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Latest & greatest articles for colorectal cancer
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One-time screening for colorectalcancer with combined fecal occult-blood testing and examination of the distal colon. Fecal occult-blood testing and sigmoidoscopy have been recommended for screening for colorectalcancer, but the sensitivity of such combined testing for detecting neoplasia is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence of neoplasia and the sensitivity of one-time screening with a fecal occult-blood test plus (...) sigmoidoscopy.Asymptomatic subjects (age range, 50 to 75 years) provided stool specimens on cards from three consecutive days for fecal occult-blood testing, which were rehydrated for interpretation. They then underwent colonoscopy. Sigmoidoscopy was defined in this study as examination of the rectum and sigmoid colon during colonoscopy, and sensitivity was estimated by determining how many patients with advanced neoplasia had an adenoma in the rectum or sigmoid colon. Advanced colonicneoplasia was defined
Compliance, satisfaction, and quality of life of patients with colorectalcancer receiving home chemotherapy or outpatient treatment: a randomised controlled trial. To compare chemotherapy given at home with outpatient treatment in terms of colorectalcancer patients' safety, compliance, use of health services, quality of life, and satisfaction with treatment.Randomised controlled trial.Large teaching hospital.87 patients receiving adjuvant or palliative chemotherapy for colorectal (...) cancer.Treatment with fluorouracil (with or without folinic acid or levamisole) at outpatient clinic or at home.Treatment toxicity; patients' compliance with treatment, quality of life, satisfaction with care, and use of health resources.42 patients were treated at outpatient clinic and 45 at home. The two groups were balanced in terms of age, sex, site of cancer, and disease stage. Treatment related toxicity was similar in the two groups (difference 7% (95% confidence interval -12% to 26%)), but there were
, oxaliplatin and raltitrexed for the treatment of advanced colorectalcancer. Health Technology Assessment 2001; 5(25): 1-137 Authors' objectives The objectives of this review are: 1. to evaluate the relative clinical effectiveness of irinotecan, oxaliplatin and raltitrexed in terms of disease progression rates 2. to estimate their relative effect on overall survival and quality-of-life-adjusted survival 3. to evaluate their side-effect profiles 4. to estimate the incremental cost-effectiveness (...) A rapid and systematic review of the evidence for the clinical effectiveness and cost-effectiveness of irinotecan, oxaliplatin and raltitrexed for the treatment of advanced colorectalcancer A rapid and systematic review of the evidence for the clinical effectiveness and cost-effectiveness of irinotecan, oxaliplatin and raltitrexed for the treatment of advanced colorectalcancer A rapid and systematic review of the evidence for the clinical effectiveness and cost-effectiveness of irinotecan
test as first phase; 2) multiphase screening with sigmoidoscopy; 3) uniphase screening with colonoscopy. For above average risk patients, the specific screening maneuvers reviewed were: 1) flexible sigmoidoscopy and genetic testing for those with familial adenomatous polyposis (FAP); 2) colonoscopy for hereditary nonpolyposis coloncancer (HNPCC); 3) colonoscopy for patients with family history (1st degree relative(s)) of polyps/colorectalcancer. Authors' conclusions Normal risk individuals (...) Screening strategies for colorectalcancer: systematic review and recommendations Screening strategies for colorectalcancer: systematic review and recommendations Screening strategies for colorectalcancer: systematic review and recommendations McLeod R, with the Canadian Task Force on Preventive Health Care Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation
