24799484

Capecitabine and oxaliplatin in the preoperative multimodality treatment of rectal cancer: surgical end points from National Surgical Adjuvant Breast and Bowel Project trial R-04.

PubMed

O'Connell, Michael J; Colangelo, Linda H; Beart, Robert W; Petrelli, Nicholas J; Allegra, Carmen J; Sharif, Saima; Pitot, Henry C; Shields, Anthony F; Landry, Jerome C; Ryan, David P; Parda, David S; Mohiuddin, Mohammed; Arora, Amit; Evans, Lisa S; Bahary, Nathan; Soori, Gamini S; Eakle, Janice; Robertson, John M; Moore, Dennis F; Mullane, Michael R; Marchello, Benjamin T; Ward, Patrick J; Wozniak, Timothy F; Roh, Mark S; Yothers, Greg; Wolmark, Norman

2014-06-20

The optimal chemotherapy regimen administered concurrently with preoperative radiation therapy (RT) for patients with rectal cancer is unknown. National Surgical Adjuvant Breast and Bowel Project trial R-04 compared four chemotherapy regimens administered concomitantly with RT. Patients with clinical stage II or III rectal cancer who were undergoing preoperative RT (45 Gy in 25 fractions over 5 weeks plus a boost of 5.4 Gy to 10.8 Gy in three to six daily fractions) were randomly assigned to one of the following chemotherapy regimens: continuous intravenous infusional fluorouracil (CVI FU; 225 mg/m(2), 5 days per week), with or without intravenous oxaliplatin (50 mg/m(2) once per week for 5 weeks) or oral capecitabine (825 mg/m(2) twice per day, 5 days per week), with or without oxaliplatin (50 mg/m(2) once per week for 5 weeks). Before random assignment, the surgeon indicated whether the patient was eligible for sphincter-sparing surgery based on clinical staging. The surgical end points were complete pathologic response (pCR), sphincter-sparing surgery, and surgical downstaging (conversion to sphincter-sparing surgery). From September 2004 to August 2010, 1,608 patients were randomly assigned. No significant differences in the rates of pCR, sphincter-sparing surgery, or surgical downstaging were identified between the CVI FU and capecitabine regimens or between the two regimens with or without oxaliplatin. Patients treated with oxaliplatin experienced significantly more grade 3 or 4 diarrhea (P < .001). Administering capecitabine with preoperative RT achieved similar rates of pCR, sphincter-sparing surgery, and surgical downstaging compared with CVI FU. Adding oxaliplatin did not improve surgical outcomes but added significant toxicity. The definitive analysis of local tumor control, disease-free survival, and overall survival will be performed when the protocol-specified number of events has occurred. © 2014 by American Society of Clinical Oncology.

Clostridial abdominal gas gangrene masquerading as a bowel perforation in an advanced-stage ovarian cancer patient.

PubMed

Abaid, L N; Thomas, R H; Epstein, H D; Goldstein, B H

2013-08-01

The coexistence of clostridial gas gangrene and a gynecologic malignancy is extremely rare, with very few cases involving ovarian cancer. A patient originally presented to our gynecologic oncology service with stage IV ovarian cancer; she underwent a diagnostic laparoscopy and neoadjuvant chemotherapy. On postoperative day 6, the patient developed severe abdominal pain, nausea, and emesis, suggestive of a bowel perforation. Further evaluation confirmed that her symptoms were attributed to Clostridium perfringens-related gas gangrene. Despite immediate surgical intervention, the patient succumbed to her disease. Clostridial gas gangrene is associated with an extremely high mortality rate. Therefore, accurate detection and prompt management are indispensable to ensuring a favorable patient outcome.

A retrospective observational study examining the characteristics and outcomes of tumours diagnosed within and without of the English NHS Bowel Cancer Screening Programme

PubMed Central

Morris, E J A; Whitehouse, L E; Farrell, T; Nickerson, C; Thomas, J D; Quirke, P; Rutter, M D; Rees, C; Finan, P J; Wilkinson, J R; Patnick, J

2012-01-01

Background: Colorectal cancer is common in England and, with long-term survival relatively poor, improving outcomes is a priority. A major initiative to reduce mortality from the disease has been the introduction of the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). Combining data from the BCSP with that in the National Cancer Data Repository (NCDR) allows all tumours diagnosed in England to be categorised according to their involvement with the BCSP. This study sought to quantify the characteristics of the tumours diagnosed within and outside the BCSP and investigate its impact on outcomes. Methods: Linkage of the NCDR and BCSP data allowed all tumours diagnosed between July 2006 and December 2008 to be categorised into four groups; screen-detected tumours, screening-interval tumours, tumours diagnosed in non-participating invitees and tumours diagnosed in those never invited to participate. The characteristics, management and outcome of tumours in each category were compared. Results: In all, 76 943 individuals were diagnosed with their first primary colorectal cancer during the study period. Of these 2213 (2.9%) were screen-detected, 623 (0.8%) were screening-interval cancers, 1760 (2.3%) were diagnosed in individuals in non-participating invitees and 72 437 (94.1%) were diagnosed in individuals not invited to participate in the programme due to its ongoing roll-out over the time period studied. Screen-detected tumours were identified at earlier Dukes' stages, were more likely to be managed with curative intent and had significantly better outcomes than tumours in other categories. Conclusion: Screen-detected cancers had a significantly better prognosis than other tumours and this would suggest that the BCSP should reduce mortality from colorectal cancer in England. PMID:22850549

Circulating DNA and its methylation level in inflammatory bowel disease and related colon cancer.

PubMed

Bai, Xuming; Zhu, Yaqun; Pu, Wangyang; Xiao, Li; Li, Kai; Xing, Chungen; Jin, Yong

2015-01-01

Both of chronic inflammation and abnormal immune in inflammatory bowel disease can induce colon cancer. Previous research showed that cell apoptosis and necrosis become the main source of circulating DNA in the peripheral blood during tumorigenesis that reduced along with methylation degree. However, its role in the process of colitis transforming to colon cancer is not clarified. Drinking 3% DSS was used to establish colitis model, while 3% dextran sodium sulfate (DSS) combined with azo oxidation methane (AOM) intraperitoneal injection was applied to establish colitis related colon cancer model. Circulating DNA and its methylation level in peripheral blood were tested. Morphology observation, HE staining, and p53 and β-catenin expression detection confirmed that drinking 3% DSS and 3% DSS combined with AOM intraperitoneal injection can successfully establish colitis and colitis associated colorectal cancer models. Circulating DNA level in colitis and colon cancer mice increased by gradient compared with control, while significant difference was observed between each other. Circulating DNA methylation level decreased obviously in colitis and colon cancer, and significant difference was observed between each other. Abnormal protein expression, circulating DNA and its methylation level in ulcerative colitis associated colorectal tissues change in gradient, suggesting that circulating DNA and its methylation level can be treated as new markers for colitis cancer transformation that has certain significance to explore the mechanism of human ulcerative colitis canceration.

Acute small bowel toxicity and preoperative chemoradiotherapy for rectal cancer: Investigating dose-volume relationships and role for inverse planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tho, Lye Mun; Glegg, Martin; Paterson, Jennifer

2006-10-01

Purpose: The relationship between volume of irradiated small bowel (VSB) and acute toxicity in rectal cancer radiotherapy is poorly quantified, particularly in patients receiving concurrent preoperative chemoradiotherapy. Using treatment planning data, we studied a series of such patients. Methods and Materials: Details of 41 patients with locally advanced rectal cancer were reviewed. All received 45 Gy in 25 fractions over 5 weeks, 3-4 fields three-dimensional conformal radiotherapy with daily 5-fluorouracil and folinic acid during Weeks 1 and 5. Toxicity was assessed prospectively in a weekly clinic. Using computed tomography planning software, the VSB was determined at 5 Gy dose intervalsmore » (V{sub 5}, V{sub 1}, etc.). Eight patients with maximal VSB had dosimetry and radiobiological modeling outcomes compared between inverse and conformal three-dimensional planning. Results: VSB correlated strongly with diarrheal severity at every dose level (p < 0.03), with strongest correlation at lowest doses. Median VSB differed significantly between patients experiencing Grade 0-1 and Grade 2-4 diarrhea (p {<=} 0.05). No correlation was found with anorexia, nausea, vomiting, abdominal cramps, age, body mass index, sex, tumor position, or number of fields. Analysis of 8 patients showed that inverse planning reduced median dose to small bowel by 5.1 Gy (p = 0.008) and calculated late normal tissue complication probability (NTCP) by 67% (p = 0.016). We constructed a model using mathematical analysis to predict for acute diarrhea occurring at V{sub 5} and V{sub 15}. Conclusions: A strong dose-volume relationship exists between VSB and acute diarrhea at all dose levels during preoperative chemoradiotherapy. Our constructed model may be useful in predicting toxicity, and this has been derived without the confounding influence of surgical excision on bowel function. Inverse planning can reduce calculated dose to small bowel and late NTCP, and its clinical role warrants

Prevalence of inflammatory bowel disease related dysplasia and cancer in 1500 colonoscopies from a referral center in northwestern Greece.

PubMed

Katsanos, Konstantinos H; Stamou, Paraskevi; Tatsioni, Athina; Tsianos, Vasileios E; Zoumbas, Stefanos; Kavvadia, Spyridoula; Giga, Anna; Vagias, Ioannis; Christodoulou, Dimitrios K; Tsianos, Epameinondas V

2011-02-01

To report on the prevalence of inflammatory bowel disease (IBD) related intestinal dysplasia and cancer in northwestern Greece. Single referral center retrospective study. The policy among all gastroenterologists of the area regarding medical treatment, patient follow up and bowel surveillance strategies including risk factors is the same. We analyzed 1494 colonoscopies from 696 consecutive IBD patients (494 UC). The follow up time [median, IQR] was 16 [8-23] years and the age at diagnosis was 28 [21-49] years. The number of patient years at risk was 16.219. Disease location for UC was: pancolitis 761 (59%), left sided colitis 455 (35%), and proctitis 69 (6%). Disease location for CD was: colitis 142 (66%), ileitis 45 (22%) and ileocolitis 21 (10%). Disease activity was in remission in 1240 (83%) of them. In total, 498 (72%) patients were on mesalazine, 169(24%) on immunosuppression and 29 (4%) on biologicals. Biopsies were taken randomly in 1429 (96%) endoscopies and were targeted in 65 (4%) of them. We recorded 69 (9.4%) cases with dysplasia and 10 (1.4%) cases with intestinal cancer (9 in UC). No difference was found for dysplasia and cancer in patients who followed up for 10-20 years or for more than 20 years. The prevalence of dysplasia and cancer is increased in UC compared to CD but the prevalence of high-grade dysplasia is comparatively low. Intestinal cancer prevalence is increasing after the first decade and then practically remains stable. Copyright © 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Biorepositories for the Breast Cancer Prevention Trial (BCPT) and the Study of Tamoxifen and Raloxifene (STAR) | Division of Cancer Prevention

Cancer.gov

The National Surgical Adjuvant Breast and Bowel Project (NSABP) has a serum and lymphocyte bank with specimens on more than 90% of the 33,000 women in the Breast Cancer Prevention Trial (BCPT) and Study of Tamoxifen and Raloxifene (STAR). They also have tumor blocks on the majority of the breast cancers that have occurred in women on these studies. |

Increased uptake and improved outcomes of bowel cancer screening with a faecal immunochemical test: results from a pilot study within the national screening programme in England.

PubMed

Moss, Sue; Mathews, Christopher; Day, T J; Smith, Steve; Seaman, Helen E; Snowball, Julia; Halloran, Stephen P

2017-09-01

The National Health Service Bowel Cancer Screening Programme (BCSP) in England uses a guaiac-based faecal occult blood test (gFOBt). A quantitative faecal immunochemical test (FIT) for haemoglobin (Hb) has many advantages, including being specific for human blood, detecting Hb at a much lower concentration with a single faecal sample and improved uptake. In 2014, a large comparative pilot study was performed within BCSP to establish the acceptability and diagnostic performance of FIT. Over a 6-month period, 40 930 (1 in 28) subjects were sent a FIT (OC-SENSOR) instead of a gFOBt. A bespoke FIT package was used to mail FIT sampling devices to and from FIT subjects. All participants positive with either gFOBt or FIT (cut-off 20 µg Hb/g faeces) were referred for follow-up. Subgroup analysis included cut-off concentrations, age, sex, screening history and deprivation quintile. While overall uptake increased by over 7 percentage points with FIT (66.4% vs 59.3%, OR 1.35, 95% CI 1.33 to 1.38), uptake by previous non-responders almost doubled (FIT 23.9% vs gFOBt 12.5%, OR 2.20, 95% CI 2.10 to 2.29). The increase in overall uptake was significantly higher in men than women and was observed across all deprivation quintiles. With the conventional 20 µg/g cut-off, FIT positivity was 7.8% and ranged from 5.7% in 59-64-year-old women to 11.1% in 70-75-year-old men. Cancer detection increased twofold and that for advanced adenomas nearly fivefold. Detection rates remained higher with FIT for advanced adenomas, even at 180 µg Hb/g. Markedly improved participation rates were achieved in a mature gFOBt-based national screening programme and disparities between men and women were reduced. High positivity rates, particularly in men and previous non-respondents, challenge the available colonoscopy resource, but improvements in neoplasia detection are still achievable within this limited resource. Published by the BMJ Publishing Group Limited. For permission to use (where not

Solar radiation is inversely associated with inflammatory bowel disease admissions.

PubMed

Jaime, Francisca; Riutort, Maria C; Alvarez-Lobos, Manuel; Hoyos-Bachiloglu, Rodrigo; Camargo, Carlos A; Borzutzky, Arturo

To explore the associations between latitude and solar radiation with inflammatory bowel disease admission rates in Chile, the country with the largest variation in solar radiation in the world. This is an ecological study, which included data on all hospital-admitted population for inflammatory bowel disease between 2001 and 2012, according to different latitudes and solar radiation exposures in Chile. The data were acquired from the national hospital discharge database from the Department of Health Statistics and Information of the Chilean Ministry of Health. Between 2001 and 2012 there were 12,869 admissions due to inflammatory bowel disease (69% ulcerative colitis, 31% Crohn's disease). Median age was 36 years (IQR: 25-51); 57% were female. The national inflammatory bowel disease admission rate was 6.52 (95% CI: 6.40-6.63) per 100,000 inhabitants with increasing rates over the 12-year period. In terms of latitude, the highest admission rates for pediatric ulcerative colitis and Crohn's disease, as well as adult ulcerative colitis, were observed in the southernmost region with lowest annual solar radiation. Linear regression analysis showed that regional solar radiation was inversely associated with inflammatory bowel disease admissions in Chile (β: -.44, p = .03). Regional solar radiation was inversely associated with inflammatory bowel disease admission rates in Chile; inflammatory bowel disease admissions were highest in the southernmost region with lowest solar radiation. Our results support the potential role of vitamin D deficiency on inflammatory bowel disease flares.

Noncolorectal malignancies in inflammatory bowel disease: more than meets the eye.

PubMed

Beaugerie, Laurent; Sokol, Harry; Seksik, Philippe

2009-01-01

In patients with Crohn's disease, the risk of small bowel adenocarcinoma is 20-40 times higher than the low background risk of the general population. In the subset of patients with longstanding small bowel lesions, the absolute risk of small bowel adenocarcinoma exceeds 1 per 100 patient-years after 25 years of follow-up and becomes equivalent to the risk of colorectal cancer. Growing evidence suggests that the pathogenesis of small bowel adenocarcinoma arising in inflammatory lesions of Crohn's disease is similar to that of colorectal cancer complicating chronic colonic inflammation (inflammation-dysplasia-cancer sequence). However, contrasting with the established endoscopic detection of colonic advanced neoplasias in patients with longstanding extensive colitis, there is no consensus at this time how to face the excess-risk of small bowel adenocarcinoma in patients at high risk. There are no specific clinical or imaging alert signs and endoscopic surveillance of the totality of the inflamed small bowel mucosa would suppose to perform repeated enteroscopies, with the potential limiting factor of stenosis. Very preliminary data suggest that chemoprevention with salicylates could be an alternative way for reducing the risk. Data from referral centers and from the CESAME cohort suggest that intestinal lymphomas may arise in the chronically inflamed segments in patients with inflammatory bowel disease (IBD). Regarding nonintestinal lymphomas, it is now established that IBD patients treated with thiopurines have an excess risk of lymphomas, exhibiting in most cases pathological features of lymphomas associated with immunosuppression, including the frequent presence of EBV in neoplastic tissues. There is growing evidence that treatment with thiopurines is responsible by itself for this excess risk. IBD patients receiving immunomodulators, especially young men, are also at risk (0.4 for 10,000 patient-years in the CESAME study) for developing fatal early post

Likely effect of adding flexible sigmoidoscopy to the English NHS Bowel Cancer Screening Programme: impact on colorectal cancer cases and deaths

PubMed Central

Geurts, S M E; Massat, N J; Duffy, S W

2015-01-01

Background: From 2013, once-only flexible sigmoidoscopy (FS) at age 55 is being phased into the England National Health Service Bowel Cancer Screening Programme (NHSBCSP), augmenting biennial guaiac faecal occult blood testing (gFOBT) at ages 60–74. Here, we project the impact of this change on colorectal cancer (CRC) cases and deaths prevented in England by mid-2030. Methods: We simulated the life-course of English residents reaching age 55 from 2013 onwards. Model inputs included population numbers, invitation rates and CRC incidence and mortality rates. The impact of gFOBT and FS alone on CRC incidence and mortality were derived from published trials, assuming an uptake of 50% for FS and 57% for gFOBT. For FS plus gFOBT, we assumed the gFOBT effect to be 75% of the gFOBT alone impact. Results: By mid-2030, 8.5 million individuals will have been invited for once-only FS screening. Adding FS to gFOBT screening is estimated to prevent an extra 9627 (−10%) cases and 2207 (−12%) deaths by mid-2030. If FS uptake is 38% or 71%, respectively, an extra 7379 (−8%) or 13 689 (−15%) cases and 1691 (−9%) or 3154 (−17%) deaths will be prevented by mid-2030. Conclusions: Adding once-only FS at age 55 to the NHSBCSP will prevent ∼10 000 CRC cases and ∼2000 CRC deaths by mid-2030 if FS uptake is 50%. In 2030, one cancer was estimated to be prevented per 150 FS screening episodes, and one death prevented per 900 FS screening episodes. The actual reductions will depend on the FS invitation schedule and uptake rates. PMID:26110973

National Cancer Moonshot Initiative platform | Office of Cancer Genomics

Cancer.gov

As part of the Vice President’s National Cancer Moonshot Initiative, the National Cancer Institute has launched an online engagement platform to enable the research community and the public to submit cancer research ideas to a Blue Ribbon Panel of scientific experts. Any member of the public is encouraged to submit his or her ideas for reducing the incidence of cancer and developing better ways to prevent, treat, and cure all types of cancer. Research ideas may be submitted in the following areas:

Genomic Alterations Observed in Colitis-Associated Cancers Are Distinct From Those Found in Sporadic Colorectal Cancers and Vary by Type of Inflammatory Bowel Disease.

PubMed

Yaeger, Rona; Shah, Manish A; Miller, Vincent A; Kelsen, Judith R; Wang, Kai; Heins, Zachary J; Ross, Jeffrey S; He, Yuting; Sanford, Eric; Yantiss, Rhonda K; Balasubramanian, Sohail; Stephens, Philip J; Schultz, Nikolaus; Oren, Moshe; Tang, Laura; Kelsen, David

2016-08-01

Patients with inflammatory bowel diseases, such as Crohn's disease (CD) and ulcerative colitis (UC), are at increased risk for small bowel or colorectal cancers (colitis-associated cancers [CACs]). We compared the spectrum of genomic alterations in CACs with those of sporadic colorectal cancers (CRCs) and investigated differences between CACs from patients with CD vs UC. We studied tumor tissues from patients with CACs treated at Memorial Sloan Kettering Cancer Center or Weill Cornell Medical College from 2003 through 2015. We performed hybrid capture-based next-generation sequencing analysis of >300 cancer-related genes to comprehensively characterize genomic alterations. We performed genomic analyses of 47 CACs (from 29 patients with UC and 18 with CD; 43 primary tumors and 4 metastases). Primary tumors developed in the ileum (n = 2), right colon (n = 18), left colon (n = 6), and rectosigmoid or rectum (n = 21). We found genomic alterations in TP53, IDH1, and MYC to be significantly more frequent, and mutations in APC to be significantly less frequent, than those reported in sporadic CRCs by The Cancer Genome Atlas or Foundation Medicine. We identified genomic alterations that might be targeted by a therapeutic agent in 17 of 47 (36%) CACs. These included the mutation encoding IDH1 R132; amplification of FGFR1, FGFR2, and ERBB2; and mutations encoding BRAF V600E and an EML4-ALK fusion protein. Alterations in IDH1 and APC were significantly more common in CACs from patients with CD than UC. In an analysis of CACs from 47 patients, we found significant differences in the spectrum of genomic alterations in CACs compared with sporadic CRCs. We observed a high frequency of IDH1 R132 mutations in patients with CD but not UC, as well as a high frequency of MYC amplification in CACs. Many genetic alterations observed in CACs could serve as therapeutic targets. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Genomic Alterations Observed in Colitis-associated Cancers are Distinct from Those Found in Sporadic Colorectal Cancers and Vary by Type of Inflammatory Bowel Disease

PubMed Central

Yaeger, Rona; Shah, Manish A.; Miller, Vincent A.; Kelsen, Judith R.; Wang, Kai; Heins, Zachary J.; Ross, Jeffrey S.; He, Yuting; Sanford, Eric; Yantiss, Rhonda K.; Balasubramanian, Sohail; Stephens, Philip J.; Schultz, Nikolaus; Oren, Moshe; Tang, Laura; Kelsen, David

2016-01-01

Background & Aims Patients with inflammatory bowel diseases such as Crohn's disease (CD) or ulcerative colitis (UC) are at increased risk for small bowel or colorectal cancers (colitis-associated cancers, CACs). We compared the spectrum of genomic alterations in CACs with those of sporadic colorectal cancers (CRCs) and investigated differences between CACs from patients with CD vs UC. Methods We studied tumor tissues from patients with CACs, treated at Memorial Sloan Kettering Cancer Center or Weill Cornell Medical College from 2003 through 2015. We performed hybrid capture based next-generation sequencing analysis of over 300 cancer-related genes to comprehensively characterize genomic alterations. Results We performed genomic analyses of 47 CACs (from 29 patients with UC and 18 with CD; 43 primary tumors and 4 metastases). Primary tumors developed in the ileum (n=2), right colon (n=18), left colon (n=6) and rectosigmoid or rectum (n=21). We found genomic alterations in TP53, IDH1, and MYC to be significantly more frequent, and mutations in APC to be significantly less frequent, than those reported in sporadic CRCs by The Cancer Genome Atlas or Foundation Medicine. We identified genomic alterations that might be targeted by a therapeutic agent in 17/47 (36%) of CACs. These included the mutation encoding IDH1 R132; amplification of FGFR1, FGFR2, and ERBB2; and mutations encoding BRAF V600E and an EML4-ALK fusion protein. Alterations in IDH1 and APC were significantly more common in CACs from patients with CD than UC. Conclusions In an analysis of CACs from 47 patients, we found significant differences in the spectrum of genomic alterations in CACs compared to sporadic CRCs. We observed a high frequency of IDH1 R132 mutations in patients with CD but not UC, as well as a high frequency of MYC amplification in CACs. Many genetic alterations observed in CACs could serve as therapeutic targets. PMID:27063727

Surgery for the resolution of symptoms in malignant bowel obstruction in advanced gynaecological and gastrointestinal cancer.

