Epidemiology of Colorectal Adenomas

Peipins, Lucy A.; Sandler, Robert S.

doi:10.1093/oxfordjournals.epirev.a036154

Cited by 141 publications

(84 citation statements)

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“…Among the different types of tissue, adenoma is most interesting to study but difficult to obtain. Most tumors arise from these benign lesions, although only a small percentage of adenomas is going to progress to malignancy (Peipins and Sandler 1994). Among the 4 members of the HSP90 family, HSP90b was focused due to its overexpression in colon cancer as shown in own previous experiments (Radeva 2009).…”

Section: Introductionmentioning

confidence: 97%

Impact of butyrate on PKM2 and HSP90β expression in human colon tissues of different transformation stages: a comparison of gene and protein data

Jahns

Wilhelm

Greulich³

et al. 2011

Genes Nutr

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Due to protection of oncogenic proteins from degradation and enhancement of glycolytic phosphometabolites for synthetic processes, respectively, heat shock protein 90 (HSP90) and pyruvate kinase type M2 (PKM2) are important proteins for tumor growth. The present study was undertaken to investigate the susceptibility of both proteins and their encoding genes to the chemopreventive agent butyrate in human colon cells. Matched tissue of different transformation stages derived from 20 individual colon cancer patients was used for the experiments. The results of quantitative real-time PCR revealed a moderate increase of HSP90b and PKM2 mRNA in colon tumors (P \ 0.01) compared to normal tissues without relation to clinical parameters. The expression pattern could be confirmed for PKM2 protein by Western blot but not for HSP90b. During culturing with butyrate, the amount of PKM2 transcripts decreased in all three tissue types with the strongest effects observed in tumors (median fold decrease 45%, P \ 0.05). The protein data have not reflected this influence supposing a more gradual degradation rate due to a longer half-life of PKM2. In contrast,

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Section: Introductionmentioning

confidence: 97%

Impact of butyrate on PKM2 and HSP90β expression in human colon tissues of different transformation stages: a comparison of gene and protein data

Jahns

Wilhelm

Greulich³

et al. 2011

Genes Nutr

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“…Most colorectal neoplasms are believed to develop from benign adenomatous polyps (39), making understanding the etiology of adenomas and their malignant transformation important in colorectal cancer prevention. No study to date has examined the combined effect of both obesity, indicated by either BMI or waist-to-hip ratio, and factors related to endogenous estrogen levels on the incidence of colorectal adenomas.…”

Section: Introductionmentioning

confidence: 99%

Do Factors Related to Endogenous and Exogenous Estrogens Modify the Relationship between Obesity and Risk of Colorectal Adenomas in Women?

Wolf

Terry

Potter

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Obesity has consistently been associated with increased colorectal cancer risk in men, but not in women. In the absence of postmenopausal hormone use (PMH), adiposederived estrogen is the primary determinant of circulating estrogen levels in postmenopausal women, perhaps ameliorating the mitogenic effects of obesity in this group. Using data from a case-control study in the United States, we examined associations among obesity, potential modifying effects of factors related to endogenous and exogenous estrogen levels, and risk of colorectal adenoma. Cases (n = 219) were women of ages 30 to 74 years with colonoscopy proven, incident, sporadic, pathologyconfirmed, adenomatous polyps of the colon and rectum. Two control groups were recruited: colonoscopy-confirmed polyp-free women (n = 438) and age-and zip code frequency -matched women randomly selected from the community (n = 247). Multivariate odds ratios and 95% confidence intervals (95% CI) for obese [body mass index (BMI) z30.0; compared with nonobese, BMI <25.0] premenopausal women were 2.09 (95% CI, 0.81-5.41) versus colonoscopy controls, and 5.18 (95% CI, 1.40-19.32) versus population controls. For PMH users, the corresponding odds ratios were 0.29 (95% CI, 0.12-0.70) versus colonoscopy controls and 0.64 (95% CI, 0.23-1.83) versus population controls. There was no significant association of BMI with adenoma risk for PMH nonusers. Findings for waist-to-hip ratio were similar to those for BMI. These data support the hypothesis that risk for colorectal adenoma may be increased with obesity among premenopausal women but decreased among postmenopausal women, especially if they also take PMH. (Cancer Epidemiol Biomarkers Prev 2007;16(4):676 -83)

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“…1 Their long asymptomatic phase allows for timely screening and adequate treatment of these premalignant lesions. Although screening colonoscopy is regarded as the ideal mechanism of detecting polyps because of its completeness and therapeutic potential, significant logistic barriers prevent its widespread implementation.…”

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confidence: 99%

Predictors of Incomplete Flexible Sigmoidoscopy

Ramakrishnan¹,

Scheid²

2003

The Journal of the American Board of Family Medicine

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Objectives: Flexible sigmoidoscopy (flex sig) is an easily administered method of screening for colorectal polyps and cancer. In some patients, the depth of insertion is incomplete, which may result in missed polyps and cancers. To address the question of prospective patient selection for this procedure, we analyzed the factors affecting depth of insertion of sigmoidoscopies performed in outpatients over a 3-year period.Study Design: The study involved retrospective chart review of procedures performed by one endoscopist over a 3-year period.Outcomes Conclusions: Our study showed a relationship between incomplete examination and increasing age, female sex (more than 75% of the incomplete examinations were in women), poor bowel preparation (in women), hysterectomy, abdominal surgery (in men) and weight loss (in men). Further research is necessary to determine whether a predictive model can be developed that would be useful to select patients most appropriate for flex sig. In those patients in whom difficulty is anticipated, the choice can be made in to perform flex sig under sedation, analgesia, with the help of distraction techniques, or offer primary colonoscopy. Most colorectal cancers arise from adenomatous polyps.1 Their long asymptomatic phase allows for timely screening and adequate treatment of these premalignant lesions. Although screening colonoscopy is regarded as the ideal mechanism of detecting polyps because of its completeness and therapeutic potential, significant logistic barriers prevent its widespread implementation. Studies evaluating colonoscopy have suggested that screening flexible sigmoidoscopy (flex sig) using the 60-cm instrument has the capability of detecting 65% to 75% of polyps and 40% to 65% of colorectal cancers. 2-4The procedure can be performed by many physicians and physician extenders with relatively less investment in training and equipment. Hence, flex sig remains an important means of screening a major segment of the population at risk for colorectal cancer.Incomplete examination is an unfortunate drawback of flex sig, because the procedure is routinely offered without sedation or analgesia for simplicity and ease of administration. Olynyk et al 5 noted that 30% of patients had a depth of insertion of less than 50 cm. Stewart et al 6 suggest a 25% incomplete examination rate and technical difficulty in up to one third of the cases. Painter et al 7 found that in up to a quarter of the patients, the descending colon was not intubated. Using radiopaque clips, Lehman et al 8 noted that a 60-cm examination reached the splenic flexure in only 33% of patients, a 50-to 55-cm examination reached the sigmoid/ descending colon junction in most instances, a 40-

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Epidemiology of Colorectal Adenomas

Cited by 141 publications

References 0 publications

Impact of butyrate on PKM2 and HSP90β expression in human colon tissues of different transformation stages: a comparison of gene and protein data

Impact of butyrate on PKM2 and HSP90β expression in human colon tissues of different transformation stages: a comparison of gene and protein data

Do Factors Related to Endogenous and Exogenous Estrogens Modify the Relationship between Obesity and Risk of Colorectal Adenomas in Women?

Predictors of Incomplete Flexible Sigmoidoscopy

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