, non-small cell lung cancer, recurrent colorectalcancer, lymphoma, and recurrent melanoma. Authors' conclusions With regard to the use of PET scans for selected malignancies, the ICSI Technology Assessment Committee finds the following: PET scans are safe there are no reports of morbidity or mortality as a result of a PET scan. The potential for misuse of the technology does exist; PET scans are inappropriate if used a) as a screening tool in the general population, b) when the results would (...) ColorectalCancer: PET scans may be used to evaluate patients with elevated levels of CEA but negative CT scans. For detection of local recurrence of colorectalcancer, PET scans have been found to be superior to CT scans. For detection of hepatic metastases, PET and CT are at least comparable, but PET provides more information about the extent of disease. Total body PET is superior to CT in identifying extrahepatic disease. Unnecessary operative procedures may be avoided in up to 20% of patients studied
colonoscopy (incomplete examination of colon), or who cannot be sedated. CTC studies (after full bowel preparation) of patients who are either at high risk for colorectalcancer or who are symptomatic have yielded sensitivity values of 38% to 96% and specificity values of 63% to 100% with conventional colonoscopy as the gold standard. Higher sensitivity and specificity values have been reported for larger lesions (>=10 mm) (Conclusion Grade II). The proficiency of the persons reading the CTC images also (...) influences the findings. For patients with symptoms, CTC appears to be superior, in terms of detection of colorectal polyps and neoplasms, to no examination or a fecal occult blood test and comparable to a flexible sigmoidoscopy examination. Unless a colonoscopy can be done on the same day as CTC, a second bowel preparation would be required to obtain tissue samples from lesions identified on CTC. With the present data acquisition and interpretation protocols, CTC is not as sensitive or specific
of breast cancer among those receiving placebo.Of the 288 breast cancer cases, 19 (6.6%) inherited disease-predisposing BRCA1 or BRCA2 mutations. Of 8 patients with BRCA1 mutations, 5 received tamoxifen and 3 received placebo (risk ratio, 1.67; 95% confidence interval, 0.32-10.70). Of 11 patients with BRCA2 mutations, 3 received tamoxifen and 8 received placebo (risk ratio, 0.38; 95% confidence interval, 0.06-1.56). From 10 studies, including this one, 83% of BRCA1 breast tumors were ER-negative (...) Tamoxifen and breast cancer incidence among women with inherited mutations in BRCA1 and BRCA2: National Surgical Adjuvant Breast and Bowel Project (NSABP-P1) Breast Cancer Prevention Trial. Among cancer-free women aged 35 years or older, tamoxifen reduced the incidence of estrogen receptor (ER)-positive but not ER-negative breast cancer. The effect of tamoxifen on breast cancer incidence among women at extremely high risk due to inherited BRCA1 or BRCA2 mutations is unknown.To evaluate
Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. Gastrointestinal stromal tumours (GISTs) are rare tumours of the gastrointestinal tract characterised by cell-surface expression of the tyrosine kinase KIT (CD117). No effective systemic treatment is available. Imatinib (STI571) inhibits a similar tyrosine kinase, BCR-ABL, leading to responses in chronic myeloid leukaemia, and has also been shown to inhibit KIT. We did a phase I study (...) mg imatinib twice daily had dose-limiting toxic effects (severe nausea, vomiting, oedema, or rash). Inhibition of tumour growth was seen in all but four patients with GISTs, resulting in 19 confirmed partial responses and six as yet unconfirmed partial responses or more than 20% regressions. 24 of 27 clinically symptomatic patients showed improvement, and 29 of 36 were still on treatment after more than 9 months. PET scan responses predicted subsequent computed tomography responses.Imatinib
Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinalcancer: a randomised multicentre trial. Although current opinion favours the use of enteral over parenteral nutrition, the clinical benefits of early postoperative nutrition in patients undergoing elective surgery have never been clearly shown. We aimed to test the hypothesis that postoperative enteral nutrition is better (fewer postoperative complications) than parenteral nutrition containing (...) similar energy and nitrogen amounts (112 kJ kg(-1) day(-1) and 1.4 g aminoacid kg(-1) day(-1)).We did a randomised multicentre clinical trial in patients with gastrointestinalcancer who were malnourished and candidates for major elective surgery. 159 patients were assigned to enteral nutrition and 158 to parenteral nutrition. The primary endpoint was the occurrence of postoperative complications, and secondary endpoints were length of postoperative hospital stay, adverse effects, and treatment