PubMed

Cousins, Sarah E; Tempest, Emma; Feuer, David J

2016-01-04

This is an update of the original Cochrane review published in Issue 4, 2000. Intestinal obstruction commonly occurs in progressive advanced gynaecological and gastrointestinal cancers. Management of these patients is difficult due to the patients' deteriorating mobility and function (performance status), the lack of further chemotherapeutic options, and the high mortality and morbidity associated with palliative surgery. There are marked variations in clinical practice concerning surgery in these patients between different countries, gynaecological oncology units and general hospitals, as well as referral patterns from oncologists under whom these patients are often admitted. To assess the efficacy of surgery for intestinal obstruction due to advanced gynaecological and gastrointestinal cancer. We searched the following databases for the original review in 2000 and again for this update in June 2015: CENTRAL (2015, Issue 6); MEDLINE (OVID June week 1 2015); and EMBASE (OVID week 24, 2015).We also searched relevant journals, bibliographic databases, conference proceedings, reference lists, grey literature and the world wide web for the original review in 2000; we also used personal contact. This searching of other resources yielded very few additional studies. The Cochrane Pain, Palliative and Supportive Care Review Group no longer routinely handsearch journals. For these reasons, we did not repeat the searching of other resources for the June 2015 update. As the review concentrates on the 'best evidence' available for the role of surgery in malignant bowel obstruction in known advanced gynaecological and gastrointestinal cancer we kept the inclusion criteria broad (including both prospective and retrospective studies) so as to include all studies relevant to the question. We sought published trials reporting on the effects of surgery for resolving symptoms in malignant bowel obstruction for adult patients with known advanced gynaecological and gastrointestinal

The establishment of a national tissue bank for inflammatory bowel disease research in Canada.

PubMed

Collins, Stephen M; McHugh, Kevin; Croitoru, Ken; Howorth, Michael

2003-02-01

The Crohn's and Colitis Foundation of Canada (CCFC) has established a national bank for tissue, serum and blood from patients with inflammatory bowel disease (IBD). Investigators from across the country submit material to the bank together with clinical data. Investigators may access their own patient information from the bank for their own study purposes, but the distribution of tissue is restricted to specific CCFC-funded projects. Currently, tissues are being collected from newly diagnosed, untreated IBD patients to support a recent initiative aimed at characterizing microbes in colonic and ileal biopsies from such patients. In the future, criteria for the submission of tissue will be tailored to specific research questions. This bank is believed to be the first national bank of its kind dedicated to research in Crohn's disease and ulcerative colitis

[A clinical study using octreotide in relieving gastrointestinal symptoms due to bowel obstruction in a terminally ill cancer patient].

PubMed

Shima, Yasuo; Yamaguchi, Kensei; Miyata, Yoshinori; Hyodo, Ichinosuke; Yagi, Yasuo; Honke, Yoshifumi

2004-09-01

Terminally ill cancer patients with complicated bowel obstructions often have poor quality of life (QOL) due to gastrointestinal symptoms such as nausea and vomiting. Many of these patients are inoperable because of poor general conditions, and half of these patients can't be managed by conventional antiemetics. There are many reports indicating octreotide is effective for these patients. In the present study, 13 patients (5 patients without a nasogastric tube and 8 patients with) were administered octreotide at 300 microg/day by 24 hours continuous subcutaneous infusion. Among the effectively evaluable 10 cases, 6 cases (60.0%) were assessed as effective according to the efficacy criteria based on the JCOG toxicity scale. In the 6 cases who had nasogastric tubes, the nasogastric aspirates decreased from 890 ml (550-1,950) to 480 ml (180-1,790). Vomiting was successfully controlled after the removals of nasogastric tubes in 4 out of 6 cases (66.7%), regarding safety, 2 out of 13 cases (15.4%) showed an excess of liver enzymes but no clinically suspected adverse effect was observed. Octreotide is effective and well tolerated in terminally ill cancer patients with malignant bowel obstruction.

A Comparison of Patient Outcomes and Quality of Life in Persons With Neurogenic Bowel: Standard Bowel Care Program Vs Colostomy

PubMed Central

Luther, Stephen L; Nelson, Audrey L; Harrow, Jeffrey J; Chen, Fangfei; Goetz, Lance L

2005-01-01

Background/Objective: The purpose of this study was to compare patient outcomes and quality of life for people with neurogenic bowel using either a standard bowel care program or colostomy. Methods: We analyzed survey data from a national sample, comparing outcomes between veterans with spinal cord injury (SCI) who perform bowel care programs vs individuals with colostomies. This study is part of a larger study to evaluate clinical practice guideline implementation in SCI. The sample included 1,503 veterans with SCI. The response rate was 58.4%. For comparison, we matched the respondents with colostomies to matched controls from the remainder of the survey cohort. A total of 74 veterans with SCI and colostomies were matched with 296 controls, using propensity scores. Seven items were designed to elicit information about the respondent's satisfaction with their bowel care program, whereas 7 other items were designed to measure bowel-related quality of life. Results: No statistically significant differences in satisfaction or quality of life were found between the responses from veterans with colostomies and those with traditional bowel care programs. Both respondents with colostomies and those without colostomies indicated that they had received training for their bowel care program, that they experienced relatively few complications, such as falls as a result of their bowel care program, and that their quality of life related to bowel care was generally good. However, large numbers of respondents with colostomies (n = 39; 55.7%) and without colostomies (n = 113; 41.7%) reported that they were very unsatisfied with their bowel care program. Conclusion: Satisfaction with bowel care is a major problem for veterans with SCI. PMID:16869085

Small bowel perforation without tumor recurrence after radiotherapy for cervical carcinoma: report of seven cases.

PubMed

Yamashita, Hideomi; Nakagawa, Keiichi; Tago, Masao; Igaki, Hiroshi; Shiraishi, Kenshirou; Nakamura, Naoki; Sasano, Nakashi; Yamakawa, Sen; Ohtomo, Kuni

2006-04-01

We describe the clinical presentation, evaluation, management and outcome of patients experiencing small bowel perforation following radiation therapy for cervical cancer. A database consisting of 95 Japanese women with stage 0-4 A cervix cancer treated between 1991 and 2004 contained seven patients (7.4%) with small bowel perforation. The median age at the time of perforation was 72.5 years (range 62-78). The median time from completion of radiotherapy to perforation was 6 months (range 2-58). Surgery (one small bowel resection and anastomosis with diversion; six small bowel resection and anastomosis) was performed immediately in all seven patients. One of seven patients died of small bowel perforation (i.e. mortality rate was 14%). Bowel adhesion was detected during the operation in only three cases (43%). Signs of peritonitis were absent in six cases (86%). Severe abdominal pain was seen in all seven patients. The perforation site was ileum in all seven cases. In all patients, pathological changes were compatible with postirradiation injury of the gastrointestinal tract. The presenting complaints of patients with bowel perforation following radiotherapy vary, and signs of peritonitis may be absent. Emergency physicians must be alert for these complications in patients who have been treated with radiotherapy.

Contouring and Constraining Bowel on a Full-Bladder Computed Tomography Scan May Not Reflect Treatment Bowel Position and Dose Certainty in Gynecologic External Beam Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yaparpalvi, Ravindra, E-mail: ryaparpa@montefiore.org; Mehta, Keyur J.; Bernstein, Michael B.

Purpose: To evaluate, in a gynecologic cancer setting, changes in bowel position, dose-volume parameters, and biological indices that arise between full-bladder (FB) and empty-bladder (EB) treatment situations; and to evaluate, using cone beam computed tomography (CT), the validity of FB treatment presumption. Methods and Materials: Seventeen gynecologic cancer patients were retrospectively analyzed. Empty-bladder and FB CTs were obtained. Full-bladder CTs were used for planning and dose optimization. Patients were given FB instructions for treatment. For the study purpose, bowel was contoured on the EB CTs for all patients. Bowel position and volume changes between FB and EB states were determined.more » Full-bladder plans were applied on EB CTs for determining bowel dose-volume changes in EB state. Biological indices (generalized equivalent uniform dose and normal tissue complication probability) were calculated and compared between FB and EB. Weekly cone beam CT data were available in 6 patients to assess bladder volume at treatment. Results: Average (±SD) planned bladder volume was 299.7 ± 68.5 cm{sup 3}. Median bowel shift in the craniocaudal direction between FB and EB was 12.5 mm (range, 3-30 mm), and corresponding increase in exposed bowel volume was 151.3 cm{sup 3} (range, 74.3-251.4 cm{sup 3}). Absolute bowel volumes receiving 45 Gy were higher for EB compared with FB (mean 328.0 ± 174.8 vs 176.0 ± 87.5 cm{sup 3}; P=.0038). Bowel normal tissue complication probability increased 1.5× to 23.5× when FB planned treatments were applied in the EB state. For the study, the mean percentage value of relative bladder volume at treatment was 32%. Conclusions: Full-bladder planning does not necessarily translate into FB treatments, with a patient tendency toward EB. Given the uncertainty in daily control over bladder volume for treatment, we strongly recommend a “planning-at-risk volume bowel” (PRV{sub B}owel) concept to account for bowel

An innovative solution to raise public awareness using a mobile colorectal clinic - The 'bowel bus'.

PubMed

Naguib, N; Lewis, M; Iredale, R; Pugh, R; Haray, P N

2017-03-01

Colorectal cancer is the fourth most common cancer in the United Kingdom; however, figures show that the uptake for bowel cancer screening lags behind other cancer screening programmes. This is a report of a multi-staged development of an outreach colorectal clinical community service provided through a Mobile Unit (a Bowel Bus). The unit delivers a one-stop colorectal clinic that provides a rapid access pathway to members of the public who have concerns about, or symptoms of, bowel cancer. The aims of the project were to increase public awareness about colorectal cancer and to provide an outreach clinic as a supplement to the hospital based colorectal clinic. This service is a result of collaborative efforts between Tenovus Cancer Care (TCC) and the colorectal surgery department of the local NHS Hospital. During one year, the Bowel Bus has provided services to 772 members of the local community. 244 patients were examined by the colorectal nurse specialist including 66 drop-in patients and 135 patients referred by the GPs. The service led to decrease in the waiting list for routine referrals to be seen in the colorectal clinic at the hospital from a mean of 10.5 weeks-5.9 weeks. A feedback questionnaire from 180 patients, used to audit the quality of the service, has confirmed an overwhelming satisfaction with the service. The Mobile Unit is a novel solution to addressing the ever increasing demand for specialist outpatient services without compromising the quality of care whilst enhancing the patient experience. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene trial: Advancing the science of recruitment and breast cancer risk assessment in minority communities

PubMed Central

McCaskill-Stevens, Worta; Wilson, John W; Cook, Elise D; Edwards, Cora L; Gibson, Regina V; McElwain, Diane L; Figueroa-Moseley, Colmar D; Paskett, Electra D; Roberson, Noma L; Wickerham, D Lawrence; Wolmark, Norman

2014-01-01

Background One of the first chemoprevention trials conducted in the western hemisphere, the National Surgical Adjuvant Breast and Bowel Project’s (NSABP) Breast Cancer Prevention Trial (BCPT), demonstrated the need to evaluate all aspects of recruitment in real time and to implement strategies to enroll racial and ethnic minority women. Purpose The purpose of this report is to review various patient recruitment efforts the NSABP developed to enhance the participation of racial and ethnic minority women in the Study of Tamoxifen and Raloxifene (STAR) trial and to describe the role that the recruitment process played in the implementation and understanding of breast cancer risk assessment in minority communities. Methods The NSABP STAR trial was a randomized, double-blinded study comparing the use of tamoxifen 20 mg/day to raloxifene 60 mg/day, for a 5-year period, to reduce the risk of developing invasive breast cancer. Eligible postmenopausal women were required to have a 5-year predicted breast cancer risk of 1.66% based on the modified Gail Model. For the current report, eligibility and enrollment data were tabulated by race/ethnicity for women who submitted STAR risk assessment forms (RAFs). Results A total of 184,460 RAFs were received, 145,550 (78.9%) from white women and 38,910 (21.1%) from minority women. Of the latter group, 21,444 (11.6%) were from African Americans/blacks, 7913 (4.5%) from Hispanics/Latinas, and 9553 (5.2%) from other racial or ethnic groups. The percentages of risk-eligible women among African Americans, Hispanics/Latinas, others, and whites were 14.2%, 23.3%, 13.7%, and 57.4%, respectively. Programs targeting minority enrollment submitted large numbers of RAFs, but the eligibility rates of the women referred from those groups tended to be lower than the rates among women referred outside of those programs. The average number of completed risk assessments increased among minority women over the course of the recruitment period compared

Low Rates of Dermatologic Care and Skin Cancer Screening Among Inflammatory Bowel Disease Patients.

PubMed

Anderson, Alyce; Ferris, Laura K; Click, Benjamin; Ramos-Rivers, Claudia; Koutroubakis, Ioannis E; Hashash, Jana G; Dunn, Michael; Barrie, Arthur; Schwartz, Marc; Regueiro, Miguel; Binion, David G

2018-04-30

Dermatologic manifestations of inflammatory bowel disease (IBD) are common, and certain IBD medications increase the risk of skin cancer. To define the rates of care and factors associated with dermatologic utilization with a focus on skin cancer screening. We utilized a prospective, natural history IBD research registry to evaluate all outpatient healthcare encounters from 2010 to 2016. Gastrointestinal, dermatologic and primary care visits per individual were identified. We calculated the proportion of patients obtaining care, categorized primary indications for dermatologic visits, determined the incidence of melanoma and non-melanoma skin cancers, and used logistic regression to determine factors associated with dermatology utilization. Of the 2127 IBD patients included, 452 (21.3%) utilized dermatology over the study period, and 55 (2.6%) had a total body skin examination at least once. The 452 patients incurred 1633 dermatology clinic visits, 278 dermatologic procedures, and 1108 dermatology telephone encounters. The most frequent indication was contact dermatitis or dermatitis. Factors associated with dermatology use were family history of skin cancer, employment, systemic steroids, longer disease duration, emergency room use, and the number of IBD-related clinic visits. Between 8.3 and 11% of IBD patients recommended for skin cancer screening visited dermatology each year, and the resulting incidence of non-melanoma skin cancer was 35.4/10,000 [95% CI 23.3-51.5] and melanoma was 6.56/10,000 [95% CI 2.1-15.3]. Less than one in ten IBD patients obtain dermatologic care. Given the increased risk of skin cancers among IBD patients, an emphasis on education, prevention, and screening merits attention.

Influence of dietary fiber on inflammatory bowel disease and colon cancer: importance of fermentation pattern.

PubMed

Rose, Devin J; DeMeo, Mark T; Keshavarzian, Ali; Hamaker, Bruce R

2007-02-01

The benefits of dietary fiber on inflammatory bowel disease may be related to the fermentative production of butyrate in the colon, which appears to decrease the inflammatory response. The benefits of dietary fiber against colon cancer may be related to both fermentative and non-fermentative processes, although poorly fermentable fibers appear more influential. Dietary fiber fermentation profiles are important in determining optimal fibers for colonic health, and may be a function of structure, processing conditions, and other food components. A greater understanding of the relationships between fermentation rate and dietary fiber structure would allow for development of dietary fibers for optimum colonic health.

Irritable Bowel Syndrome

MedlinePlus

... Staying Safe Videos for Educators Search English Español Irritable Bowel Syndrome KidsHealth / For Teens / Irritable Bowel Syndrome What's in ... intestinal disorder called irritable bowel syndrome. What Is Irritable Bowel Syndrome? Irritable bowel syndrome (IBS) is a common intestinal ...

Bowel incontinence

MedlinePlus

Uncontrollable passage of feces; Loss of bowel control; Fecal incontinence; Incontinence - bowel ... older, women tend to have problems with bowel control more often than men. Children who have problems ...

Cigarette smoking, obesity, physical activity, and alcohol use as predictors of chemoprevention adherence in the National Surgical Adjuvant Breast and Bowel Project P-1 Breast Cancer Prevention Trial

PubMed Central

Land, Stephanie R.; Cronin, Walter M.; Wickerham, D. Lawrence; Costantino, Joseph P.; Christian, Nicholas J.; Klein, William M.P.; Ganz, Patricia A.

2011-01-01

Background The double-blind, prospective, National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial (BCPT) demonstrated a 50% reduction in the risk of breast cancer (BC) for tamoxifen versus placebo, yet many women at risk of BC do not adhere to the 5-year course. This first report of the rich BCPT drug adherence data examines predictors of adherence. Methods 13,338 women at high risk of BC were randomly assigned 6/92-9/97 to 20 mg/day tamoxifen versus placebo; we analyzed the 11,064 enrolled more than 3 years before trial unblinding. Primary endpoint was full drug adherence (100% of assigned pills per staff report, excluding protocol-required discontinuation) at 1 and 36 months; secondary was adequate adherence (76-100%). Protocol-specified multivariable logistic regression tested lifestyle factors, controlling for demographic and medical predictors. Results 13% were current smokers. 60% were overweight/obese. 46% had moderate/heavy physical activity. 21%, 66%, 13% drank 0, 0-1, 1+ drinks/day. 91% were adequately adherent at 1 mo; 79% at 3 yrs. Alcohol use was associated with reduced full adherence at 1 mo (p=.016; odds ratio [OR]=0.79 1+ versus 0), as was age (p<.001; OR=1.4 age 60+), college education (p<.001; OR=0.78) and per-capita household annual income (p<.001; OR=1.2 per $30,000). Smoking (p=.003; OR=0.75), age (p=.024, OR=1.1), college education (p=.037; OR=1.4), tamoxifen assignment (p=.031; OR=.84), and BC risk (p<.001; OR=1.5 high v low) predicted adequate adherence at 36 months. There were no significant associations with obesity or physical activity. Conclusions Alcohol use and smoking might indicate a need for greater adherence support. PMID:21862698

Hereditary factors are unlikely behind unusual pattern of early - Onset colorectal cancer in Egyptians: A study of family history and pathology features in Egyptians with large bowel cancer (cross-sectional study).

PubMed

Abou-Zeid, Ahmed A; Jumuah, Wael A; Ebied, Essam F; Abd El Samee Atia, Karim Sabry; El Ghamrini, Yasser; Somaie, Dina A

2017-08-01

Colorectal cancer in Egypt has a higher incidence in young patients compared to western countries, where the disease is more prevalent in the old age group. This difference has been attributed to higher incidence of hereditary cancers in young Egyptian patients. The aim of this study is to compare the family history criteria and pathology features of tumors in young (≤40 years) and old (>40 years) Egyptian patients with adenocarcinoma of the colon and rectum. This is the analysis of our prospectively collected data on the pathology features of tumors in 313 consecutive patients (133 young, 180 old) with colorectal cancer presenting to the Department of Surgery within an eight-year period. A detailed family history was obtained from 258 patients (112 young, 146 old). 41 young and 48 old patients reported family history of cancer, the difference was not statistically significant. Ten young patients (9%) reported a family history of colorectal cancer in a first degree relative (3 fitting into Amsterdam criteria, 7 fitting into less strict criteria) which was not significantly different from the old age group. The pathologic features of tumors in both groups resembled sporadic rather than hereditary cancer and there was no significant difference between groups in tumor location, degree of differentiation, mucin production, synchronous and metachronous colorectal tumors or polyps and grossly stricturing or ulcerating tumors. Extracolonic tumors developed in one young and two old patients. The characteristics of large bowel cancer in young Egyptian patients do not differ significantly from those in older patients. Despite the high incidence of large bowel cancer in young Egyptian patients, family history and pathologic features of tumors do not support a hereditary origin of colorectal cancer in this age group in Egypt. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Palliative Management of Malignant Bowel Obstruction in Terminally Ill Patient

PubMed Central

Thaker, Darshit A; Stafford, Bruce C; Gaffney, Luke S

2010-01-01

Mr. P was a 57-year-old man who presented with symptoms of bowel obstruction in the setting of a known metastatic pancreatic cancer. Diagnosis of malignant bowel obstruction was made clinically and radiologically and he was treated conservatively (non-operatively)with octreotide, metoclopromide and dexamethasone, which provided good control over symptoms and allowed him to have quality time with family until he died few weeks later with liver failure. Bowel obstruction in patients with abdominal malignancy requires careful assessment. The patient and family should always be involved in decision making. The ultimate goals of palliative care (symptom management, quality of life and dignity of death) should never be forgotten during decision making for any patient. PMID:21811356

Patient-Reported Outcomes in Sentinel Node–Negative Adjuvant Breast Cancer Patients Receiving Sentinel-Node Biopsy or Axillary Dissection: National Surgical Adjuvant Breast and Bowel Project Phase III Protocol B-32

PubMed Central

Land, Stephanie R.; Kopec, Jacek A.; Julian, Thomas B.; Brown, Ann M.; Anderson, Stewart J.; Krag, David N.; Christian, Nicholas J.; Costantino, Joseph P.; Wolmark, Norman; Ganz, Patricia A.

