Age and Time as Factors in the Left-to-right Shift of the Subsite of Colorectal Adenocarcinoma: A Study of 213,383 Cases From the California Cancer Registry

Saltzstein, Sidney L.; Behling, Cynthia

doi:10.1097/01.mcg.0000225550.26751.6a

Cited by 94 publications

(90 citation statements)

References 16 publications

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“…36 The mean age in the current study cohort was at least a decade younger than that of Western populations. 37 Because leftsided CRC has been reported to be associated with younger age, 38 this may possibly explain the high incidence of left-sided tumors noted in the current study population. We believe the finding that the majority of CRC cases in the current study cohort were left-sided tumors and the patients had a lower mean age at the time of diagnosis compared with Western populations can explain in part the low prevalence of BRAF noted herein and hence the low incidence of the serrated pathway compared with a Western population.…”

Section: 32mentioning

confidence: 69%

Molecular markers and pathway analysis of colorectal carcinoma in the Middle East

Beg

Siraj

Prabhakaran

et al. 2015

Cancer

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BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers in the world. A newly proposed integrated pathway comprising traditional, alternate, and serrated pathways by genetic and epigenetic factors was defined recently and hypothesized to play a role in the pathogenesis of CRC; however, to the authors' knowledge, there is a paucity of information regarding these proposed molecular pathways in different ethnic groups. METHODS: Molecular characterization of 770 CRC specimens was performed for microsatellite instability, BRAF, and KRAS by polymerase chain reaction and 500 cases for CpG island methylator phenotype (CIMP) high phenotype by MethyLight technology. Tumors were assigned to different molecular pathways and examined for clinicopathological correlation and survival analysis. RESULTS: The traditional pathway constituted 33.4% of CRC cases, the alternate pathway comprised 11.6%, and the serrated molecular pathway accounted for only 0.8% of Middle Eastern CRC cases. Approximately 54.2% of CRC cases did not qualify to fit into any pathway and thus were designated as an unassigned group. Molecular pathways were found to be significantly associated with tumor site and grade. A subset of cases with an uncategorized pathway demonstrated a significant survival difference (P 5 .0079). CONCLUSIONS: The serrated pathway was found to account for a very low percentage of the CRC patient cohort in the current study. The unassigned group accounted for the majority of Middle Eastern CRC cases, and therefore methods of CRC pathway analysis might not be applicable to this ethnic group. The current study demonstrates the need to unravel the molecular genetic basis of this disease to further subcategorize these CRC cases. It also identifies a need for further studies on different populations for a better understanding of their exact role and incidence. Cancer 2015;121:3799-808.

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Section: 32mentioning

confidence: 69%

Molecular markers and pathway analysis of colorectal carcinoma in the Middle East

Beg

Siraj

Prabhakaran

et al. 2015

Cancer

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“…Within the colon, women have more proximal colon cancers (Svensson et al, 2002), whereas in men there is a predominance of distal colon cancer, in particular in White males; moreover, the male-to-female ratios progressively increase from the proximal colon to the distal colorectum (Wu et al, 2001). The left-to-right shift of incidence is greater among women than among men (Saltzstein and Behling, 2007). Furthermore, a more increased incidence of proximal colon cancer in women was reported early in 1983 by Beart et al(1983), and the continuing trends could be found afterwards (Obrand and Gordon, 1998).…”

Section: Genetic Pathwaymentioning

confidence: 87%

“…The male-to-female ratios progressively increased from the proximal colon to the distal colon; the ratios of proximal-to-distal CRC gradually increased with advancing age Saltzstein and Behling, 2007 California cancer registry including 213 383 cases…”

Section: Genetic Pathwaymentioning

confidence: 99%

Colorectal cancer, one entity or three

Lai

2009

J. Zhejiang Univ. Sci. B

212

163

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Abstract:Understanding of the mechanism of colorectal carcinogenesis has been gaining momentum for some years on account of its high incidence and impact on the lives of individuals affected. Different genetic abnormalities have been found in colorectal cancers from different sites. For example, proximal colon cancer is usually related to the nucleotide instability pathway, as microsatellite instability (MSI). However, distal colon cancer is usually associated with specific chromosomal instability (CIN). The development of cancer at the rectum, though similar to that at the colon, displays its own unique features. These differences might be partially attributed to different embryological development and physiological circumstances. Environmental factors such as diet and alcohol intake also differ in their role in the development of tumors in the three segments, proximal colon, distal colon, and rectum. "Proximal shift" of colon cancer has been known for some time, and survival rates of colorectal cancer are higher when rectal cancers are excluded, both of which emphasize the three different segments of colorectal cancer and their different properties. Meanwhile, colonic and rectal cancers are distinctive therapeutic entities. The concept of three entities of colorectal cancer may be important in designing clinical trails or therapeutic strategies. However, the dispute about the inconsistency of data concerning the site-specific mechanism of colorectal carcinoma does exist, and more evidence about molecular events of carcinogenesis and targeted therapy needs to be collected to definitely confirm the conception.

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“…The disproportionate decrease in left sided tumors have also been attributed to preference of use of sigmoidoscopy over colonoscopy because of its cost and simplicity. Due to increased use of sigmoidoscopy, majority of adenomatous polyps from the left colon are removed prior to their malignant transformation (Saltzstein et al, 2007). There seems to be an increasing trend of detection of these malignancies at an earlier stage, especially with increase in detection of Modified Duke's B.…”

Section: Discussionmentioning

confidence: 99%

Changing Trends of Colorectal Carcinoma in Nepalese Young Adults

Кансакар¹,

Singh²

2012

Asian Pacific Journal of Cancer Prevention

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The number of young adults with CRC increased from 28 to 34. However, the proportion of young patients in both groups was 28% of all CRC patients. The mean ages were 34±4.7 and 31.8±5.1 years in early and recent 5 years, respectively, and the male female ratio changed from 2:3 to 4:3. Abdominal pain as the most common presenting symptom was replaced by bleeding per rectum in recent years. The mean duration from onset of symptoms to seeking medical advice decreased from 7.8 months to 5.6 months in recent years. More patients (85.3%) were subjected to endoscopic examination in recent years than early years (60.7%) and right colonic cancer increased from 10.7% to 26.5%. However, the rectum was the commonest site in both early (71.4%) and recent (50%) groups. CRC was detected significantly at an earlier stage (7.1% vs 32.4%) in recent years with large proportion of modified Dukes B stage. Poorly differentiated adenocarcinoma was the predominant histology in both groups (50% vs 60.7%). Curative resection had risen in recent years (39.3% vs 73.6%). Conclusion: CRC among Nepalese young adults accounts for a high incidence (28%) of all CRC cases. Although right sided colonic cancer has been increasing, rectum is the commonest site. There is also an increasing trend for diagnosis at earlier stages of the disease which can be treated with curative intent.

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Age and Time as Factors in the Left-to-right Shift of the Subsite of Colorectal Adenocarcinoma: A Study of 213,383 Cases From the California Cancer Registry

Abstract: The most attractive hypothesis is that a greater likelihood of prior polypectomy, and thus prevention of more cancers, occurs on the left side than on the right.

Cited by 94 publications

References 16 publications

Molecular markers and pathway analysis of colorectal carcinoma in the Middle East

Molecular markers and pathway analysis of colorectal carcinoma in the Middle East

Colorectal cancer, one entity or three

Changing Trends of Colorectal Carcinoma in Nepalese Young Adults

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