2010-01-01

Purpose Sentinel lymph node resection (SNR) may reduce morbidity while providing the same clinical utility as conventional axillary dissection (AD). National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 is a randomized phase III trial comparing SNR immediately followed by AD (SNAD) to SNR and subsequent AD if SN is positive. We report the definitive patient-reported outcomes (PRO) comparisons. Patients and Methods Eligible patients had clinically node-negative, operable invasive breast cancer. The PRO substudy included all SN-negative participants enrolled May 2001 to February 2004 at community institutions in the United States (n = 749; 78% age ≥ 50; 87% clinical tumor size ≤ 2.0 cm; 84% lumpectomy; 87% white). They completed questionnaires presurgery, 1 and 2 to 3 weeks postoperatively, and every 6 months through year 3. Arm symptoms, arm use avoidance, activity limitations, and quality of life (QOL) were compared with intent-to-treat two-sample t-tests and repeated measures analyses. Results Arm symptoms were significantly more bothersome for SNAD compared with SNR patients at 6 months (mean, 4.8 v 3.0; P < .001) and at 12 months (3.6 v 2.5; P = .006). Longitudinally, SNAD patients were more likely to experience ipsilateral arm and breast symptoms, restricted work and social activity, and impaired QOL (P ≤ .002 all items). From 12 to 36 months, fewer than 15% of either SNAD or SNR patients reported moderate or greater severity of any given symptom or activity limitation. Conclusion Arm morbidity was greater with SNAD than with SNR. Despite considerable fears about complications from AD for breast cancer, this study demonstrates that initial problems with either surgery resolve over time. PMID:20679600

Bowel preparation for colonoscopy with magnesium sulphate and low-volume polyethylene glycol.

PubMed

Tepeš, Bojan; Mlakar, Dominika N; Metličar, Tanja

2014-06-01

Patient compliance with bowel cleansing procedures represents one of the most objectionable aspects of colonoscopy. Adverse reactions to the purgative may result in failure to complete the preparation, inadequate visualization of the colon, polyp and even carcinoma miss rate and unwillingness to attend a follow-up colonoscopy. The primary objective of the study was to evaluate the effectiveness of bowel cleansing with magnesium sulphate and low-volume polyethylene glycol (PEG) with electrolytes. The second objective was to evaluate whether bowel cleansing was better in participants scheduled for morning colonoscopies or afternoon colonoscopies. Magnesium sulphate mineral water (2 l) and 2 l of low-volume PEG and electrolytes solution were used as our bowel cleansing protocol. A total of 13 914 participants, who participated in the Slovenian colorectal cancer screening programme in the period between 2009 and 2011, were included. Excellent bowel preparation was achieved in 11 484 (82.61%) participants; 1894 (13.62%) participants had good bowel preparation, 439 (3.16%) participants had fair bowel preparation and 85 (0.61%) participants had poor bowel preparation. Better results were achieved in the afternoon colonoscopies and in younger participant groups (P<0.001). No serious side effects of bowel cleansing were reported. This is the first study to use magnesium sulphate mineral water and PEG plus electrolytes for bowel cleansing. We found excellent bowel cleansing in 82.61% participants and in more participants if colonoscopy was performed in the afternoon.

Bowel cancer screening is safe, detects earlier stage cancer and adenomas in 50% of cases: experience of the prevalent round of screening from two first wave centres in the North East of England.

PubMed

Rajasekhar, P T; Clifford, G M; Lee, T J W; Rutter, M D; Waddup, G; Ritchie, M; Nylander, D; Painter, J; Singh, J; Ward, I; Dempsey, N; Bowes, J; Handley, G; Henry, J; Rees, C J

2012-01-01

The NHS Bowel Cancer Screening Programme (BCSP) began roll-out in 2006 aiming to reduce cancer mortality through detection at an earlier stage. We report results from the prevalent round of screening at two first wave centres and compare with the UK pilot study. This is a service evaluation study. Data were collected prospectively for all individuals undergoing faecal occult blood testing (FOBt) and colonoscopy including: uptake and outcomes of FOBt, colonoscopic performance, findings, histological data and complications. Continuous data were compared using a two-tailed test of two proportions. The South of Tyne and Tees Bowel Cancer Screening centres. Participants of the BCSP. 1) Colonoscopy Quality Assurance and 2) Cancer stage shift. 195,772 individuals were invited to participate. Uptake was 54% and FOBt positivity 1.7%. 1524 underwent colonoscopy with caecal intubation in 1485 (97%). 180 (12%) cancers were detected. Dukes stages were: 76 (42%) A; 47 (26%) B; 47 (26%) C; 8 (4%) D and 2 (1%) unknown. This demonstrates a significantly earlier stage at diagnosis compared with data from 2867 non-screening detected cancers (p<0.001). Adenomas were detected in 758 (50%). One perforation occurred (0.07%) and two intermediate bleeds requiring transfusion only (0.12%). Both caecal intubation and adenoma detection were significantly higher than in the UK pilot study (p<0.001). The prevalent round of screening demonstrates a high adenoma and cancer detection rate and significantly earlier stage at diagnosis. Complications were few providing reassurance regarding safety. Efforts are required to improve uptake.

Bowel cancer screening is safe, detects earlier stage cancer and adenomas in 50% of cases: experience of the prevalent round of screening from two first wave centres in the North East of England

PubMed Central

Rajasekhar, P T; Clifford, G M; Lee, T J W; Rutter, M D; Waddup, G; Ritchie, M; Nylander, D; Painter, J; Singh, J; Ward, I; Dempsey, N; Bowes, J; Handley, G; Henry, J; Rees, C J

2012-01-01

Objective The NHS Bowel Cancer Screening Programme (BCSP) began roll-out in 2006 aiming to reduce cancer mortality through detection at an earlier stage. We report results from the prevalent round of screening at two first wave centres and compare with the UK pilot study. Design This is a service evaluation study. Data were collected prospectively for all individuals undergoing faecal occult blood testing (FOBt) and colonoscopy including: uptake and outcomes of FOBt, colonoscopic performance, findings, histological data and complications. Continuous data were compared using a two-tailed test of two proportions. Setting The South of Tyne and Tees Bowel Cancer Screening centres. Patients Participants of the BCSP. Main Outcome Measures 1) Colonoscopy Quality Assurance and 2) Cancer stage shift. Results 195,772 individuals were invited to participate. Uptake was 54% and FOBt positivity 1.7%. 1524 underwent colonoscopy with caecal intubation in 1485 (97%). 180 (12%) cancers were detected. Dukes stages were: 76 (42%) A; 47 (26%) B; 47 (26%) C; 8 (4%) D and 2 (1%) unknown. This demonstrates a significantly earlier stage at diagnosis compared with data from 2867 non-screening detected cancers (p<0.001). Adenomas were detected in 758 (50%). One perforation occurred (0.07%) and two intermediate bleeds requiring transfusion only (0.12%). Both caecal intubation and adenoma detection were significantly higher than in the UK pilot study (p<0.001). Conclusions The prevalent round of screening demonstrates a high adenoma and cancer detection rate and significantly earlier stage at diagnosis. Complications were few providing reassurance regarding safety. Efforts are required to improve uptake. PMID:28839624

77 FR 30297 - National Cancer Institute; Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... unwarranted invasion of personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel... Cancer Institute, NIH, 6116 Executive Blvd., Room 8133, Bethesda, MD 20892-8328, 301-451-4757, david...

75 FR 37451 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer...

75 FR 42449 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and...

75 FR 28028 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and... the meeting. Name of Committee: National Cancer Institute Clinical Trials and Translational Research...

76 FR 7869 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer... Committee: National Cancer Institute Director's Consumer Liaison Group; DCLG. Date: February 22-23, 2011...

75 FR 11894 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer... Committee: National Cancer Institute Director's Consumer Liaison Group. Date: March 24-26, 2010. Time: March...

76 FR 574 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and... advance of the meeting. Name of Committee: National Cancer Institute Clinical Trials and Translational...

76 FR 22407 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and... the meeting. Name of Committee: National Cancer Institute Clinical Trials and Translational Research...

75 FR 42449 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group; Subcommittee A--Cancer...

The Association of Long-term Treatment-related Side Effects With Cancer-specific and General Quality of Life Among Prostate Cancer Survivors

PubMed Central

Davis, Kimberly M.; Kelly, Scott P.; Luta, George; Tomko, Catherine; Miller, Anthony B.; Taylor, Kathryn L.

2018-01-01

OBJECTIVE To examine the association between treatment-related side effects and cancer-specific and general quality of life (QOL) among long-term prostate cancer survivors. MATERIALS AND METHODS Within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, we conducted telephone interviews with prostate cancer survivors (N = 518) who were 5-10 years after diagnosis. We assessed demographic and clinical information, sexual, urinary, and bowel treatment-related side effects (Expanded Prostate Cancer Index Composite), cancer-specific QOL (Functional Assessment of Cancer Therapy—total score), and general QOL (the Medical Outcomes Study Short Form 12’s physical and mental subscales). RESULTS Participants were aged 74.6 years on average, primarily White (88.4%), and married (81.7%). Pearson correlation coefficients between the 3 treatment-related side effect domains (urinary, sexual, and bowel) and QOL ranged between 0.14 and 0.42 (P <.0001). Multivariable linear regression analyses revealed that poorer urinary and sexual functioning and greater bowel side effects were independently associated with poorer cancer-specific QOL (P <.0001). Bowel and urinary functions were also associated with poorer general QOL on the Medical Outcomes Study Short Form 12’s physical component summary and mental component summary (P <.05). Bowel side effects demonstrated the strongest association with all QOL outcomes. CONCLUSION Treatment-related side effects persisted for up to 10 years after diagnosis and continued to be associated with men’s QOL. These results suggest that each of the treatment-related side effects was independently associated with cancer-specific QOL. Compared with the other Expanded Prostate Cancer Index Composite domains, bowel side effects had the strongest association with cancer-specific and general QOL. These associations emphasize the tremendous impact that bowel side effects continue to have for men many years after their initial diagnosis

75 FR 992 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... Appendix 2), notice is hereby given of the meeting of the National Cancer Advisory Board. The meeting will... clearly unwarranted invasion of personal privacy. Name of Committee: National Cancer Advisory Board; Ad...

76 FR 51378 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Board of Scientific... Committee: National Cancer Institute Board of Scientific Advisors, caBIG Oversight Ad hoc Subcommittee. Date...

75 FR 3243 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Board of Scientific... Committee: National Cancer Institute Board of Scientific Advisors. Date: March 8-9, 2010. Time: March 8...

75 FR 75690 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-06

... listed below in advance of the meeting. Name of Committee: National Cancer Institute Clinical Trials and... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials [[Page...

78 FR 30932 - National Cancer Institute; Cancellation of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Cancellation of Meeting Notice is hereby given of the cancellation of the National Cancer Institute Special Emphasis Panel, June 7, 2013, 10:00 a.m. to June 7, 2013, 1:00 p.m., National Institutes of Health, National Cancer Institute, 9609 Medical...

Bowel morbidity following radiochemotherapy and image-guided adaptive brachytherapy for cervical cancer: Physician- and patient reported outcome from the EMBRACE study.

PubMed

Jensen, Nina Boje Kibsgaard; Pötter, Richard; Kirchheiner, Kathrin; Fokdal, Lars; Lindegaard, Jacob Christian; Kirisits, Christian; Mazeron, Renaud; Mahantshetty, Umesh; Jürgenliemk-Schulz, Ina Maria; Segedin, Barbara; Hoskin, Peter; Tanderup, Kari

2018-06-01

This study describes late bowel morbidity prospectively assessed in the multi-institutional EMBRACE study on MRI-guided adaptive brachytherapy in locally advanced cervical cancer (LACC). A total of 1176 patients were analyzed. Physician reported morbidity (CTCAE v.3.0) and patient reported outcome (PRO) (EORTC QLQ C30/CX24) were assessed at baseline and at regular follow-up. At 3/5 years the actuarial incidence of bowel morbidity grade 3-4 was 5.0%/5.9%, including incidence of stenosis/stricture/fistula of 2.0%/2.6%. Grade 1-2 morbidity was pronounced with prevalence rates of 28-33% during follow-up. Diarrhea and flatulence were most frequently reported, significantly increased after 3 months and remained elevated during follow-up. Incontinence gradually worsened with time. PRO revealed high prevalence rates. Diarrhea ≥"a little" increased from 26% to 37% at baseline to 3 months and remained elevated, difficulty in controlling bowel increased from 11% to 26% at baseline to 3 months gradually worsening with time. Constipation and abdominal cramps improved after treatment. Bowel morbidity reported in this large cohort of LACC patients was limited regarding severe/life-threatening events. Mild-moderate diarrhea, flatulence and incontinence were prevalent after treatment with PROs indicating a considerable and clinically relevant burden. Critical knowledge based on the extent and manifestation pattern of treatment-related morbidity will serve future patient management. Copyright © 2018 Elsevier B.V. All rights reserved.

76 FR 28236 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Cancer Prevention... Review and Logistics Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive...

Small bowel dilation in children with short bowel syndrome is associated with mucosal damage, bowel-derived bloodstream infections, and hepatic injury.

PubMed

Hukkinen, Maria; Mutanen, Annika; Pakarinen, Mikko P

2017-09-01

Liver disease occurs frequently in short bowel syndrome. Whether small bowel dilation in short bowel syndrome could influence the risk of liver injury through increased bacterial translocation remains unknown. Our aim was to analyze associations between small bowel dilation, mucosal damage, bloodstream infections, and liver injury in short bowel syndrome patients. Among short bowel syndrome children (n = 50), maximal small bowel diameter was measured in contrast series and expressed as the ratio to the height of the fifth lumbar vertebra (small bowel diameter ratio), and correlated retrospectively to fecal calprotectin and plasma citrulline-respective markers of mucosal inflammation and mass-bloodstream infections, liver biochemistry, and liver histology. Patients with pathologic small bowel diameter ratio >2.17 had increased fecal calprotectin and decreased citrulline (P < .04 each). Of 33 bloodstream infections observed during treatment with parenteral nutrition, 16 were caused by intestinal bacteria, cultured 15 times more frequently when small bowel diameter ratio was >2.17 (P < .001). Intestinal bloodstream infections were predicted by small bowel diameter ratio (odds ratio 1.88, P = .017), and their frequency decreased after operative tapering procedures (P = .041). Plasma bilirubin concentration, gamma-glutamyl transferase activity, and histologic grade of cholestasis correlated with small bowel diameter ratio (0.356-0.534, P < .014 each), and were greater in the presence of intestinal bloodstream infections (P < .001 for all). Bloodstream infections associated with portal inflammation, cholestasis, and fibrosis grades (P < .031 for each). In linear regression, histologic cholestasis was predicted by intestinal bloodstream infections, small bowel diameter ratio, and parenteral nutrition (β = 0.36-1.29; P < .014 each), while portal inflammation by intestinal bloodstream infections only (β = 0.62; P = .033). In children with short bowel

Prostate cancer chemoprevention agent development: the National Cancer Institute, Division of Cancer Prevention portfolio.

PubMed

Parnes, Howard L; House, Margaret G; Kagan, Jacob; Kausal, David J; Lieberman, Ronald

2004-02-01

We describe the current National Cancer Institute chemoprevention agent development program and provide a summary of the intermediate end points used. The National Cancer Institute is currently sponsoring a wide range of studies of promising chemoprevention agents in a variety of informative cohorts, eg high grade prostatic intraepithelial neoplasia, positive family history of cancer, increased prostate specific antigen with negative biopsies, prostate cancer followed expectantly, prostate cancer awaiting definitive therapy and the general population. The rationale for each agent under investigation is derived from epidemiological observations, prostate cancer treatment trials, secondary analyses of large cancer prevention studies, an understanding of cancer biology and prostate carcinogenesis, and/or experimental animal models. Carcinogenesis is a multistep process occurring over decades which is characterized by disruption of the normal regulatory pathways controlling cellular proliferation, programmed cell death and differentiation. Administration of agents to reverse, inhibit or slow this process of malignant transformation is known as chemoprevention. Chemoprevention represents a promising approach to reducing the morbidity and mortality of prostate cancer. A variety of agents are currently being studied in phase 2 clinical trials, some of which may warrant subsequent evaluation in phase 3 trials with definitive cancer end points. Two large phase 3 trials, the Prostate Cancer Prevention Trial and the Selenium and Vitamin E Cancer Prevention Trial, which are ongoing, are also sponsored by the National Cancer Institute.

76 FR 42718 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Cancer Therapies..., Rockville, MD 20582. Contact Person: Delia Tang, MD, Scientific Review Officer, National Cancer Institute...

76 FR 17930 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group; Subcommittee A--Cancer..., Division of Extramural Activities, National Cancer Institute, 6116 Executive Blvd, Room 8107, MSC 8328...

75 FR 26267 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... Appendix 2), notice is hereby given of the meeting of the National Cancer Advisory Board. The meeting will... clearly unwarranted invasion of personal privacy. Name of Committee: National Cancer Advisory Board Ad hoc...

Safety and efficacy of percutaneous cecostomy/colostomy for treatment of large bowel obstruction in adults with cancer.

PubMed

Tewari, Sanjit O; Getrajdman, George I; Petre, Elena N; Sofocleous, Constantinos T; Siegelbaum, Robert H; Erinjeri, Joseph P; Weiser, Martin R; Thornton, Raymond H

2015-02-01

To assess the safety and efficacy of image-guided percutaneous cecostomy/colostomy (PC) in the management of colonic obstruction in patients with cancer. Twenty-seven consecutive patients underwent image-guided PC to relieve large bowel obstruction at a single institution between 2000 and 2012. Colonic obstruction was the common indication. Patient demographics, diagnosis, procedural details, and outcomes including maximum colonic distension (MCD; ie, greatest transverse measurement of the colon on radiograph or scout computed tomography image) were recorded and retrospectively analyzed. Following PC, no patient experienced colonic perforation; pain was relieved in 24 of 27 patients (89%). Catheters with tip position in luminal gas rather than mixed stool/gas or stool were associated with greater decrease in MCD (-40%, -12%, and -16%, respectively), with the difference reaching statistical significance (P = .002 and P = .013, respectively). Catheter size was not associated with change in MCD (P = .978). Catheters were successfully removed from six of nine patients (67%) with functional obstructions and two of 18 patients (11%) with mechanical obstructions. One patient underwent endoscopic stent placement after catheter removal. Three patients required diverting colostomy after PC, and their catheters were removed at the time of surgery. One major complication (3.7%; subcutaneous emphysema, pneumomediastinum, and sepsis) occurred 8 days after PC and was successfully treated with cecostomy exchange, soft-tissue drainage, and intravenous antibiotic therapy. Image-guided PC is safe and effective for management of functional and mechanical bowel obstruction in patients with cancer. For optimal efficacy, catheters should terminate within luminal gas. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

About the Frederick National Laboratory for Cancer Research | Frederick National Laboratory for Cancer Research

Cancer.gov

The Frederick National Laboratory is a Federally Funded Research and Development Center (FFRDC) sponsored by the National Cancer Institute (NCI) and currently operated by Leidos Biomedical Research, Inc. The laboratory addresses some of the most urge

Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study.

PubMed

Beaugerie, Laurent; Brousse, Nicole; Bouvier, Anne Marie; Colombel, Jean Frédéric; Lémann, Marc; Cosnes, Jacques; Hébuterne, Xavier; Cortot, Antoine; Bouhnik, Yoram; Gendre, Jean Pierre; Simon, Tabassome; Maynadié, Marc; Hermine, Olivier; Faivre, Jean; Carrat, Fabrice

2009-11-07

Reports of an increased risk of lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease are controversial. We assessed this risk in a prospective observational cohort study. 19,486 patients with inflammatory bowel disease, of whom 11,759 (60.3%) had Crohn's disease and 7727 (39.7%) had ulcerative colitis or unclassified inflammatory bowel disease, were enrolled in a nationwide French cohort by 680 gastroenterologists, who reported details of immunosuppressive therapy during the observation period, cases of cancer, and deaths. The risk of lymphoproliferative disorder was assessed according to thiopurine exposure. Median follow-up was 35 months (IQR 29-40). At baseline, 5867 (30.1%) of patients were receiving, 2809 (14.4%) had discontinued, and 10,810 (55.5%) had never received thiopurines. 23 new cases of lymphoproliferative disorder were diagnosed, consisting of one case of Hodgkin's lymphoma and 22 cases of non-Hodgkin lymphoproliferative disorder. The incidence rates of lymphoproliferative disorder were 0.90 per 1000 (95% CI 0.50-1.49) patient-years in those receiving, 0.20/1000 (0.02-0.72) patient-years in those who had discontinued, and 0.26/1000 (0.10-0.57) patient-years in those who had never received thiopurines (p=0.0054). The multivariate-adjusted hazard ratio of lymphoproliferative disorder between patients receiving thiopurines and those who had never received the drugs was 5.28 (2.01-13.9, p=0.0007). Most cases associated with thiopurine exposure matched the pathological range of post-transplant disease. Patients receiving thiopurines for inflammatory bowel disease have an increased risk of developing lymphoproliferative disorders. Programme Hospitalier de Recherche Clinique National (AOM05157), Association François Aupetit, Délégation Inter-régionale de la Recherche clinique Ile de France-Assistance Publique Hôpitaux de Paris (AP-HP), Ligue contre le Cancer, and Fonds de Recherche de la Société Nationale

Scottish Bowel Screening Programme Colonoscopy Quality - scope for improvement?

PubMed

Quyn, A J; Fraser, C G; Stanners, G; Carey, F A; Rees, C J; Moores, B; Steele, R J

2018-06-04

The delivery of the Scottish Bowel Screening Programme (SBoSP) is rooted in the provision of a high quality, effective and participant-centred service. Safe and effective colonoscopy forms an integral part of the process. Additional accreditation as part of a multi-faceted programme for participating colonoscopists, as in England, does not exist in Scotland. This study aimed to describe the quality of colonoscopy in the SBoSP and compare this to the English national screening standards. Data were collected from the SBoSP between 2007 and 2014. End-points for analysis were caecal intubation, cancer, polyp and adenoma detection, and complications. Overall results were compared with 2012 published English national standards for screening and outcomes from 2006-2009. During the study period 53,332 participants attended for colonoscopy. Colonoscopy completion rate was 95.6% overall. The mean cancer detection rate (CDR) was 7.1%, the polyp detection rate (PDR) 45.7% and the adenoma detection rate (ADR) was 35.5%.The overall complication rate was 0.47%. Colonoscopy quality in the SBoSP has exceeded the standard set for screening colonoscopy in England, despite not adopting a multi-faceted programme for screening colonoscopy. However, the overall ADR in Scotland was 9.1% lower than that in England which has implications for colonoscopy quality and may have an impact on the cancer prevention rates, a key aim of the SBoSP. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

76 FR 21386 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

....395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Protein Technologies...

Dietary Practices, Addictive Behavior and Bowel Habits and Risk of Early Onset Colorectal Cancer: a Case Control Study.

PubMed

Khan, Naveed Ali; Hussain, Mehwish; ur Rahman, Ata; Farooqui, Waqas Ahmed; Rasheed, Abdur; Memon, Amjad Siraj

2015-01-01

The abrupt rise of colorectal cancer in developing countries is raising concern in healthcare settings. Studies on assessing relationships with modifiable and non-modifiable risk factors in the Pakistani population have been limited. The present investigation was designed to examine associations of dietary practices, addictive behavior and bowel habits in developing colorectal cancer (CRC) among patients in a low-resource setup. An age-gender matched case control study was conducted from October 2011 to July 2015 in Karachi, Pakistan. Cases were from the surgical oncology department of a public sector tertiary care hospital, while their two pair-matched controls were recruited from the general population. A structured questionnaire was used which included questions related to demographic characteristics, family history, dietary patterns, addictive behavior and bowel habits. A family history of cancer was associated with a 2.2 fold higher chance of developing CRC. Weight loss reduced the likelihood 7.6 times. Refraining from a high fat diet and consuming more vegetables showed protective effects for CRC. The risk of CRC was more than twice among smokers and those who consumed Asian specific addictive products as compared to those who avoid using these addictions (ORsmoking: 2.12, 95% CI: 1.08 - 4.17, ORpan: 2.92, 95% CI: 1.6 - 5.33, ORgutka: 2.13, 95% CI: 1.14 - 3.97). Use of NSAID attenuated risk of CRC up to 86% (OR: 0.14, 95% CI: 0.07 - 0.31). Most of the findings showed concordance with the literature elucidating protective effects of consuming vegetables and low fat diet while documenting adverse associations with family history, weight loss, constipation and hematochezia. Moreover, this study highlighted Asian specific indigenous addictive products as important factors. Further studies are needed to validate the findings produced by this research.

76 FR 41273 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Commitee: National Cancer Institute Initial Review Group, Subcommittee A--Cancer...

75 FR 66770 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Clinical Proteomic...

75 FR 14172 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... unwarranted invasion of personal privacy. Name of Committee: National Cancer Institute Initial Review Group...

76 FR 51378 - National Cancer Institute Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer... the National Cancer Advisory Board Ad hoc Subcommittee on Global Cancer Research meeting. The meeting...

77 FR 15783 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel Nanotechnology... proposals. Place: National Institutes of Health, National Cancer Institute, 6116 Executive Blvd., Conference...

78 FR 38355 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; NCI National..., Division of Extramural Activities, National Cancer Institute, NIH, 9606 Medical Center Drive, 7W514, MSC...

Bowel urgency in patients with irritable bowel syndrome.

PubMed

Basilisco, Guido; De Marco, Elisabetta; Tomba, Carolina; Cesana, Bruno Mario

2007-01-01

Bowel urgency is the most bothersome symptom in irritable bowel syndrome patients with diarrhea, but its pathophysiology is poorly understood. Our aim was to assess the relationships among reporting the symptom, the reservoir functions of the colon and rectum, and the patients' psychologic profile. The study involved 28 consecutive patients with irritable bowel syndrome and 17 healthy subjects. The presence or absence of bowel urgency was verified by means of a questionnaire during the 3 days required for the ingestion of radio-opaque markers. On the fourth day, an abdominal x-ray was taken to assess colonic transit time, and rectal sensory and motor responses were measured during rectal distention. The subjects' psychologic profiles were assessed using a psychologic symptoms checklist. Forty-six percent of the patients reported urgency associated with at least 1 defecation. The multivariate logistic regression analysis showed that colonic transit was the only variable independently associated with reported bowel urgency, but the threshold for the sensation of urgency was not removed from the model since its borderline significance level. Rectal compliance was closely associated with the threshold for the sensation of urgency during rectal distention but was not an independent factor for reporting the sensation. The patients with and without urgency showed altered psychologic profiles. The symptom of urgency is associated with objective alterations in the colonic and rectal reservoir of patients with irritable bowel syndrome.

75 FR 42453 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open...

Psychiatric morbidity after surgery for inflammatory bowel disease: A systematic review

PubMed Central

Zangenberg, Marie Strøm; El-Hussuna, Alaa

2017-01-01

AIM To examine the evidence about psychiatric morbidity after inflammatory bowel disease (IBD)-related surgery. METHODS PRISMA guidelines were followed and a protocol was published at PROSPERO (CRD42016037600). Inclusion criteria were studies describing patients with inflammatory bowel disease undergoing surgery and their risk of developing psychiatric disorder. RESULTS Twelve studies (including 4340 patients) were eligible. All studies were non-randomized and most had high risk of bias. Patients operated for inflammatory bowel disease had an increased risk of developing depression, compared with surgical patients with diverticulitis or inguinal hernia, but not cancer. In addition, patients with Crohn’s disease had higher risk of depression after surgery compared with non-surgical patients. Patients with ulcerative colitis had higher risk of anxiety after surgery compared with surgical colorectal cancer patients. Charlson comorbidity score more than three and female gender were independent predictors for depression and anxiety following surgery. CONCLUSION The review cannot give any clear answer to the risks of psychiatric morbidity after surgery for IBD studies with the lowest risk of bias indicated an increased risk of depression among surgical patients with Crohn’s disease and increased risk of anxiety among patients with ulcerative colitis. PMID:29358872

Safety of treatments for inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).

PubMed

Biancone, Livia; Annese, Vito; Ardizzone, Sandro; Armuzzi, Alessandro; Calabrese, Emma; Caprioli, Flavio; Castiglione, Fabiana; Comberlato, Michele; Cottone, Mario; Danese, Silvio; Daperno, Marco; D'Incà, Renata; Frieri, Giuseppe; Fries, Walter; Gionchetti, Paolo; Kohn, Anna; Latella, Giovanni; Milla, Monica; Orlando, Ambrogio; Papi, Claudio; Petruzziello, Carmelina; Riegler, Gabriele; Rizzello, Fernando; Saibeni, Simone; Scribano, Maria Lia; Vecchi, Maurizio; Vernia, Piero; Meucci, Gianmichele

2017-04-01

Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn's disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs. These observations prompted the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) to establish Italian guidelines on the safety of currently available treatments for Crohn's disease and ulcerative colitis. These guidelines discuss the use of aminosalicylates, systemic and low bioavailability corticosteroids, antibiotics (metronidazole, ciprofloxacin, rifaximin), thiopurines, methotrexate, cyclosporine A, TNFα antagonists, vedolizumab, and combination therapies. These guidelines are based on current knowledge derived from evidence-based medicine coupled with clinical experience of a national working group. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

76 FR 9353 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel; Quantitative Imaging for Evaluation of Responses to Cancer... Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive Blvd., Room 8101...

76 FR 11800 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel; Biosensors for Early Cancer Detection and Risk Assessment. Date... Logistics Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard...

75 FR 3239 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... Committee: National Cancer Institute Special Emphasis Panel, Basal-like Breast Cancer Assay. Date: March 10... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel, Data Harmonization and Advanced Computation of Population Health...

75 FR 14173 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee J...

75 FR 71134 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-22

... and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee J...

78 FR 36200 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Cancer Biology and... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center... Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center Drive...

76 FR 59413 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee J... Of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard, Room 8111, Bethesda...

75 FR 52537 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group; Subcommittee J... of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard, Room 8111, Bethesda...

78 FR 8156 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Companion... Review Officer, Special Review and Logistics Branch, Division of Extramural Activities, National Cancer...

78 FR 19275 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel Tumor Immunology...., Chief Resources and Training Review Branch, Division of Extramural Activities, National Cancer Institute...

77 FR 75640 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; NCI Omnibus Review... Programs Review Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive...

75 FR 44272 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group; Subcommittee G... Review Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive Blvd...

78 FR 9932 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; R01 Grant... applications. Place: National Cancer Institute, 6116 Executive Boulevard, Rockville, MD 20852, (Telephone...

78 FR 17419 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... unwarranted invasion of personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive...

76 FR 57063 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee F..., Resources and Training Review Branch, Division of Extramural Activities, National Cancer Institute, NIH...

75 FR 71713 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Basic and... Review Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive Blvd...

76 FR 22407 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group; Subcommittee J..., Division of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard, Room 8111, Bethesda...

75 FR 3240 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee F... Review Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive Blvd...

75 FR 21002 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... Cancer Institute Special Emphasis Panel, SPORE in Lymphoma and Breast Cancer. Date: June 15-16, 2010... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Drug Discovery...

78 FR 15023 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel Cancer Causation... Cancer Institute, NHH, 6116 Executive Blvd., Room 8050A, Bethesda, MD 20892-8328, 301-402-9415...

75 FR 32489 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group; Subcommittee H... Activities, National Cancer Institute, 6116 Executive Boulevard, Room 8103, Bethesda, MD 20892, (301) 594...

76 FR 31619 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; SBIR Phase IIB... Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive Blvd., Rm 8053...

75 FR 48699 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee I--Career..., Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive Blvd, Rm 8113, Bethesda...

77 FR 75639 - National Cancer Institute Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Proposed Frederick National Laboratory for Cancer Research Strategic Plan. Place: The Lawrence Berkeley..., Berkeley, CA 94720. Contact Person: Thomas M. Vollberg, Sr., Ph.D., Executive Secretary, National Cancer...

75 FR 3242 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, In vivo Cellular and... Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard, Room 7147...

75 FR 14172 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; NCI-CNP (U54) Review...

76 FR 42720 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee I--Career... Extramural Activities, National Cancer Institute, NIH, 6116 Executive Blvd, Rm 8113, Bethesda, MD 20892, 301...

76 FR 20360 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group; Subcommittee F... Activities, National Cancer Institute, NIH, 6116 Executive Blvd., Room 8105, Bethesda, MD 20892, 301-451-4759...

78 FR 16861 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel Tissue Culture Tumor... Activities, NIH National Cancer Institute, 6116 Executive Boulevard, Room 7149, Bethesda, MD 20892-8329, 301...

76 FR 28238 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee I--Career... Activities, National Cancer Institute, NIH, 6116 Executive Blvd, Rm 8113, Bethesda, MD 20892, 301-435-5655...

75 FR 57473 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... unwarranted invasion of personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel... Activities, National Cancer Institute, NIH, 6116 Executive Boulevard, Room 8113, Bethesda, MD 20892. 301-435...

Late Side Effects and Quality of Life After Radiotherapy for Rectal Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bruheim, Kjersti, E-mail: Kjersti.Bruheim@medisin.uio.n; Guren, Marianne G.; Skovlund, Eva

2010-03-15

Purpose: There is little knowledge on long-term morbidity after radiotherapy (50 Gy) and total mesorectal excision for rectal cancer. Therefore, late effects on bowel, anorectal, and urinary function, and health-related quality of life (QoL), were studied in a national cohort (n = 535). Methods and Materials: All Norwegian patients who received pre- or postoperative (chemo-)radiotherapy for rectal cancer from 1993 to 2003 were identified. Patients treated with surgery alone served as controls. Patients were without recurrence or metastases. Bowel and urinary function was scored with the LENT SOMA scale and the St. Marks Score for fecal incontinence and QoL withmore » the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). Results: Median time since surgery was 4.8 years. Radiation-treated (RT+) patients (n = 199) had increased bowel frequency compared with non-radiation-treated (RT-) patients (n = 336); 19% vs. 6% had more than eight daily bowel movements (p < 0.001). In patients without stoma, a higher proportion of RT+ (n = 69) compared with RT- patients (n = 240), were incontinent for liquid stools (49% vs. 15%, p < 0.001), needed a sanitary pad (52% vs. 13%, p < 0.001), and lacked the ability to defer defecation (44% vs. 16%, p < 0.001). Daily urinary incontinence occurred more frequently after radiotherapy (9% vs. 2%, p = 0.001). Radiation-treated patients had worse social function than RT- patients, and patients with fecal or urinary incontinence had impaired scores for global quality of life and social function (p < 0.001). Conclusions: Radiotherapy for rectal cancer is associated with considerable long-term effects on anorectal function, especially in terms of bowel frequency and fecal incontinence. RT+ patients have worse social function, and fecal incontinence has a negative impact on QoL.« less

76 FR 5595 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-01

... Detecting Low Abundance Cancer-Related Proteins/ Peptides. Date: April 1, 2011. Time: 8:30 a.m. to 5 p.m... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Detection of Cancer...

78 FR 20118 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Cancer Biology and... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center..., Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology...

78 FR 30933 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, June 7, 2013, 9:00 a.m. to June 7, 2013, 10:00 a.m., National Institutes of Health, National Cancer Institute, 9609...

76 FR 31619 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer... on May 10, 2011, 76 FR 27069. This notice is amending the National Cancer Advisory Board meeting...

75 FR 54451 - National Ovarian Cancer Awareness Month, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-07

... National Ovarian Cancer Awareness Month, 2010 By the President of the United States of America A Proclamation While we have made great strides in the battle against ovarian cancer, this disease continues to claim more lives than any other gynecologic cancer. During National Ovarian Cancer Awareness Month, we...

Investigation of body image as a mediator of the effects of bowel and GI symptoms on psychological distress in female survivors of rectal and anal cancer.

PubMed

Benedict, Catherine; Rodriguez, Vivian M; Carter, Jeanne; Temple, Larissa; Nelson, Christian; DuHamel, Katherine

2016-04-01

Treatment for rectal and anal cancer (RACa) can result in persistent bowel and gastrointestinal (GI) dysfunction. Body image problems may develop over time and exacerbate symptom-related distress. RACa survivors are an understudied group, however, and factors contributing to post-treatment well-being are not well understood. This study examined whether poorer body image explained the relation between symptom severity and psychological distress. Participants (N = 70) completed the baseline assessment of a sexual health intervention study. Bootstrap methods tested body image as a mediator between bowel and GI symptom severity and two indicators of psychological distress (depressive and anxiety symptoms), controlling for relevant covariates. Measures included the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-CR38) Diarrhea, GI Symptoms, and Body Image subscales and Brief Symptom Index Depression and Anxiety subscales. Women averaged 55 years old (SD = 11.6), White (79 %), and were 4 years post-treatment. Greater Depression was related to poorer Body Image (r = -.61) and worse Diarrhea (r = .35) and GI Symptoms (r = .48). Greater Anxiety was related to poorer Body Image (r = -.42) and worse GI Symptoms (r = .45), but not Diarrhea (r = .20). Body Image mediated the effects of bowel and GI symptoms on Depression, but not on Anxiety. Long-term bowel and GI dysfunction are distressing and affect how women perceive and relate to their bodies, exacerbating survivorship difficulties. Interventions to improve adjustment post-treatment should address treatment side effects, but also target body image problems to alleviate depressive symptoms. Reducing anxiety may require other strategies. Body image may be a key modifiable factor to improve well-being in this understudied population. Longitudinal research is needed to confirm findings.

78 FR 59362 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

...., Chief, Research Programs Review Branch, Division of Extramural Activities, National Cancer Institute... . Name of Committee: National Cancer Institute Special Emphasis Panel Quantitative Imaging for Evaluation..., Cancer Cause and Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer...

77 FR 59934 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

....396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399... Committee: National Cancer Institute Special Emphasis Panel; Minority-Based Community Clinical Oncology... Committee: National Cancer Institute Special Emphasis Panel; Exploratory/Developmental Research Programs in...

78 FR 38355 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, July 23, 2013, 10:00 a.m. to July 23, 2013, 04:00 p.m., National Cancer...

78 FR 38355 - National Cancer Institute Amended; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Amended; Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, July 08, 2013, 12:00 p.m. to July 08, 2013, 02:00 p.m., National Cancer...

78 FR 27408 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS... ``Development of Blood-based Methods for the Detection of Cancer Recurrence in Post-Therapy Breast Cancer... Officer, Research Programs Review Branch, Division of Extramural Activities, National Cancer Institute...

75 FR 11896 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel; Process Analytic Technologies, Date: April 6, 2010, Time: 1 p.m... of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard, Room 7142, Bethesda...

77 FR 12600 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... Extramural Activities, National Cancer Institute, NIH, 6116 Executive Boulevard, Room 8055B, Bethesda, MD..., Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive Blvd., Room 8101... Review Officer, Special Review and Logistics Branch, Division of Extramural Activities, National Cancer...

National cancer plans: the French experience.

PubMed

Khayat, David

2013-01-01

With a prediction of about 20 million cases and 10 million deaths occurring to 2020, cancer is becoming one of the most important challenges in the field of human health. National Cancer Control plans are effective tools to set up actions that, by their specificity in regard to the local epidemiology and resources, can break the rising curve of human toll that we are paying to this disease. In this article we present the French experience with the National Cancer Plans. We point out the most significant actions that were developed in the areas of prevention, screening, care, access to innovative treatments, and research.

Bowel Movement

MedlinePlus

A bowel movement is the last stop in the movement of food through your digestive tract. Your stool passes out of ... what you eat and drink. Sometimes a bowel movement isn't normal. Diarrhea happens when stool passes ...

78 FR 53154 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center... applications. Place: National Cancer Institute Shady Grove, 9609 Medical Center Drive, Room 7W034, Rockville...

Delayed presentation of a bowel Bovie injury after laparoscopic ventral hernia repair.

PubMed

Bhullar, Jasneet Singh; Gayagoy, Jennifer; Chaudhary, Sushant; Kolachalam, Ramachandra B

2013-01-01

Bowel injury during laparoscopic surgery is a rare but serious complication. A Bovie injury to the bowel can cause delayed perforation of the viscus, thus increasing the possibility of a preventable morbidity. Patients presenting with perforation peritonitis within 24 hours and up to 2 to 3 weeks after laparoscopic Bovie injury to the bowel have been reported in the literature. A 74-year-old woman underwent a laparoscopic ventral hernia mesh repair. Intraoperatively, a small area of superficial Bovie injury to the small bowel was repaired with Lembert sutures and tissue glue. Postoperatively, the patient recovered well, but she presented with perforation peritonitis 3 months after surgery. An exploratory laparotomy showed a jejunal perforation in the same area that was injured with cautery and repaired during the previous surgery. The patient was only using inhaled steroids for asthma on and off but had a remote history of chemotherapy and radiation for colorectal cancer. Bovie injury to the bowel has a hidden depth, causing a slow transmural tissue necrosis, and it might also impair local healing and eventually lead to perforation. Thus, the patient may present later than the usual period for wound healing and remodeling as previously reported. Given the disastrous consequence, it is imperative to perform a good surgical repair of even a minor Bovie injury to the bowel. This is the first report of a delayed presentation (>1 month) of a Bovie injury of the bowel.

Delayed Presentation of a Bowel Bovie Injury After Laparoscopic Ventral Hernia Repair

PubMed Central

Gayagoy, Jennifer; Chaudhary, Sushant; Kolachalam, Ramachandra B.

2013-01-01

Introduction: Bowel injury during laparoscopic surgery is a rare but serious complication. A Bovie injury to the bowel can cause delayed perforation of the viscus, thus increasing the possibility of a preventable morbidity. Patients presenting with perforation peritonitis within 24 hours and up to 2 to 3 weeks after laparoscopic Bovie injury to the bowel have been reported in the literature. Case Description: A 74-year-old woman underwent a laparoscopic ventral hernia mesh repair. Intraoperatively, a small area of superficial Bovie injury to the small bowel was repaired with Lembert sutures and tissue glue. Postoperatively, the patient recovered well, but she presented with perforation peritonitis 3 months after surgery. An exploratory laparotomy showed a jejunal perforation in the same area that was injured with cautery and repaired during the previous surgery. The patient was only using inhaled steroids for asthma on and off but had a remote history of chemotherapy and radiation for colorectal cancer. Conclusion: Bovie injury to the bowel has a hidden depth, causing a slow transmural tissue necrosis, and it might also impair local healing and eventually lead to perforation. Thus, the patient may present later than the usual period for wound healing and remodeling as previously reported. Given the disastrous consequence, it is imperative to perform a good surgical repair of even a minor Bovie injury to the bowel. This is the first report of a delayed presentation (>1 month) of a Bovie injury of the bowel. PMID:24018096

A national agenda for Latino cancer prevention and control.

PubMed

Ramirez, Amelie G; Gallion, Kipling J; Suarez, Lucina; Giachello, Aida L; Marti, Jose R; Medrano, Martha A; Pérez-Stable, Eliseo J; Talavera, Gregory A; Trapido, Edward J

2005-06-01

Although cancer is a leading cause of morbidity and premature death among Latinos, there is limited knowledge of cancer-related issues and priorities of greatest significance to the Latino population, the largest minority group in the nation. This information is vital in helping to guide Latino cancer research, training, and awareness efforts at national, regional, and local levels. To help identify cancer issues of greatest relevance to Latinos, Redes En Accion, The National Hispanic/Latino Cancer Network, a major network among the National Cancer Institute's Special Populations Networks, conducted a survey of 624 key opinion leaders from around the country. Respondents were asked to rank the three cancer sites most important to Latinos in their region and the five issues of greatest significance for this population's cancer prevention and control. Recommendations were prioritized for three specific areas: 1) research, 2) training and/or professional education, and 3) awareness and/or public education. Among cancers, breast carcinoma was ranked number one, followed in order by cervical and lung carcinomas. The issues of greatest significance to Latinos were 1) access to cancer screening and care, 2) tobacco use, 3) patient-doctor communication, 4) nutrition, and 5) risk communication. This survey solicited information from scientists, health care professionals, leaders of government agencies, professional and community-based organizations, and other stakeholders in Latino health. The results laid the foundation for a national Redes En Accion Latino cancer agenda, thus providing a useful tool for individuals and organizations engaged in cancer prevention and control efforts among the Hispanic-Latino population.

[Premalignant conditions of the small bowel].

PubMed

Drastich, P

2013-01-01

Small intestinal dysplastic lesions are rare and difficult to detect before they progress to cancer. New investigative modalities, such as capsule endoscopy and doubleballoon enteroscopy, are very promising in search for premalignant lesions. Screening patients at high-risk for small bowel neoplasia is the only sensible approach. Duodenal adenoma represents the most easily accessible tumors with the possibility of curative endoscopic resection. Due to the strong association of the small bowel and colonic adenomas, it is always necessary to perform colonoscopy. In young patients, the exclusion of familial polyposis by genetic testing is always mandatory. Patients with celiac disease are especially at risk of developing nonHodgkins lymphomas and adenocarcinomas. There is a high-risk of ampuloma and other adenomas in patients with familial adenomatous polyposis. Patients with prolonged and complicated course of Crohns disease, Peutz Jeghers syndrome and patients with ileoanal pouch have higher risk of adenocarcinoma of the small intestine.

78 FR 54477 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 21, 2013, 11:00 a.m. to October 21, 2013, 3:00 p.m., National Cancer Institute Shady Grove, West Tower, 9609...

78 FR 66946 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 03, 2013, 09:00 a.m. to October 03, 2013, 12:00 p.m., National Cancer Institute Shady Grove, 9609 Medical...

78 FR 64226 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 16, 2013, 10:00 a.m. to October 16, 2013, 03:00 p.m., National Cancer Institute Shady Grove, West Tower, 9609...

78 FR 42091 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, July 30, 2013, 9:00 a.m.-4:00 p.m., National Cancer Institute, 9609 Medical Center Drive, Room 2W908 Rockville, MD,...

Bowel preparation for pediatric colonoscopy: report of the NASPGHAN endoscopy and procedures committee.

PubMed

Pall, Harpreet; Zacur, George M; Kramer, Robert E; Lirio, Richard A; Manfredi, Michael; Shah, Manoj; Stephen, Thomas C; Tucker, Neil; Gibbons, Troy E; Sahn, Benjamin; McOmber, Mark; Friedlander, Joel; Quiros, J A; Fishman, Douglas S; Mamula, Petar

2014-09-01

Pediatric bowel preparation protocols used before colonoscopy vary greatly, with no identified standard practice. The present clinical report reviews the evidence for several bowel preparations in children and reports on their use among North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition members. Publications in the pediatric literature for bowel preparation regimens are described, including mechanisms of action, efficacy and ease of use, and pediatric studies. A survey distributed to pediatric gastroenterology programs across the country reviews present national practice, and cleanout recommendations are provided. Finally, further areas for research are identified.

Validity of cancer diagnosis in the National Health Insurance database compared with the linked National Cancer Registry in Taiwan.

PubMed

Kao, Wei-Heng; Hong, Ji-Hong; See, Lai-Chu; Yu, Huang-Ping; Hsu, Jun-Te; Chou, I-Jun; Chou, Wen-Chi; Chiou, Meng-Jiun; Wang, Chun-Chieh; Kuo, Chang-Fu

2017-08-16

We aimed to evaluate the validity of cancer diagnosis in the National Health Insurance (NHI) database, which has routinely collected the health information of almost the entire Taiwanese population since 1995, compared with the Taiwan National Cancer Registry (NCR). There were 26,542,445 active participants registered in the NHI database between 2001 and 2012. National Cancer Registry and NHI database records were compared for cancer diagnosis; date of cancer diagnosis; and 1, 2, and 5 year survival. In addition, the 10 leading causes of cancer deaths in Taiwan were analyzed. There were 908,986 cancer diagnoses in NCR and NHI database and 782,775 (86.1%) in both, with 53,192 (5.9%) in the NHI database only and 73,019 (8.0%) in the NCR only. The positive predictive value of the NHI database cancer diagnoses was 94% for all cancers; the positive predictive value of the 10 specific cancers ranged from 95% (lung cancer) to 82% (cervical cancer). The date of diagnosis in the NHI database was generally delayed by a median of 15 days (interquartile range 8-18) compared with the NCR. The 1, 2, and 5 year survival rates were 71.21%, 60.85%, and 47.44% using the NHI database and were 71.18%, 60.17%, and 46.09% using NCR data. Recording of cancer diagnoses and survival estimates based on these diagnosis codes in the NHI database are generally consistent with the NCR. Studies using NHI database data must pay careful attention to eligibility and record linkage; use of both sources is recommended. Copyright © 2017 John Wiley & Sons, Ltd.

An evaluation of cancer survivorship activities across national comprehensive cancer control programs

PubMed Central

Underwood, J. Michael; Lakhani, Naheed; Rohan, Elizabeth; Moore, Angela; Stewart, Sherri L.

2015-01-01

Introduction Centers for Disease Control and Prevention’s (CDC) National Comprehensive Cancer Control Program (NCCCP) funds states, the District of Columbia, tribal organizations, territories, and jurisdictions across the USA develop and implement jurisdiction-specific comprehensive cancer control (CCC) plans. The objective of this study was to analyze NCCCP action plan data for incorporation and appropriateness of cancer survivorship-specific goals and objectives. Methods In August 2013, NCCCP action plans maintained within CDC’s Chronic Disease Management Information System (CDMIS) from years 2010 to 2013 were reviewed to assess the inclusion of cancer survivorship objectives. We used the CDMIS search engine to identify “survivorship” within each plan and calculated the proportion of programs that incorporate cancer survivorship-related content during the study period and in each individual year. Cancer survivorship objectives were then categorized by compatibility with nationally accepted, recommended strategies from the report A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies (NAP). Results From 2010 to 2013, 94 % (n=65) of NCCCP action plans contained survivorship content in at least 1 year during the time period and 38 % (n=26) of all NCCCP action plans addressed cancer survivorship every year during the study period. Nearly 64 % (n=44) of NCCCP action plans included cancer survivorship objectives recommended in NAP. Conclusion Nearly all NCCCP action plans addressed cancer survivorship from 2010 to 2013, and most programs implemented recommended cancer survivorship efforts during the time period. Implications for Cancer Survivors NCCCP grantees can improve cancer survivorship support by incorporating recommended efforts within each year of their plans. PMID:25732543

76 FR 37358 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Core Infrastructure and Methological Research for Cancer Epidemiology Cohorts, Date: July 12, 2011, Time: 8 a,m, to 5 p,m...

77 FR 24969 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

... Special Emphasis Panel; SPORE in Breast, Prostate and Thyroid Cancers. Date: May 23-24, 2012. Time: 8 a.m... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... clearly unwarranted invasion of personal privacy. Name of Committee: National Cancer Institute Special...

76 FR 50487 - National Cancer Institute Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; NCI SPORE in Childhood ALL, Skin, Brain, Lung and Gastrointestinal Cancers. Date: September 14-16, 2011. Time: 5 p.m. to... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

75 FR 79010 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel Education. Date: January 25, 2011. Time: 3 p.m. to 4:30 p.m..., Resources and Training Review Branch, Division of Extramural Activities, National Cancer Institute, 6116...

77 FR 8890 - National Cancer Institute Cancellation of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Cancellation of Meeting Notice is hereby given of the cancellation of the National Cancer Institute Board of Scientific Advisors, March 5, 2012, 9 a.m. to March 6, 2012, 12 p.m., National Institutes of Health, Building...

76 FR 26310 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) for Cancer and Statistical...

76 FR 577 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Therapeutic Strategies for Cancer. Date: February 2-4, 2011. Time: 3 p.m. to 5 p.m. Agenda: To review and evaluate grant...

75 FR 11895 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer... 276 to ``Medicinal Food Products for Cancer Chemotherapy.'' The meeting is closed to the public. Dated...

76 FR 81952 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... Emphasis Panel SPORE in Lymphoma, Brain, Head/Neck and Lung Cancers, and Sarcoma. Date: February 8-9, 2012... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, P01 Special Emphasis...

76 FR 52960 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... Emphasis Panel, Mechanisms of Cell Signaling in Cancer. Date: October 13-14, 2011. Time: 3 to 5 p.m. Agenda... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Discovery, Imaging...

78 FR 28237 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... Cells for Cancer Diagnostics, Prognosis and Treatment. Date: June 7, 2013. Time: 9:00 a.m. to 10:00 a.m... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Systems for...

Predictors of Grade 3 or Higher Late Bowel Toxicity in Patients Undergoing Pelvic Radiation for Cervical Cancer: Results From a Prospective Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chopra, Supriya, E-mail: schopra@actrec.gov.in; Dora, Tapas; Chinnachamy, Anand N.

Purpose: The present study investigates relationship between dose–volume parameters and severe bowel toxicity after postoperative radiation treatment (PORT) for cervical cancer. Methods and Materials: From June 2010 to December 2012, a total of 71 patients undergoing PORT were included. Small bowel (SB) and large bowel (LB) loops were contoured 2 cm above the target volume. The volume of SB and LB that received 15 Gy, 30 Gy, and 40 Gy was calculated (V15 SB, V15 LB, V30 SB, V30 LB, V40 SB, V 40 LB). On follow-up, bowel toxicity was scored using Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. A reciever operatingmore » characteristic (ROC) curve identified volume thresholds that predicted for grade 3 or higher toxicity with highest specificity. All data was dichotomized across these identified cut-off values. Univariate and multivariate analysis was performed using SPSS, version 15. Results: The median patient age was 47 years (range, 35-65 years). Of the 71 patients, 46 received image-guided intensity modulated radiation therapy, and 25 received conformal radiation (50 Gy in 25 fractions for 5 weeks). Overall, 63 of 71 patients received concurrent chemotherapy. On a median follow-up of 18 months (range, 8-29 months), grade 2 or higher bowel toxicity was seen in 22 of 71 patients (30.9%) and grade 3 or higher bowel toxicity was seen in 9 patients (12.6%). On univariate analysis, V15 SB <275 cc (P=.01), V30 SB <190 cc (P=.02), V40 SB <150 cc (P=.01), and V15 LB <250 cc (P=.03), and V40 LB <90 cc (P=.04) predicted for absence of grade 3 or higher toxicity. No other patient- or treatment-related factors were statistically significant. On multivariate analysis, only V15 SB (P=.002) and V15 LB (P=.03) were statistically significant. Conclusions: V 15 Gy SB and LB are independent predictors of late grade 3 or higher toxicity. Restricting V15 SB and V15 LB to <275 cc and <250 cc can reduce grade 3 or higher toxicity to less than 5%.« less

78 FR 28235 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... Basal- like Breast Cancer. Date: June 13, 2013. Time: 12:00 p.m. to 1:00 p.m. Agenda: To review and... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, Novel Imaging Agents...

77 FR 67015 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel NCI Omnibus and Cancer Therapy. Date: November 14-15, 2012. Time: 2:00 p.m. to 5:00 p.m. Agenda: To review and evaluate...

77 FR 8268 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer... Center, Bethesda, MD 20814. The NCAB Ad Hoc Subcommittee on Global Cancer Research will still convene on...

75 FR 80510 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Novel Digital X-ray Sources for Cancer Imaging Applications. Date: January 11, 2011. Time: 11 a.m. to 3 p.m. Agenda: To review...

75 FR 16816 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel, NCI SPORE in Skin and Prostate Cancers. Date: June 15-16, 2010. Time: 4 p.m. to 5 p.m. Agenda: To review and evaluate... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

76 FR 576 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open... the Contact Person listed below in advance of the meeting. Name of Committee: President's Cancer Panel...

75 FR 57474 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open... the Contact Person listed below in advance of the meeting. Name of Committee: President's Cancer Panel...

77 FR 49001 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-15

... the Contact Person listed below in advance of the meeting. Name of Committee: President's Cancer Panel... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open...

75 FR 70013 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

... the Contact Person listed below in advance of the meeting. Name of Committee: President's Cancer Panel... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open...

77 FR 63845 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... the Contact Person listed below in advance of the meeting. Name of Committee: President's Cancer Panel... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open...

78 FR 5467 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer... on January 14, 2013, 78 FR 2682. This notice is being amended to cancel the Ad hoc Global Cancer...

76 FR 52960 - National Cancer Institute Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and... interpretation or other reasonable accommodations, should notify the Contact Person listed below in advance of...

77 FR 58851 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer... reasonable accommodations, should notify the Contact Person listed below in advance of the meeting. Name of...

76 FR 20693 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer... reasonable accommodations, should notify the Contact Person listed below in advance of the meeting. Name of...

75 FR 2150 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and... interpretation or other reasonable accommodations, should notify the Contact Person listed below in advance of...

76 FR 39884 - National Cancer Institute Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Board of Scientific... reasonable accommodations, should notify the Contact Person listed below in advance of the meeting. Name of...

76 FR 53687 - National Cancer Institute Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Board of Scientific... reasonable accommodations, should notify the Contact Person listed below in advance of the meeting. Name of...

77 FR 35414 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and... interpretation or other reasonable accommodations, should notify the Contact Person listed below in advance of...

77 FR 1703 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and... interpretation or other reasonable accommodations, should notify the Contact Person listed below in advance of...

76 FR 51044 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer... reasonable accommodations, should notify the Contact Person listed below in advance of the meeting. Name of...

77 FR 5029 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer... reasonable accommodations, should notify the Contact Person listed below in advance of the meeting. Name of...

77 FR 26303 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and... interpretation or other reasonable accommodations, should notify the Contact Person listed below in advance of...

77 FR 31030 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer... reasonable accommodations, should notify the Contact Person listed below in advance of the meeting. Name of...

75 FR 54161 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-03

... Panel; SPORE in Sarcoma, Brain, Liver, Lung, and Prostate Cancers. Date: September 29-30, 2010. Time: 8... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel; Disparities, Cancer Risk and Prognostic Factors, PO1. Date...

Men's help-seeking behavior with regards to lower bowel symptoms.

PubMed

Oberoi, Devesh V; Jiwa, Moyez; McManus, Alexandra; Hodder, Rupert

2015-03-01

To explore the barriers to help-seeking among men experiencing lower bowel symptoms. Semi-structured interviews were conducted with 13 men recruited via purposive sampling. Interviews were audio-taped, transcribed, and analyzed thematically. Misinterpretation of the symptoms and the attribution of the symptoms to non-medical causes were common barriers to help-seeking. Other barriers include the cost of consulting a GP, llow level of confidence in consultation, and fear of cancer diagnosis. Some participants did not seek medical advice as the symptoms were intermittent or resolved with over-the-counter medications. There is a need for health promotion campaigns for men with regards to seeking timely medical advice for lower bowel symptoms.

National Cancer Societies and their public statements on alcohol consumption and cancer risk.

PubMed

Amin, Gopal; Siegel, Michael; Naimi, Timothy

2018-04-25

Studies have shown that alcohol consumption is a risk factor for oral, pharyngeal, laryngeal, esophageal, liver, colon, rectal and breast cancer. It would therefore be expected that cancer prevention organizations would incorporate these facts into their public stance on the consumption of alcohol. The aims of this study were to: (1) assess how national cancer societies in developed English-speaking countries [i.e. English-speaking countries belonging to the Organization for Economic Co-operation and Development (OECD)] communicate alcohol-related cancer risk to the public and (2) compare whether these organization's advocacy of increased alcohol taxes is in line with their advocacy of tobacco tax increases to reduce cancer risk. We searched the websites of the following national cancer organizations for all statements related to the relationship between alcohol consumption and cancer risk: Cancer Council Australia, Canadian Cancer Society, Irish Cancer Society, Cancer Society New Zealand, Cancer Research UK and the American Cancer Society. A categorical system was developed to code the qualitative data for health statements, alcohol consumption recommendations, and tax policy recommendations. Websites were analyzed in March of 2017. All organizations, with the exception of the American Cancer Society and Canadian Cancer Society, state that alcohol is a group 1 carcinogen and that even low-level alcohol consumption increases risk for some cancers. Additionally, while the American Cancer Society supports increasing tobacco taxes through its cancer action network, it has not advocated for increased alcohol taxes in relation to support for tobacco tax increases. Analysis in 2017 of the websites for national cancer societies in Australia, Canada, Ireland, New Zealand, the United Kingdom and the United States-including Cancer Council Australia, the Canadian Cancer Society, the Irish Cancer Society, Cancer Society New Zealand, Cancer Research UK and the American Cancer

75 FR 33628 - National Cancer Institute; Cancellation of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Cancellation of Meeting Notice is hereby given of the cancellation of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee, July 14, 2010, 8 a.m. to July 14, 2010, 4 p.m...

76 FR 49493 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute.... Appendix 2), notice is hereby given of the meeting of the National Cancer Advisory Board. The meeting will... accommodations, should notify the Contact Person listed below in advance of the meeting. A portion of the meeting...

75 FR 20370 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... Special Emphasis Panel, Breast Cancer Biology. Date: May 20, 2010. Time: 8 a.m. to 5 p.m. Agenda: To... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel, Assay Systems for Drug Efficacy in Cancer Stem Cells. Date...

Physical activity, bowel function, and quality of life among rectal cancer survivors.

PubMed

Krouse, Robert S; Wendel, Christopher S; Garcia, David O; Grant, Marcia; Temple, Larissa K F; Going, Scott B; Hornbrook, Mark C; Bulkley, Joanna E; McMullen, Carmit K; Herrinton, Lisa J

2017-11-01

Physical activity (PA) is positively associated with numerous health benefits among cancer survivors. This study examined insufficiently investigated relationships among PA, health-related quality of life (HRQOL), and bowel function (BF) in rectal cancer survivors. RC survivors (n = 1063) ≥5 years from diagnosis in two Kaiser permanente regions were mailed a multidimensional survey to assess HRQOL and BF. PA was assessed by a modified Godin Leisure-Time Exercise Questionnaire. PA minutes were categorized into weighted categories based on guidelines: (1) not active (zero PA minutes); (2) insufficiently active (1-149 PA minutes); (3) meeting guidelines (150-299 PA minutes); and (4) above guidelines (≥300 PA minutes). Relationships of PA with HRQOL and BF were evaluated using multiple linear regression, stratified by sex and ostomy status for BF. Types of PA identified as helpful for BF and symptoms addressed were summarized. Response rate was 60.5%. Of 557 participants, 40% met or exceeded PA guidelines, 34% were not active, and 26% were insufficiently active. Aerobic activities, specifically walking and cycling, were most commonly reported to help BF. Higher PA was associated with better psychological wellbeing and multiple SF12 scales, worse BF scores in men with ostomies, and better BF scores in women. Meeting or exceeding PA guidelines was associated with higher HRQOL. Although the BF findings are exploratory, they suggest women may benefit from increased PA, whereas men with ostomies may face challenges that require more study. Identifying PA strategies that will lead to improved patient compliance and benefit are needed.

Bowel cleansing before colonoscopy: Balancing efficacy, safety, cost and patient tolerance

PubMed Central

Harrison, Nicole M; Hjelkrem, Michael C

2016-01-01

Effective colorectal cancer screening relies on reliable colonoscopy findings which are themselves dependent on adequate bowel cleansing. Research has consistently demonstrated that inadequate bowel preparation adversely affects the adenoma detection rate and leads gastroenterologists to recommend earlier follow up than is consistent with published guidelines. Poor preparation affects as many as 30% of colonoscopies and contributes to an increased cost of colonoscopies. Patient tolerability is strongly affected by the preparation chosen and manner in which it is administered. Poor tolerability is, in turn, associated with lower quality bowel preparations. Recently, several new developments in both agents being used for bowel preparation and in the timing of administration have brought endoscopists closer to achieving the goal of effective, reliable, safe, and tolerable regimens. Historically, large volume preparations given in a single dose were administered to patients in order to achieve adequate bowel cleansing. These were poorly tolerated, and the unpleasant taste of and significant side effects produced by these large volume regimens contributed significantly to patients’ inability to reliably complete the preparation and to a reluctance to repeat the procedure. Smaller volumes, including preparations that are administered as tablets to be consumed with water, given as split doses have significantly improved both the patient experience and efficacy, and an appreciation of the importance of the preparation to colonoscopy interval have produced additional cleansing. PMID:26788258

75 FR 13559 - National Cancer Institute; Cancellation of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Cancellation of Meeting Notice is hereby given of the cancellation of the National Cancer Institute Special Emphasis Panel, April 8, 2010, 8 a.m. to April 9, 2010, 5 p.m., Hilton Washington DC/Rockville Hotel, 1750...

Frederick National Laboratory, National Cancer Institute of Mexico to Offer Training Fellowships | Frederick National Laboratory for Cancer Research

Cancer.gov

FREDERICK, Md. -- The Frederick National Laboratory for Cancer Research will extend its scientific mentoring across international borders for the first time by offering postdoctoral research fellowships to scientists under an agreement with the Nati

Cross-cultural variation in disease-related concerns among patients with inflammatory bowel disease.

PubMed

Levenstein, S; Li, Z; Almer, S; Barbosa, A; Marquis, P; Moser, G; Sperber, A; Toner, B; Drossman, D A

2001-06-01

The aim of this work was to study cross-cultural variations in the impact of inflammatory bowel disease (IBD) on health-related quality of life by an international comparison of disease-related concerns. Item and factor scores on the Rating Form of Inflammatory Bowel Disease Patient Concerns and overall mean concern levels were compared by analysis of variance among 2002 IBD patients in eight countries. The overall level of concern varied from 51 out of 100 in Portugal to 19 in Sweden, with intermediate scores for Italy (43), Canada (40), United States (39), France (39), Austria (33), and Israel (25). Having surgery, an ostomy, the uncertain nature of the disease, and medication side effects were each rated among the first five in importance in six countries. Other items varied considerably. For example, concern regarding pain and suffering was high in Israel and low in Portugal, whereas concern over developing cancer was low in Italy. Concern over financial issues and access to high-quality health care were inversely associated with measures of national economic prosperity. 1) Cross-cultural comparisons of patient concerns related to IBD are feasible using translated scales. 2) Reporting tendencies vary greatly; within Europe, patients from southern countries report greater overall concern. 3) The complications and the variable evolution of disease elicit general concern, but the importance of specific issues varies among countries. 4) The reasons for national differences may have social, cultural, and/or economic determinants with relevance to the patient-physician relationship, patient education, and therapeutic decision making.

National Cancer Center Singapore: the way forward.

PubMed

Teo, Melissa; Soo, Khee Chee

2016-02-01

Cancer is the leading cause of death in Singapore, comprising almost 30% of annual deaths. The incidence and prevalence continue to rise, resulting in Singapore having the highest age-standardized rate of cancer in southeast Asia. A review of national health policies in 1992 resulted in the creation of a National Cancer Centre Singapore (NCCS) in 1999. The current NCCS, with its three pillars of clinical service, research and education, manages about 70% of all new cancer cases in the countries public healthcare system. As it outgrows its current outfit and looks to the new NCCS building in 2020, the goal must be for strategic planning to attract and retain the best minds and heart in the field of cancer if it were to continue to be successful in achieving its vision and mission. This article chronicles the NCCS's history and details the foundation of its strategic plans.

77 FR 55848 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee. The...

77 FR 64817 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee. The...

78 FR 24224 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee. The...

78 FR 312 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee. The...

78 FR 53463 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee. The...

Bowel parasitosis and neuroendocrine tumours of the appendix. A report from the Italian TREP project.

PubMed

Virgone, C; Cecchetto, G; Besutti, V; Ferrari, A; Buffa, P; Alaggio, R; Alessandrini, L; Dall'Igna, P

2015-05-01

Five children with a neuroendocrine tumour (NET) of the appendix associated with a parasitic bowel infection are described, and the possibility of inflammation-triggered carcinogenesis is discussed. Schistosoma haematobium is linked primarily to bladder cancer but it has been reported in association with several other histotypes, including NETs of the gastrointestinal tract. Conversely, Enterobius vermicularis has not yet been claimed to participate in the onset of pre-cancerous conditions or tumours. The rare occurrence of contemporary appendiceal NETs and parasitic infection, raises the intriguing hypothesis of an inflammation-related carcinogenesis, although a cause-effect relationship cannot be established. Larger international series of childhood appendiceal NETs, which also include countries with higher prevalence of parasitic bowel infections, are needed to further clarify this possible cause-effect relationship.

76 FR 37357 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... of cancer. The outcome of the evaluation will provide information to internal NCI committees that... of the potential therapeutic to improve the treatment of various forms of cancer. The research...

77 FR 15782 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... for potential new therapeutics for the treatment of cancer. The outcome of the evaluation will provide... of cancer. The research proposals and the discussions could disclose confidential trade secrets or...

78 FR 15021 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... for potential new therapeutics for the treatment of cancer. The outcome of the evaluation will provide... of cancer. The research proposals and the discussions could disclose confidential trade secrets or...

76 FR 42719 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... for potential new therapeutics for the treatment of cancer. The outcome of the evaluation will provide... of cancer. The research proposals and the discussions could disclose confidential trade secrets or...

75 FR 71712 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... for potential new therapeutics for the treatment of cancer. The outcome of the evaluation will provide... of cancer. The research proposals and the discussions could disclose confidential trade secrets or...

76 FR 66733 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... of cancer. The outcome of the evaluation will provide information to internal NCI committees that... of the potential therapeutic to improve the treatment of various forms of cancer. The research...

76 FR 10381 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... for potential new therapeutics for the treatment of cancer. The outcome of the evaluation will provide... of cancer. The research proposals and the discussions could disclose confidential trade secrets or...

78 FR 44577 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Board of Scientific Advisors ad hoc Subcommittee on HIV and AIDS...

78 FR 9402 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Director's Consumer Liaison Group. The meeting will be open to the...

78 FR 313 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Board of Scientific Advisors ad hoc Subcommittee on HIV and AIDS...

78 FR 60887 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Institute Board of Scientific Advisors. The meeting will be open to the public,...

78 FR 66034 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. Appendix 2), notice is hereby given of meeting of the National Cancer Advisory Board. The meeting will be open to the public as indicated below,...

77 FR 15782 - National Cancer Institute Amended; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Amended; Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, April 18, 2012, 1 p.m. to April 18, 2012, 5 p.m., National Institutes of...

75 FR 11896 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, March 25, 2010, 12:30 p.m. to March 25, 2010, 5:30 p.m., National...

75 FR 4093 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Advisory Board, February 8, 2010, 6:30 p.m. to February 10, 2010, 12 p.m., National Institutes of Health...

75 FR 32957 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Board of Scientific Advisors, June 28, 2010, 8 a.m. to June 29, 2010, 12 p.m., National Institutes...

78 FR 9933 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... potential new cancer diagnostics. The outcome of the evaluation will be information for consideration by an... contract resources for development of the potential diagnostics to improve the treatment of cancer. The...

77 FR 61614 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

... potential new cancer diagnostics. The outcome of the evaluation will be information for consideration by an... contract resources for development of the potential diagnostics to improve the treatment of cancer. The... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

75 FR 17839 - National Cancer Control Month, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... Cancer Control Month, 2010 By the President of the United States of America A Proclamation Cancer is.... During National Cancer Control Month, let us renew our commitment to combat this disease by raising... as ``Cancer Control Month.'' NOW, THEREFORE, I, BARACK OBAMA, President of the United States of...

Advanced Endoscopic Imaging for Surveillance for Dysplasia and Colorectal Cancer in inflammatory Bowel Disease: Could the Pathologist be Further Helped?

PubMed Central

Sinagra, Emanuele; Tomasello, Giovanni; Raimondo, Dario; Sturm, Andreas; Giunta, Marco; Messina, Marco; Damiano, Giuseppe; Palumbo, Vincenzo D.; Spinelli, Gabriele; Rossi, Francesca; Facella, Tiziana; Marasà, Salvatore; Cottone, Mario; Lo Monte, Attilio I.

2014-01-01

Patients with inflammatory bowel disease (IBD) have an increased risk of developing intestinal cancer. The magnitude of that increased risk as well as how best to mitigate it remain a topic of ongoing investigation in the field. It is important to quantify the risk of colorectal cancer in association with IBD. The reported risk varies widely between studies. This is partly due to the different methodologies used in the studies. Because of the limitations of surveillance strategies based on the detection of dysplasia, advanced endoscopic imaging and techniques involving the detection of alterations in mucosal antigens and genetic abnormalities are being investigated. Development of new biomarkers, predicting future occurrence of colonic neoplasia may lead to more biomarker-based surveillance. There are promising results that may lead to more efficient surveillance in IBD patients and more general acceptance of its use. A multidisciplinary approach, involving in particular endoscopists and pathologists, together with a centralized patient management, could help to optimize treatments and follow-up measures, both of which could help to reduce the IBD-associated cancer risk. PMID:24496155

78 FR 9932 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Board of Scientific Advisors, March 4, 2013, 9:00 a.m. to March 5, 2013, 1:00 p.m., National...

77 FR 13133 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, March 7, 2012, 12:15 p.m. to March 7, 2012, 3:15 p.m., National Institutes...

75 FR 44274 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel, Nanotechnology Imaging and Sensing Platforms for Improved Diagnosis of Cancer. Date: August 31, 2010. Time: 12 p.m. to 1:30 p.m. Agenda: To review and evaluate...

Cancer registries in Japan: National Clinical Database and site-specific cancer registries.

PubMed

Anazawa, Takayuki; Miyata, Hiroaki; Gotoh, Mitsukazu

2015-02-01

The cancer registry is an essential part of any rational program of evidence-based cancer control. The cancer control program is required to strategize in a systematic and impartial manner and efficiently utilize limited resources. In Japan, the National Clinical Database (NCD) was launched in 2010. It is a nationwide prospective registry linked to various types of board certification systems regarding surgery. The NCD is a nationally validated database using web-based data collection software; it is risk adjusted and outcome based to improve the quality of surgical care. The NCD generalizes site-specific cancer registries by taking advantage of their excellent organizing ability. Some site-specific cancer registries, including pancreatic, breast, and liver cancer registries have already been combined with the NCD. Cooperation between the NCD and site-specific cancer registries can establish a valuable platform to develop a cancer care plan in Japan. Furthermore, the prognosis information of cancer patients arranged using population-based and hospital-based cancer registries can help in efficient data accumulation on the NCD. International collaboration between Japan and the USA has recently started and is expected to provide global benchmarking and to allow a valuable comparison of cancer treatment practices between countries using nationwide cancer registries in the future. Clinical research and evidence-based policy recommendation based on accurate data from the nationwide database may positively impact the public.

Optimal Bowel Preparation for Video Capsule Endoscopy

PubMed Central

Song, Hyun Joo; Moon, Jeong Seop; Shim, Ki-Nam

2016-01-01

During video capsule endoscopy (VCE), several factors, such as air bubbles, food material in the small bowel, and delayed gastric and small bowel transit time, influence diagnostic yield, small bowel visualization quality, and cecal completion rate. Therefore, bowel preparation before VCE is as essential as bowel preparation before colonoscopy. To date, there have been many comparative studies, consensus, and guidelines regarding different kinds of bowel cleansing agents in bowel preparation for small bowel VCE. Presently, polyethylene glycol- (PEG-) based regimens are given primary recommendation. Sodium picosulphate-based regimens are secondarily recommended, as their cleansing efficacy is less than that of PEG-based regimens. Sodium phosphate as well as complementary simethicone and prokinetics use are considered. In this paper, we reviewed previous studies regarding bowel preparation for small bowel VCE and suggested optimal bowel preparation of VCE. PMID:26880894

Low-dose rate prostate brachytherapy is well tolerated in patients with a history of inflammatory bowel disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peters, Christopher A.; Cesaretti, Jamie A.; Stone, Nelson N.

2006-10-01

Purpose: We report on the follow-up of 24 patients with a prior history of inflammatory bowel disease (IBD) treated with brachytherapy for early-stage prostate cancer. Methods and Materials: Twenty-four patients with a history of inflammatory bowel disease (17 with ulcerative colitis (UC), 7 with Crohn's disease [CD]) underwent prostate brachytherapy between 1992 and 2004. Fifteen patients were treated with I-125 implantation and 6 patients were treated with Pd-103 alone or in combination with 45 Gy external beam radiation. Charts were reviewed for all patients, and all living patients were contacted by phone. National Cancer Institute common toxicity scores for proctitismore » were assigned to all patients. Actuarial risk of late toxicity was calculated by the Kaplan-Meier method. Statistical analysis was performed using SPSS software. Follow-up ranged from 3 to 126 months (median, 48.5 months; mean, 56.8 months). Results: None of the patients experienced Grade 3 or 4 rectal toxicity. Four patients experienced Grade 2 late rectal toxicity. The 5-year actuarial freedom from developing late Grade 2 rectal toxicity was 81%. At a median follow-up of 48.5 months, 23 patients were alive and had no evidence of disease with a median prostate-specific antigen for the sample of 0.1 ng/mL (range, <0.05-0.88 ng/mL). One patient died of other causes unrelated to his prostate cancer. Conclusions: Prostate brachytherapy is well tolerated in patients with a history of controlled IBD. Therefore, brachytherapy should be considered a viable therapeutic option in this patient population.« less

77 FR 4052 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... Skin Cancers. Date: February 8-9, 2012. Time: 8 a.m. to 6 p.m. Agenda: To review and evaluate grant... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... Cancer Institute Special Emphasis Panel, Review of P01 Grant Applications (SEP One). [[Page 4053

77 FR 73667 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... Behavioral Research in Cancer Control. Date: January 9-10, 2013. Time: 10:00 a.m. to 2:00 p.m. Agenda: To..., Research Programs Review Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116... Committee: National Cancer Institute Special Emphasis Panel; Quantitative Imaging for the Evaluation of...

78 FR 34395 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee, July 10, 2013, 09:00 a.m. to July 10, 2013, 04:00 p.m., National Institutes of...

78 FR 69858 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Director's Consumer Liaison Group, October 17, 2013, 10:00 a.m. to October 17, 2013, 04:30 p.m., National Institutes of Health, Building 31, ...

78 FR 13881 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee, March 13, 2013, 9:00 a.m. to March 13, 2013, 4:00 p.m., National Institutes of...

78 FR 16273 - National Cancer Institute Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, March 28, 2013, 8:00 a.m. to March 28, 2013, 5:00 p.m., National Institutes of Health, 6116 Executive Boulevard, Room...

78 FR 46357 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the teleconference meeting of the National Cancer Institute Board of Scientific Advisors ad hoc Subcommittee on HIV/AIDS Malignancy, August 08, 2013, 10:30 a.m. to 12:00 p.m., National...

78 FR 70312 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Advisory Board, December 09, 2013, 06:00 p.m. to December 10, 2013, 05:00 p.m., National Institutes of Health, Building 31, 31 Center Drive, Bethesda,...

78 FR 73866 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Advisory Board, December 09, 2013, 04:00 p.m. to December 10, 2013, 05:00 p.m., National Institutes of Health, Building 31, 31 Center Drive, Bethesda,...

Irritable Bowel Syndrome

MedlinePlus

Irritable bowel syndrome (IBS) is a problem that affects the large intestine. It can cause abdominal cramping, bloating, and a change in bowel ... go back and forth between the two. Although IBS can cause a great deal of discomfort, it ...

76 FR 66732 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Clinical Trials and Translational Research Advisory Committee, November 9, 2011, 9 a.m. to...

KRAS and TP53 mutations in inflammatory bowel disease-associated colorectal cancer: a meta-analysis

PubMed Central

Du, Lijun; Kim, John J.; Shen, Jinhua; Chen, Binrui; Dai, Ning

2017-01-01

Although KRAS and TP53 mutations are common in both inflammatory bowel disease-associated colorectal cancer (IBD-CRC) and sporadic colorectal cancer (S-CRC), molecular events leading to carcinogenesis may be different. Previous studies comparing the frequency of KRAS and TP53 mutations in IBD-CRC and S-CRC were inconsistent. We performed a meta-analysis to compare the presence of KRAS and TP53 mutations among patients with IBD-CRC, S-CRC, and IBD without dysplasia. A total of 19 publications (482 patients with IBD-CRC, 4,222 with S-CRC, 281 with IBD without dysplasia) met the study inclusion criteria. KRAS mutation was less frequent (RR=0.71, 95%CI 0.56-0.90; P=0.004) while TP53 mutation was more common (RR=1.24, 95%CI 1.10-1.39; P<0.001) in patients with IBD-CRC compared to S-CRC. Both KRAS (RR=3.09, 95%CI 1.47-6.51; P=0.003) and TP53 (RR=2.15, 95%CI 1.07-4.31 P=0.03) mutations were more prevalent in patients with IBD-CRC compared to IBD without dysplasia. In conclusion, IBD-CRC and S-CRC appear to have biologically different molecular pathways. TP53 appears to be more important than KRAS in IBD-CRC compared to S-CRC. Our findings suggest possible roles of TP53 and KRAS as biomarkers for cancer and dysplasia screening among patients with IBD and may also provide targeted therapy in patients with IBD-CRC. PMID:28077799

76 FR 1446 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-10

..., Resources And Training Review Branch, Division of Extramural Activities, National Cancer Institute, NIH..., Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399, Cancer...

75 FR 65364 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

..., Special Review and Logistics Branch, Division of Extramural Activities, National Cancer Institute, 6116..., Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399, Cancer...

78 FR 57400 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

... Organizational Engagement; and Proposed Organizational Change: Division of Extramural Activities. Place: National....396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399...

Frederick National Lab Collaborates with Moffitt Cancer Center on HPV and Oral Cancer | Frederick National Laboratory for Cancer Research

Cancer.gov

The Frederick National Lab and Moffitt Cancer Center have established a collaboration to research antibody responses against the human papillomavirus (HPV) in males following administration of the Gardasil vaccine. The vaccine prevents HPV infections

77 FR 68136 - National Cancer Institute Amended; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Amended; Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Advisory Board, November 28, 2012, 6:30 p.m. to November 29, 2012, 5:00 p.m., National Institutes of Health, Building 31C, Wing C, Conference Room 10,...

78 FR 35292 - National Cancer Institute Amended; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Amended; Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Advisory Board and NCI Board of Scientific Advisors, June 23, 2013, 05:00 p.m. to June 24, 2013, 5:15 p.m., National Institutes of Health, Building 31,...

78 FR 54745 - National Prostate Cancer Awareness Month, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

... National Prostate Cancer Awareness Month, 2013 By the President of the United States of America A Proclamation Among American men, prostate cancer is both the second most commonly diagnosed cancer and the second-leading cause of cancer deaths. Although prostate cancer incidence and mortality rates have...

The burden of prostate cancer in Asian nations

PubMed Central

Cullen, Jennifer; Elsamanoudi, Sally; Brassell, Stephen A.; Chen, Yongmei; Colombo, Monica; Srivastava, Amita; McLeod, David G.

2012-01-01

Introduction: In this review, the International Agency for Research on Cancer's cancer epidemiology databases were used to examine prostate cancer (PCa) age-standardized incidence rates (ASIR) in selected Asian nations, including Cancer Incidence in Five Continents (CI5) and GLOBOCAN databases, in an effort to determine whether ASIRs are rising in regions of the world with historically low risk of PCa development. Materials and Methods: Asian nations with adequate data quality were considered for this review. PCa ASIR estimates from CI5 and GLOBOCAN 2008 public use databases were examined in the four eligible countries: China, Japan, Korea and Singapore. Time trends in PCa ASIRs were examined using CI5 Volumes I-IX. Results: While PCa ASIRs remain much lower in the Asian nations examined than in North America, there is a clear trend of increasing PCa ASIRs in the four countries examined. Conclusion: Efforts to systematically collect cancer incidence data in Asian nations must be expanded. Current CI5 data indicate a rise in PCa ASIR in several populous Asian countries. If these rates continue to rise, it is uncertain whether there will be sufficient resources in place, in terms of trained personnel and infrastructure for medical treatment and continuum of care, to handle the increase in PCa patient volume. The recommendation by some experts to initiate PSA screening in Asian nations could compound a resource shortfall. Obtaining accurate estimates of PCa incidence in these countries is critically important for preparing for a potential shift in the public health burden posed by this disease. PMID:22529743

History | Frederick National Laboratory for Cancer Research

Cancer.gov

The Frederick National Laboratory for Cancer Research was established as the Frederick Cancer Research and Development Center in 1972 when about 70 acres and 67 buildings of the U.S. Army were transferred to the U.S. Department of Health and Huma

75 FR 44274 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 21, 2010, 8 a.m. to October 21, 2010, 5 p.m., Doubletree Hotel...

77 FR 13133 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, March 22, 2012, 8 a.m. to March 23, 2012, 5 p.m., Bethesda North Marriott...

76 FR 37358 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, July 7, 2011, 8 a.m. to July 8, 2011, 5 p.m., Bethesda North Marriott...

78 FR 17421 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, April 5, 2013, 09:00 a.m.-- 4:00 p.m., 5635 Fishers Lane, Room- 508...

78 FR 17936 - National Cancer Institute Amended; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Amended; Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, April 24, 2013, 8:30 a.m.-4:30 p.m., 9000 Rockville Pike, Building 45...

Predictors of Aggressive Inflammatory Bowel Disease

PubMed Central

Yarur, Andres J.; Strobel, Sebastian G.; Deshpande, Amar R.

2011-01-01

Inflammatory bowel disease comprises a group of conditions characterized by idiopathic inflammation of the gastrointestinal tract. The natural course of disease can range from an indolent course with prolonged periods of remission to aggressive, incapacitating disease. Predicting which patients are more susceptible to developing severe disease is important, especially when choosing therapeutic agents and treatment strategies. This paper reviews current evidence on the main demographic, clinical, endoscopic, histologic, serologic, and genetic markers that predict aggressive inflammatory bowel disease. In ulcerative colitis, we considered disease to be aggressive when patients had a high relapse rate, need for admission and/or surgery, development of colon cancer, or extraintestinal manifestations. We defined aggressive Crohn's disease as having a high relapse rate, development of penetrating disease, need for repeat surgery, or multiple admissions for flares. In Crohn's disease, involvement of the upper gastrointestinal tract and ileum, penetrating disease, early age at diagnosis, smoking, extensive ulceration of the mucosa, high titers of serum antibodies, and mutations of the NOD2 gene are markers of aggressive disease. In ulcerative colitis, patients with more extensive involvement of the colon (pancolitis) have more symptomatology and are at higher risk for needing a colectomy and developing colon cancer. Also, plasmocytic infiltration of the colonic mucosa and crypt atrophy predict treatment failure. As with diagnosis, no single method can predict disease aggressiveness. Multiple serologic and genetic tests are being developed to refine the accuracy of prediction. Endoscopic findings can also predict the future course of disease. At present, clinical manifestations are the most useful way to make therapeutic decisions. PMID:22298958

The effects of aminosalicylates or thiopurines on the risk of colorectal cancer in inflammatory bowel disease.

PubMed

Carrat, F; Seksik, P; Colombel, J-F; Peyrin-Biroulet, L; Beaugerie, L

2017-02-01

Whether aminosalicylates or thiopurines reduce the risk of colorectal cancer (CRC) in inflammatory bowel (IBD) disease is controversial. To assess simultaneously the chemopreventive effect of aminosalicylates or thiopurines in a case-control study nested in the CESAME observational cohort that enrolled consecutive patients with IBD between May 2004 and June 2005. Patients were followed up to December 2007. Study population comprised 144 case patients who developed CRC from the diagnosis of IBD (65 and 79 cases diagnosed, respectively, before and from 2004, starting year of the prospective observational period of CESAME) and 286 controls matched for gender, age, IBD subtype and year of diagnosis, and cumulative extent of colitis. Exposure to aminosalicylates or thiopurines was defined by an exposure to the treatment during the year of the diagnosis of cancer. The propensity of receiving 5-ASA and thiopurines was quantified by a composite score taking into account patient and IBD characteristics. The role of aminosalicylates or thiopurines was assessed by multivariate analysis. Propensity scores and the history of primary sclerosing cholangitis were entered into the multivariate model for adjustment. By multivariate analysis adjusted for propensity, a significant protective effect of exposure to drugs during the year of cancer was found for aminosalicylates (OR = 0.587, 95% CI: 0.367-0.937, P = 0.0257), but not for thiopurines (OR = 0.762, 95% CI: 0.432-1.343, P = 0.3468). In a case-control study nested in the CESAME cohort, a significant decrease in the risk of colorectal cancer in IBD was associated with exposure to aminosalicylates, not to thiopurines. © 2016 John Wiley & Sons Ltd.

Unique patterns of CpG island methylation in inflammatory bowel disease-associated colorectal cancers

PubMed Central

Olaru, Alexandru V.; Cheng, Yulan; Agarwal, Rachana; Yang, Jian; David, Stefan; Abraham, John M.; Yu, Wayne; Lazarev, Mark; Brant, Steven R.; Marohn, Michael R.; Hutcheon, David F.; Harpaz, Noam; Meltzer, Stephen J.; Mori, Yuriko

2011-01-01

Objective CpG island (CGI) hypermethylation at discrete loci is a prevalent cancer-promoting abnormality in sporadic colorectal carcinomas (S-CRCs). We investigated genome-wide CGI methylation in inflammatory bowel disease (IBD)-associated CRCs (IBD-CRCs). Design Methylation microarray analyses were conducted on 7 IBD-CRCs, 17 S-CRCs, and 8 normal control colonic tissues from patients without CRC or IBD. CGI methylator phenotype (CIMP), a surrogate marker for widespread cancer-specific CGI hypermethylation, was examined in 30 IBD-CRCs and 43 S-CRCs. Results The genome-wide CGI methylation pattern of IBD-CRCs was CIMP status-dependent. Based on methylation array data profiling of all autosomal loci, CIMP+ IBD-CRCs grouped together with S-CRCs, while CIMP− IBD-CRCs grouped together with control tissues. CIMP− IBD-CRCs demonstrated less methylation than did age-matched CIMP− S-CRCs at all autosomal CGIs (z-score −0.17 vs. 0.09, p=3×10−3) and CRC-associated hypermethylation target CGIs (z-score −0.43 vs. 0.68, p=1×10-4). Age-associated hypermethylation target CGIs were significantly overrepresented in CGIs that were hypermethylated in S-CRCs (p=1×10−192), but not in CGIs that were hypermethylated in IBD-CRCs (p=0.11). In contrast, KRAS mutation prevalence were similar between IBD-CRCs and S-CRCs. Notably, CIMP+ prevalence was significantly higher in older than in younger IBD-CRC cases (4.2% vs. 50.0%, p=0.02), but not in S-CRC cases (16.7% vs. 9.7%, p=0.92). Conclusions Cancer-specific CGI hypermethylation and age-associated CGI hypermethylation are diminished in IBD-CRCs relative to S-CRCs, while KRAS mutation rate is comparable between these cancers. CGI hypermethylation appears to play only a minor role in IBD-associated carcinogenesis. We speculate that aging, rather than inflammation per se, promotes CIMP+ CRCs in IBD patients. PMID:21830278

76 FR 16431 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... Programs Review Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive Blvd..., Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology...

76 FR 44021 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

... Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive Boulevard, Room..., Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology...

77 FR 28612 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-15

... Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive Blvd., Room..., Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology...

78 FR 9932 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, March 25, 2013, 8:00 a.m. to March 25, 2013, 5:00 p.m., Hilton Washington...

Annual Report to the Nation: Overall cancer mortality declines

Cancer.gov

The 2018 Annual Report to the Nation on the Status of Cancer finds overall cancer death rates continue to decline and cancer incidence dropped in men and remained stable in women. A companion study reports on recent changes in prostate cancer trends.

National CT Colonography Trial (ACRIN 6664): Comparison of Three Full-Laxative Bowel Preparations in More Than 2500 Average-Risk Patients

PubMed Central

Hara, Amy K.; Kuo, Mark D.; Blevins, Meridith; Chen, Mei-Hsiu; Yee, Judy; Dachman, Abraham; Menias, Christine O.; Siewert, Betina; Cheema, Jugesh I.; Obregon, Richard G.; Fidler, Jeff L.; Zimmerman, Peter; Horton, Karen M.; Coakley, Kevin; Iyer, Revathy B.; Halvorsen, Robert A.; Casola, Giovanna; Johnson, C. Daniel

2011-01-01

OBJECTIVE The purpose of our study was to compare the effect of three different full-laxative bowel preparations on patient compliance, residual stool and fluid, reader confidence, and polyp detection at CT colonography (CTC). SUBJECTS AND METHODS A total of 2531 patients underwent CTC followed by colonoscopy for the American College of Radiology Imaging Network (ACRIN) National CTC Trial. Of this total, 2525 patients used one of three bowel preparations with bisacodyl tablets and stool and fluid tagging: 4 L of polyethylene glycol (PEG); 90 mL of phosphosoda; or 300 mL of magnesium citrate. Patients reported percent compliance with the bowel preparation and radiologists graded each CTC examination for the amount of residual fluid and stool on a scale from 1 (none) to 4 (nondiagnostic). Reader confidence for true-positive findings was reported on a 5-point scale: 1 (low) to 5 (high). Sensitivity and specificity for detecting polyps ≥ 6 mm and ≥ 1 cm compared with colonoscopy were calculated for each preparation. RESULTS The most commonly prescribed preparation was phosphosoda (n = 1403) followed by PEG (n = 1020) and magnesium citrate (n = 102). Phosphosoda had the highest patient compliance (p = 0.01), least residual stool (p < 0.001), and highest reader confidence versus PEG for examinations with polyps (p = 0.06). Magnesium citrate had significantly more residual fluid compared with PEG and phosphosoda (p = 0.006). The sensitivity and specificity for detecting colon polyps ≥ 6 mm and ≥ 1 cm did not differ significantly between preparations. CONCLUSION Polyp detection was comparable for all three preparations, although phosphosoda had significantly higher patient compliance and the least residual stool. PMID:21512073

Toll-like receptors in inflammatory bowel diseases: A decade later

PubMed Central

Cario, Elke

2010-01-01

Differential alteration of Toll-like receptor (TLR) expression in inflammatory bowel disease (IBD) was first described 10 years ago. Since then, studies from many groups have led to the current concept that TLRs represent key mediators of innate host defense in the intestine, involved in maintaining mucosal as well as commensal homeostasis. Recent findings in diverse murine models of colitis have helped to reveal the mechanistic importance of TLR dysfunction in IBD pathogenesis. It has become evident that environment, genetics, and host immunity form a multidimensional and highly interactive regulatory triad that controls TLR function in the intestinal mucosa. Imbalanced relationships within this triad may promote aberrant TLR signaling, critically contributing to acute and chronic intestinal inflammatory processes in IBD colitis and associated cancer. (Inflamm Bowel Dis 2010) PMID:20803699

Telomere length and genetics are independent colorectal tumour risk factors in an evaluation of biomarkers in normal bowel.

PubMed

Fernandez-Rozadilla, Ceres; Kartsonaki, Christiana; Woolley, Connor; McClellan, Michael; Whittington, Deb; Horgan, Gareth; Leedham, Simon; Kriaucionis, Skirmantas; East, James; Tomlinson, Ian

2018-03-06

Colorectal cancer (CRC) screening might be improved by using a measure of prior risk to modulate screening intensity or the faecal immunochemical test threshold. Intermediate molecular biomarkers could aid risk prediction by capturing both known and unknown risk factors. We sampled normal bowel mucosa from the proximal colon, distal colon and rectum of 317 individuals undergoing colonoscopy. We defined cases as having a personal history of colorectal polyp(s)/cancer, and controls as having no history of colorectal neoplasia. Molecular analyses were performed for: telomere length (TL); global methylation; and the expression of genes in molecular pathways associated with colorectal tumourigenesis. We also calculated a polygenic risk score (PRS) based on CRC susceptibility polymorphisms. Bowel TL was significantly longer in cases than controls, but was not associated with blood TL. PRS was significantly and independently higher in cases. Hypermethylation showed a suggestive association with case:control status. No gene or pathway was differentially expressed between cases and controls. Gene expression often varied considerably between bowel locations. PRS and bowel TL (but not blood TL) may be clinically-useful predictors of CRC risk. Sample collection to assess these biomarkers is feasible in clinical practice, especially where population screening uses flexible sigmoidoscopy or colonoscopy.

76 FR 3641 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-20

... Training Review Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive... Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control...

76 FR 69744 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-09

... Review Officer, Special Review and Logistics Branch, Division of Extramural Activities, National Cancer..., Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398...

75 FR 16153 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-31

... Construction; 93.393, Cancer Cause and Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS) Dated...

76 FR 62082 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... Sciences and Epidemiology National Cancer Institute. The meeting will be closed to the public as indicated... Epidemiology, National Cancer Institute. Date: November 14, 2011. Time: 8:30 a.m. to 4 p.m. Agenda: To review...

76 FR 33321 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... Sciences and Epidemiology National Cancer Institute. The meeting will be closed to the public as indicated... Epidemiology, National Cancer Institute. Date: July 12, 2011. Time: 9 a.m. to 4 p.m. Agenda: To review and...

78 FR 64507 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of meetings of the Board of Scientific Counselors for Clinical Sciences and Epidemiology National Cancer...

77 FR 31627 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Board of Scientific Counselors for Clinical Sciences and Epidemiology National Cancer...

78 FR 26055 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center... Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control...

78 FR 2682 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... 552b(c)(6), Title 5 U.S.C., as amended. The grant applications and the discussions could disclose... hoc Subcommittee on Global Cancer Research. Open: February 7, 2013, 6:30 p.m. to 8:00 p.m. Agenda... Research, National Cancer Institute, National Institutes of Health, 6130 Executive Boulevard, EPN/7025...

Excess risk of urinary tract cancers in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study.

PubMed

Bourrier, A; Carrat, F; Colombel, J-F; Bouvier, A-M; Abitbol, V; Marteau, P; Cosnes, J; Simon, T; Peyrin-Biroulet, L; Beaugerie, L

2016-01-01

The risk of urinary tract cancers, including kidney and bladder cancers, was increased in transplant recipients receiving thiopurines. To assess the risk of urinary tract cancers in patients with inflammatory bowel disease (IBD) receiving thiopurines in the CESAME observational cohort. Between May 2004 and June 2005, 19 486 patients with IBD, 30.1% of whom were receiving thiopurines, were enrolled. Median follow-up was 35 months (IQR: 29-40). Ten and six patients developed respectively kidney and bladder cancer. The incidence rates of urinary tract cancer were 0.48/1000 patient-years in patients receiving thiopurines (95% CI: 0.21-0.95), 0.10/1000 patient-years in patients who discontinued thiopurines (95% CI: 0.00-0.56) and 0.30/1000 patient-years in patients never treated with thiopurines (95% CI: 0.12-0.62) at entry. The standardised incidence ratio of urinary tract cancer was 3.40 (95% CI: 1.47-6.71, P = 0.006) in patients receiving thiopurines, 0.64 (95% CI: 0.01-3.56, P = 0.92) in patients previously exposed to thiopurines and 1.17 (95% CI: 0.47-12.42, P = 0.78) in patients never treated with thiopurines. The multivariate-adjusted hazard ratio (HR) of urinary tract cancer between patients receiving thiopurines and those not receiving thiopurines was 2.82 (95% CI: 1.04-7.68, P = 0.04). Other significant risk factors were male gender (HR: 3.98, 95% CI: 1.12-14.10, P = 0.03) and increasing age (HR after 65 years (ref <50): 13.26, 95% CI: 3.52-50.03, P = 0.0001). Patients with IBD receiving thiopurines have an increased risk of urinary tract cancers. Clinically relevant excess risk is observed in older men. © 2015 John Wiley & Sons Ltd.

76 FR 62079 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

..., discussion, and evaluation of individual intramural programs and projects conducted by the National Cancer... Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research...

76 FR 33321 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

..., discussion, and evaluation of individual intramural programs and projects conducted by the National Cancer... Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research...

75 FR 67379 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

... Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399... Review Officer, Research Programs Review Branch, Division of Extramural Activities, National Cancer...

The National LGBT Cancer Action Plan: A White Paper of the 2014 National Summit on Cancer in the LGBT Communities

PubMed Central

Margolies, Liz; Sigurdsson, Hrafn Oli; Walland, Jonathan; Radix, Asa; Rice, David; Buchting, Francisco O.; Sanchez, Nelson F.; Bare, Michael G.; Boehmer, Ulrike; Cahill, Sean; Griebling, Tomas L.; Bruessow, Diane; Maingi, Shail

2016-01-01

Abstract Despite growing social acceptance of lesbians, gay men, bisexuals, and transgender (LGBT) persons and the extension of marriage rights for same-sex couples, LGBT persons experience stigma and discrimination, including within the healthcare system. Each population within the LGBT umbrella term is likely at elevated risk for cancer due to prevalent, significant cancer risk factors, such as tobacco use and human immunodeficiency virus infection; however, cancer incidence and mortality data among LGBT persons are lacking. This absence of cancer incidence data impedes research and policy development, LGBT communities' awareness and activation, and interventions to address cancer disparities. In this context, in 2014, a 2-day National Summit on Cancer in the LGBT Communities was convened by a planning committee for the purpose of accelerating progress in identifying and addressing the LGBT communities' concerns and needs in the spheres of cancer research, clinical cancer care, healthcare policy, and advocacy for cancer survivorship and LGBT health equity. Summit participants were 56 invited persons from the United States, United Kingdom, and Canada, representatives of diverse identities, experiences, and knowledge about LGBT communities and cancer. Participants shared lessons learned and identified gaps and remedies regarding LGBT cancer concerns across the cancer care continuum from prevention to survivorship. This white paper presents background on each of the Summit themes and 16 recommendations covering the following: sexual orientation and gender identity data collection in national and state health surveys and research on LGBT communities and cancer, the clinical care of LGBT persons, and the education and training of healthcare providers.

77 FR 46765 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Advisory Board. The meeting will be closed to the public in accordance...

78 FR 64228 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 16, 2013, 04:00 p.m. to October 17, 2013, 05:00 p.m., Bethesda North Marriott Hotel & Conference Center, 5701...

78 FR 66024 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 16, 2013, 08:00 a.m. to October 17, 2013, 05:00 p.m., Bethesda North Marriott, Rockville, MD which was...

78 FR 64228 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 17, 2013, 05:00 p.m. to October 18, 2013, 06:00 p.m., Bethesda North Marriott Hotel & Conference Center, 5701...

78 FR 64223 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, November 07, 2013, 8:00 a.m. to November 07, 2013, 6:00 p.m., Bethesda North Marriott Hotel & Conference Center, 5701...

78 FR 66029 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 09, 2013, 08:00 a.m. to October 10, 2013, 05:00 p.m., Hilton Washington/Rockville, 1750 Rockville Pike,...

78 FR 48455 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Cancer Advisory Board. The meeting will be closed to the public in accordance...

78 FR 64958 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the Subcommittee J--Career Development, October 24, 2013, 8:00 a.m. to October 25, 2013, 6:00 p.m., National Cancer Institute Shady Grove, West Tower, 9609 Medical Center...

78 FR 66374 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 15, 2013, 4:00 p.m. to October 16, 2013, 5:00 p.m., Hilton Washington/Rockville, 1750 Rockville Pike,...

77 FR 31628 - National Cancer Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the Board of Scientific Counselors for Basic Sciences National Cancer Institute. The meeting...

78 FR 58322 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, November 06, 2013, 06:30 p.m. to November 07, 2013, 04:00 p.m., Hilton Washington/Rockville, 1750 Rockville Pike,...

78 FR 58323 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 17, 2013, 4:00 p.m. to October 18, 2013, 06:00 p.m., Bethesda North Marriott Hotel & Conference Center, 5701...

78 FR 66021 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 01, 2013, 08:00 a.m. to October 02, 2013, 05:00 p.m., Bethesda Marriott Hotel, 5151 Pooks Hill Road, Bethesda...

78 FR 66029 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 03, 2013, 08:00 a.m. to October 04, 2013, 05:00 p.m., Hilton Rockville Hotel, 1750 Rockville Pike, Rockville,...

78 FR 64958 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, October 15, 2013, 4:00 p.m. to October 16, 2013, 5:00 p.m., Bethesda North Marriott Hotel & Conference Center, 5701...

78 FR 31570 - National Cancer Institute: Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute: Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, June 20, 2013, 03:00 p.m. to June 21, 2013, 06:00 p.m., Hilton Washington/Rockville, 1750 Rockville Pike, Rockville,...

78 FR 7794 - National Cancer Institute Amended; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Amended; Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, March 11, 2013, 8:00 a.m. to March 12, 2013, 5:00 p.m., Hilton Washington/Rockville, 1750 Rockville Pike, Rockville,...

Large-bowel surgery, 1979: self-assessment.

PubMed Central

Matheson, N A; Valerio, D

1980-01-01

Evidence of wide variability in the immediate results of large-bowel surgery stimulated self-assessment during 1979. The hazards of large-bowel surgery can usually be avoided by good bowel preparation, sound anastomotic technique, primary resection in large bowel emergencies, avoidance of anastomosis when hazardous, and antibiotic lavage for extant or potential peritoneal and wound contamination. PMID:7427416

75 FR 2878 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

..., Resources and Training Review Branch, Division of Extramural Activities, National Cancer Institute, 6116... Officer, Research Programs Review Branch, Division of Extramural Activities, National Cancer Institute... Ahmad, PhD, Scientific Review Officer, Research Programs Review Branch, Division of Extramural...

Impact of bowel preparation on surveillance colonoscopy interval.

PubMed

Singhal, Shashideep; Virk, Muhammad Asif; Momeni, Mojdeh; Krishnaiah, Mahesh; Anand, Sury

2014-07-01

Atpresent there are no guidelines for colonoscopy surveillance interval in subjects with unsatisfactory bowel preparation. Study was designed to compare outcomes of repeat colonoscopy at different surveillance intervals in patients with unsatisfactory preparation on index exam. Ten thousand nine hundred and eight colonoscopies were done during the study period. Patients with index colonoscopy exam complete up to cecum but suboptimal bowel prep were included. Two hundred and ninety-seven patients met the inclusion criteria. The interval for repeat colonoscopy was <1 year in 38.5%, 1-2 years in 33.3%, 2-3 years in 16.7%, and 3-5 years in 11.5% subjects. Adenoma detection rate (ADR) was 24%, high-risk adenoma detection rate (HR-ADR) was 8.4%, and colorectal cancer detection rate was 1.7%. The HR-ADR based on surveillance intervals <1 year, 1-2 years, 2-3 years, and 3-5 years was 8%, 7.9%, 2%, and 19.4%, respectively. The HR-ADR was significantly higher at surveillance interval 3-5 years (p < 0.05). Colonoscopies repeated at interval >3 years showed a significant HR-ADR. The study indicates that a surveillance interval of 3 years can be reasonable for subjects having an index colonoscopy with suboptimal/fair/poor bowel prep and complete colon examination. Colonoscopy should be repeated earlier if symptoms develop.

75 FR 63493 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-15

..., Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of... Institute Special Emphasis Panel, Community/Minority Based Clinical Oncology Program (CCOP)(U10). Date.... 93.392, Cancer Construction; 93.393, Cancer Cause and Prevention Research; 93.394, Cancer Detection...

75 FR 5092 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-01

... Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399... . Name of Committee: National Cancer Institute Special Emphasis Panel, Quantitative Cell-Based Imaging...

76 FR 17930 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

[email protected] . Name of Committee: National Cancer Institute Special Emphasis Panel; Quantitative...; 93.393,Cancer Cause and Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398...

Inpatient cancer rehabilitation: the experience of a national comprehensive cancer center.

PubMed

Shin, Ki Y; Guo, Ying; Konzen, Benedict; Fu, Jack; Yadav, Rajesh; Bruera, Eduardo

2011-05-01

Cancer rehabilitation is an important but often underutilized treatment in the comprehensive care of the cancer patient. Cancer patients have varying levels of access to rehabilitation services. Acute inpatient, inpatient consultation-based, and outpatient-based cancer rehabilitation services have been described in the literature. We will discuss acute inpatient cancer rehabilitation and some of its outcomes at the University of Texas MD Anderson Cancer Center in Houston, TX, which is the only national comprehensive cancer center to have its own acute inpatient rehabilitation unit dedicated solely to cancer patients. We retrospectively reviewed the inpatient medical records of consecutive inpatients admitted to the acute inpatient cancer rehabilitation unit from September 2008 to August 2009 for the following information: patient age, sex, primary tumor type, rehabilitation diagnoses, length of stay, discharge destination, and payer source. From September 2008 to August 2009, the physical medicine and rehabilitation service at MD Anderson Cancer Center had 1098 inpatient consultations, of which 427 patients were admitted to the inpatient rehabilitation unit with a mean length of stay of 11 days. Of the 427 patients, 73 (17%) were patients with primary neurologic-based tumor, 71 (16%) were patients with hematologic-based tumors, 48 (11%) were sarcoma patients, 35 (8%) were gastrointestinal tumor patients, 27 (6%) were head and neck tumor patients, 25 (6%) were prostate and bladder cancer patients, 24 (6%) were lung cancer patients, 22 (5%) were melanoma patients, 20 (5%) were breast cancer patients, 15 (4%) were renal cancer patients, 14 (3%) were gynecologic cancer patients, and 53 (12%) were patients with other types of cancer. Of the 427 patients admitted to acute inpatient rehabilitation at MD Anderson Cancer Center, 324 (76%) were discharged home, 72 (17%) went back to acute care service, 15 (4%) were sent to a skilled nursing facility, 9 (2%) were discharged

Small Bowel Transplant

PubMed Central

2003-01-01

EXECUTIVE SUMMARY Objective The Medical Advisory Secretariat undertook a review of the evidence on the effectiveness and cost-effectiveness of small bowel transplant in the treatment of intestinal failure. Small Bowel Transplantation Intestinal failure is the loss of absorptive capacity of the small intestine that results in an inability to meet the nutrient and fluid requirements of the body via the enteral route. Patients with intestinal failure usually receive nutrients intravenously, a procedure known as parenteral nutrition. However, long-term parenteral nutrition is associated with complications including liver failure and loss of venous access due to recurrent infections. Small bowel transplant is the transplantation of a cadaveric intestinal allograft for the purpose of restoring intestinal function in patients with irreversible intestinal failure. The transplant may involve the small intestine alone (isolated small bowel ISB), the small intestine and the liver (SB-L) when there is irreversible liver failure, or multiple organs including the small bowel (multivisceral MV or cluster). Although living related donor transplant is being investigated at a limited number of centres, cadaveric donors have been used in most small bowel transplants. The actual transplant procedure takes approximately 12-18 hours. After intestinal transplant, the patient is generally placed on prophylactic antibiotic medication and immunosuppressive regimen that, in the majority of cases, would include tacrolimus, corticosteroids and an induction agent. Close monitoring for infection and rejection are essential for early treatment. Medical Advisory Secretariat Review The Medical Advisory Secretariat undertook a review of 35 reports from 9 case series and 1 international registry. Sample size of the individual studies ranged from 9 to 155. As of May 2001, 651 patients had received small bowel transplant procedures worldwide. According to information from the Canadian Organ Replacement

77 FR 20491 - National Cancer Control Month, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... discoveries. During National Cancer Control Month, we remember those we have lost, support Americans fighting... combatting cancer. We owe the knowledge we have gained and the lives we have saved to the countless doctors...

Stricturoplasty-a bowel-sparing option for long segment small bowel Crohn's disease.

PubMed

Limmer, Alexandra M; Koh, Hoey C; Gilmore, Andrew

2017-08-01

Stricturoplasty is a surgical option for management of severe stricturing Crohn's disease of the small bowel. It avoids the need for small bowel resection and the associated metabolic complications. This report contrasts the indications and technical aspects of two different stricturoplasty techniques. Case 1 describes an extensive Michelassi (side-to-side isoperistaltic) stricturoplasty performed for a 100 cm segment of diseased small bowel in a 45-year-old patient. Case 2 describes the performance of 12 Heineke-Mikulicz stricturoplasties in a 23-year-old patient with multiple short fibrotic strictures.

Stricturoplasty—a bowel-sparing option for long segment small bowel Crohn's disease

PubMed Central

Koh, Hoey C.; Gilmore, Andrew

2017-01-01

Abstract Stricturoplasty is a surgical option for management of severe stricturing Crohn's disease of the small bowel. It avoids the need for small bowel resection and the associated metabolic complications. This report contrasts the indications and technical aspects of two different stricturoplasty techniques. Case 1 describes an extensive Michelassi (side-to-side isoperistaltic) stricturoplasty performed for a 100 cm segment of diseased small bowel in a 45-year-old patient. Case 2 describes the performance of 12 Heineke-Mikulicz stricturoplasties in a 23-year-old patient with multiple short fibrotic strictures. PMID:29423160

Recommendations for a national agenda to substantially reduce cervical cancer

PubMed Central

Brewer, Noel T.; Saslow, Debbie; Alexander, Kenneth; Chernofsky, Mildred R.; Crosby, Richard; Derting, Libby; Devlin, Leah; Dunton, Charles J.; Engle, Jeffrey; Fernandez, Maria; Fouad, Mona; Huh, Warner; Kinney, Walter; Pierce, Jennifer; Rios, Elena; Rothholz, Mitchel C.; Shlay, Judith C.; Shedd-Steele, Rivienne; Vernon, Sally W.; Walker, Joan; Wynn, Theresa; Zimet, Gregory D.; Casey, Baretta R.

2016-01-01

Purpose Prophylactic human papillomavirus (HPV) vaccines and new HPV screening tests, combined with traditional Pap test screening, provide an unprecedented opportunity to greatly reduce cervical cancer in the USA. Despite these advances, thousands of women continue to be diagnosed with and die of this highly preventable disease each year. This paper describes the initiatives and recommendations of national cervical cancer experts toward preventing and possibly eliminating this disease. Methods In May 2011, Cervical Cancer-Free America, a national initiative, convened a cervical cancer summit in Washington, DC. Over 120 experts from the public and private sector met to develop a national agenda for reducing cervical cancer morbidity and mortality in the USA. Results Summit participants evaluated four broad challenges to reducing cervical cancer: (1) low use of HPV vaccines, (2) low use of cervical cancer screening, (3) screening errors, and (4) lack of continuity of care for women diagnosed with cervical cancer. The summit offered 12 concrete recommendations to guide future national and local efforts toward this goal. Conclusions Cervical cancer incidence and mortality can be greatly reduced by better deploying existing methods and systems. The challenge lies in ensuring that the array of available prevention options are accessible and utilized by all age-appropriate women—particularly minority and underserved women who are disproportionately affected by this disease. The consensus was that cervical cancer can be greatly reduced and that prevention efforts can lead the way towards a dramatic reduction in this preventable disease in our country. PMID:23828553

75 FR 10295 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... G. Lovinger, PhD, Scientific Review Administrator, Special Review and Logistics Branch, Division of... Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard, Room 7142... and Referral Branch, Division of Extramural Activities, National Cancer Institute, NIH, 6116 Executive...

Morbidity and Mortality of Radical Nephrectomy for Patients With Disseminated Cancer: An Analysis of the National Surgical Quality Improvement Program Database.

PubMed

Wallis, Christopher J D; Bjarnason, Georg; Byrne, James; Cheung, Douglas C; Hoffman, Azik; Kulkarni, Girish S; Nathens, Avery B; Nam, Robert K; Satkunasivam, Raj

2016-09-01

To determine the effect of disseminated cancer on perioperative outcomes following radical nephrectomy. We conducted a retrospective cohort study of patients undergoing radical nephrectomy for kidney cancer from 2005 to 2014 using the American College of Surgeons National Surgical Quality Improvement Program, a multi-institutional prospective registry that captures perioperative surgical complications. Patients were stratified according to the presence (n = 657) or absence (n = 7143) of disseminated cancer at the time of surgery. We examined major complications (death, reoperation, cardiac event, or neurologic event) within 30 days of surgery. Secondary outcomes included pulmonary, infectious, venous thromboembolic, and bleeding complications; prolonged length of stay; and concomitant procedures (bowel, liver, spleen, pancreas, and vascular procedures). Adjusted odds ratio (aOR) and 95% confidence interval (95% CI) were calculated using multivariate logical regression models. Patients with disseminated cancer were older and more likely to be male, have greater comorbidities, and have undergone open surgery. Major complications were more common among patients with disseminated cancer (7.8%) than those without disseminated cancer (3.2%; aOR 2.01, 95% CI 1.46-2.86). Mortality was significantly higher in patients with disseminated cancer (3.2%) than those without disseminated cancer (0.5%; P < .0001). Pulmonary (aOR 1.68, 95% CI 1.09-2.59), thromboembolic (aOR 1.72, 95% CI 1.01-2.96), and bleeding complications (aOR 2.12, 95% CI 1.73-2.60) were more common among patients with disseminated cancer as was prolonged length of stay (aOR 1.27, 95% CI 1.06-1.53). Nephrectomy in patients with disseminated cancer is a morbid operation with significant perioperative mortality. These data may be used for preoperative counseling of patients undergoing cytoreductive nephrectomy. Copyright © 2016 Elsevier Inc. All rights reserved.

78 FR 44136 - Submission for OMB review; 30-day Comment Request: National Cancer Institute (NCI) Cancer...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

...; 30-day Comment Request: National Cancer Institute (NCI) Cancer Nanotechnology Platform Partnership...: Dorothy Farrell, Center for Strategic Scientific Initiatives, Office of Cancer Nanotechnology Research... Cancer Institute (NCI) Alliance for Nanotechnology in Cancer Platform Partnership Scientific Progress...

77 FR 36564 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open to the public, with attendance limited to...

78 FR 16274 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open to the public, with attendance limited to...

78 FR 69432 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open to the public, with attendance limited to...

78 FR 50064 - National Cancer Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the President's Cancer Panel. The meeting will be open to the public, with attendance limited to...

Bowel injury following induced abortion.

PubMed

Jhobta, R S; Attri, A K; Jhobta, A

2007-01-01

Bowel injury is an uncommonly reported yet serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries. A sudden increase in cases prompted the authors to analyze this problem. A retrospective review was done of 11 cases of bowel injury following induced abortion seen over 2 years at Government Medical College and Hospital, Chandigarh, India. Young, married women of low socioeconomic status with a strong preference for male children were the predominant recipients of induced abortion in India. The terminal ileum and pelvic colon were the most commonly injured portions of the bowel owing to their anatomic locations. Preoperative resuscitation, then resection with exteriorization of bowel and thorough peritoneal lavage, is the treatment for bowel injury incurred during induced abortion when the patient presents late.

The importance of timely information in national cancer screening programmes.

PubMed

Droljc, Anze; Grbec, Tomaz; Orel, Andrej

2009-01-01

The Ministry of Health of Slovenia decided to support the introduction of two new organised screening programmes for cancer, one for breast and the other for colon cancer in 2005. This was an addition to the first, already running, programme for cervical cancer. Two of them are entrusted to the Institute of Oncology while the National CINDI programme takes care of the third one. Besides connection to some external public databases, cancer screening programmes require national Cancer Registry data. High quality and user friendly information support for citizens and medical professionals following doctrinal requirements and possible changes is a must.

78 FR 66946 - National Cancer Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, December 04, 2013, 01:00 p.m. to December 04, 2013, 02:30 p.m., NCI Shady Grove, 9609 Medical Center Drive, Room 7W11...

Chemoprevention of Colorectal Cancer

PubMed Central

Lang, Michaela; Gasche, Christoph

2017-01-01

Colorectal cancer has become one of the most prevalent malignant diseases for both men and women. Patients with inflammatory bowel diseases or certain inherited cancer syndromes are at extremely high risk of developing colorectal cancer and have naturally the highest need for cancer prevention. In familial adenomatous polyposis (FAP) and Lynch syndrome most of the underlying germline mutations can be detected by DNA sequencing, and medical counselling of affected individuals involves both surveillance tests and chemopreventive measures. However, as the mechanisms leading to colorectal cancer differ in these high risk groups, the molecular action of chemopreventive drugs needs to be adjusted to the certain pathway of carcinogenesis. In the last decades a number of drugs have been tested, including sulindac, aspirin, celecoxib, and mesalazine, but some of them are still controversially discussed. This review summarizes the advances and current standards of colorectal cancer prevention in patients with inflammatory bowel disease, FAP and Lynch syndrome. PMID:25531498

76 FR 5597 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-01

... Cancer Institute Special Emphasis Panel; Vaccine for Prevention of HIV Infection. Date: February 24, 2011... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... concerning individuals associated with the grant applications and/or contract proposals, the disclosure of...

77 FR 49450 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-16

... Committee: National Cancer Institute Special Emphasis Panel; Core Infrastructure and Methodological Research...; Small Grants for Behavioral Research in Cancer Control. Date: September 18-19, 2012.. Time: 9 a.m. to 12...., Scientific Review Officer, Research Programs Review Branch, Division of Extramural Activities, National...

Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results From the Randomized PORTEC-2 Trial

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boer, Stephanie M. de, E-mail: s.m.de_boer.ONCO@lumc.nl; Nout, Remi A.; Jürgenliemk-Schulz, Ina M.

Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I high–intermediate-risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking aids, and incontinence pads. Analysis was done using linear mixed modelsmore » for subscales and (ordinal) logistic regression with random effects for single items. A two-sided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (P=.03), diarrhea by 8.4% versus 0.9% (P=.04), limitations due to bowel symptoms by 10.5% versus 1.8% (P=.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, P=.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.« less

Cancer incidence and mortality in France in 1975-95.

PubMed

Ménégoz, F; Black, R J; Arveux, P; Magne, V; Ferlay, J; Buémi, A; Carli, P M; Chapelain, G; Faivre, J; Gignoux, M; Grosclaude, P; Mace-Lesec'h, J; Raverdy, N; Schaffer, P

1997-10-01

The aims of the European Network of Cancer Registries (ENCR) are to improve the quality, comparability and availability of cancer registry data in Europe. This paper on cancer incidence and mortality in France presents the most recent available data, with short-term projections to 1995, and a commentary based, where possible, on epidemiological research carried out in France. Cancer incidence in men in France increased throughout the study period 1975 to 1995, from 92,000 new cases in 1975 to about 135,000 in 1995. This increase was partly due to the ageing of the French population, but incidence rates have also increased, particularly from 1975 to 1985. The trend appears to be levelling off in the 1990s, with an incidence rate in 1995 of about 482 per 100,000 (this and subsequent rates quoted are standardized to the European Standard Population). Among women, the all-cancer incidence rates also increased during the 1970s and 1980s. Although the rate of increase was less pronounced than in men, the trend is continuing in the 1990s. The estimated age standardized rate in 1995 was 309 per 100,000, representing 104,000 new cases. The main components of these changes in the last decade were, for men, increases in large bowel and prostate cancer, which have been partly compensated for by decreases in oral cavity, larynx and stomach cancer. For women the trend was dominated by the continuing increase in breast cancer with increases also in large bowel and lung cancers. Of the numerically important cancers in women, only stomach cancer has shown a clear decline. The situation in 1995 was that breast cancer remained the predominant cancer affecting women in France, accounting for almost one third of all new cases of cancer diagnosed and one fifth of cancer deaths. The next most frequent cancers in women were those of the large bowel. Regrettably, incidence rates of both breast and bowel cancer are increasing in women. For men in France the most frequent cancers in 1995

Cancer incidence estimates at the national and district levels in Colombia.

PubMed

Piñeros, Marion; Ferlay, Jacques; Murillo, Raúl

2006-01-01

To estimate national and district cancer incidence for 18 major cancer sites in Colombia. National and district incidence was estimated by applying a set of age, sex and site-specific incidence/mortality ratios, obtained from a population-based cancer registry, to national and regional mortality. The work was done in Bogotá (Colombia) and Lyon (France) between May 2003 and August 2004. The annual total number of cases expected (all cancers but skin) was 17 819 in men and 18 772 in women. Among males the most frequent cancers were those of the prostate (45.8 per 100 000), stomach (36.0), and lung (20.0). In females the most frequent were those of the cervix uteri (36.8 per 100 000), breast (30.0), and stomach (20.7). Districts with the lowest death certification coverage yielded the highest incidence rates. In the absence of national population-based cancer registry data, estimates of incidence provide valuable information at national and regional levels. As mortality data are an important source for the estimation,the quality of death certification should be considered as a possible cause of bias.

Osteoporosis in Inflammatory Bowel Disease

PubMed Central

Ali, Tauseef; Lam, David; Bronze, Michael S.; Humphrey, Mary Beth

2010-01-01

Osteoporosis commonly afflicts patients with inflammatory bowel disease, and many factors link the 2 states together. A literature review was conducted about the pathophysiology of osteoporosis in relation to inflammatory bowel disease. Screening guidelines for osteoporosis in general as well as those directed at patients with inflammatory bowel disease are reviewed, as are currently available treatment options. The purpose of this article is to increase physician awareness about osteopenia and osteoporosis occurring in patients with inflammatory bowel disease and to provide basic, clinically relevant information about the pathophysiology and guidelines to help them treat these patients in a cost-effective manner. PMID:19559158

"That was me" a patient's perspective on flat lesion in inflammatory bowel disease.

PubMed

Zarrow, Rachel; Zarrow, Alison; Zarrow, Hilary

2014-07-01

This article advocates the use of chromoendoscopy to detect flat lesions over the use of colonoscopy alone. The authors illustrate their point by telling the story of their father, who died of colon cancer despite following the gold standard inflammatory bowel disease protocol. Copyright © 2014 Elsevier Inc. All rights reserved.

System of Scientific Advisory Boards at the National Cancer Institute.

PubMed

Rambaut, P C; Bynum, B S; DeVita, V T

1989-09-20

This article describes the Boards of Scientific Counselors of the National Cancer Institute (NCI) and focuses on their role and their relationship to the other advisory boards used by NCI in the governance of the National Cancer Program. The advisory boards consist of the President's Cancer Panel, the National Cancer Advisory Board, the Boards of Scientific Counselors of the four programmatic divisions, and the Frederick Cancer Research Facility Advisory Committee. Each of these boards is an element of the organized system by which NCI obtains its scientific advice. The system provides a forum in which scientific directions and priorities are debated, ideas for research initiatives compete, and advice is given on the allocation of research and training funds. This article is a sequel to a number of earlier papers reviewing the corporate management structure that has been developed over the past decade at NCI.

Vaccination and Health Maintenance Issues to Consider in Patients With Inflammatory Bowel Disease

PubMed Central

Wasan, Sharmeel K.; Farraye, Francis A.

2017-01-01

Patients with inflammatory bowel disease (IBD) do not receive routine preventive care at the same rate as the general population. IBD places patients at increased risk for developing vaccine-preventable illnesses. This risk is further exacerbated by immunosuppressive therapy. This article highlights the necessary vaccinations for IBD patients and the timing of vaccination for immunosuppressed patients, and discusses the health maintenance needs and preventive care issues related to heart disease, smoking, osteoporosis, mental health, cervical cancer, and skin cancer. PMID:29339947

Accuracy of abdominal auscultation for bowel obstruction.

PubMed

Breum, Birger Michael; Rud, Bo; Kirkegaard, Thomas; Nordentoft, Tyge

2015-09-14

To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction. Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann(®) Electronic Stethoscope. The recordings were processed to yield 25-s sound sequences in random order on PCs. Observers, recruited from doctors within the department, classified the sound sequences as either normal or pathological. The reference tests for bowel obstruction were intraoperative and endoscopic findings and clinical follow up. Sensitivity and specificity were calculated for each observer and compared between junior and senior doctors. Interobserver variation was measured using the Kappa statistic. Bowel sound sequences from 98 patients were assessed by 53 (33 junior and 20 senior) doctors. Laparotomy was performed in 47 patients, 35 of whom had bowel obstruction. Two patients underwent colorectal stenting due to large bowel obstruction. The median sensitivity and specificity was 0.42 (range: 0.19-0.64) and 0.78 (range: 0.35-0.98), respectively. There was no significant difference in accuracy between junior and senior doctors. The median frequency with which doctors classified bowel sounds as abnormal did not differ significantly between patients with and without bowel obstruction (26% vs 23%, P = 0.08). The 53 doctors made up 1378 unique pairs and the median Kappa value was 0.29 (range: -0.15-0.66). Accuracy and inter-observer agreement was generally low. Clinical decisions in patients with possible bowel obstruction should not be based on auscultatory assessment of bowel sounds.

Accuracy of abdominal auscultation for bowel obstruction