2001LancetControlled trial quality: predicted high
Use of irinotecan (Camptosar, CPT-11) combined with 5-fluorouracil and leucovorin (5FU/LV) as first-line therapy for metastatic colorectalcancer Use of irinotecan (Camptosar, CPT-11) combined with 5-fluorouracil and leucovorin (5FU/LV) as first-line therapy for metastatic colorectalcancer Use of irinotecan (Camptosar, CPT-11) combined with 5-fluorouracil and leucovorin (5FU/LV) as first-line therapy for metastatic colorectalcancerGastrointestinalCancerDisease Site Group CRD summary (...) of irinotecan and 5FU-LV is most effective. Research: The authors did not state any implications for future research. They identified 6 ongoing trials (as at January 2003). Funding Cancer Care Ontario; Ontario Ministry of Health and Long-term Care. Bibliographic details GastrointestinalCancerDisease Site Group. Use of irinotecan (Camptosar, CPT-11) combined with 5-fluorouracil and leucovorin (5FU/LV) as first-line therapy for metastatic colorectalcancer. Cancer Care Ontario Practice Guidelines Initiative
invasive cancer to progress to late-stage cancer; years before late-stage CRC is detected; proportion of cancers detected in the early stage; sensitivity for polyps and CRC and specificity of FOBT; sensitivity and specificity of FS and COL; rate of colonoscopy-induced perforation of the largebowel, and COL-induced mortality. Additional to the initial model, racial and ethnic differences in colorectalcancer incidence, the proportion of left-sided cancers, and the proportion of early cancers were (...) % for polyps and 60% for CRC. The specificity of FOBT was 90%. The sensitivity and specificity of FS/COL were 90% and 98%, respectively. The rate of COL-induced perforation of the largebowel was 7 in 10,000. The COL-induced mortality was 5 in 100,000. The California Cancer Registry estimates (SEER estimates in brackets) of the proportion of ColorectalCancers occurring before age 50 were 13 (8.6) for Asians, 10.7 (10.6) for blacks, 13.7 (11.1) for Latinos and 5.4 (5.5) for whites. The average annual age
given. Bibliographic details Yim H B, Jacobson B C, Saltzman J R, Johannes R S, Bounds B C, Lee J H, Shields S J, Ruymann F W, Van Dam J, Carr-Locke D L. Clinical outcome of the use of enteral stents for palliation of patients with malignant upper GI obstruction. Gastrointestinal Endoscopy 2001; 53(3): 329-332 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Adult; Aged; Aged, 80 and over; Cohort Studies; Duodenal Diseases /diagnosis /mortality /therapy; Female; Gastric Outlet (...) of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The health intervention studied was endoscopic deployment of enteral stents for patients with malignantgastrointestinal (GI) obstruction who were not fit for surgery. Type of intervention Palliative care. Economic study type Cost
study of prognostic factors in patients with unresected hepatic metastases from colorectalcancer. Foundation Francaise de Cancerologie Digestive. British Journal of Surgery 1995;82:1397-1400. Indexing Status Subject indexing assigned by CRD MeSH Adenocarcinoma /drug therapy; Antineoplastic Combined Chemotherapy Protocols /therapeutic use /economics; ColorectalNeoplasms /drug therapy; Cost-Benefit Analysis; Drug Administration Schedule; Fluorouracil /administration & Liver Neoplasms /drug therapy (...) Costs of neoadjuvant chemotherapy and surgery in patients with liver metastases from advanced colorectalcancer Costs of neoadjuvant chemotherapy and surgery in patients with liver metastases from advanced colorectalcancer Costs of neoadjuvant chemotherapy and surgery in patients with liver metastases from advanced colorectalcancer Poston G, Benjamin I S, Diamond T, Finch-Jones M, Parks R W, Primrose J N, Rees M, Sherlock D J, Yeung S, Carita P, Nicholls C J Record Status This is a critical
of gene tests to detect hereditary predisposition to cancer: economic considerations. Journal of the National Cancer Institute 1995;87:1131-6. Gryfe R, Kim H, Hsieh ET, Aronson MD, Holowaty EJ, Bull SB, et al. Tumor microsatellite and clinical outcome in young patients with colorectalcancer. New England Journal of Medicine 2000;342:69-77. Jarvinen HJ, Aarnio M, Mustonen H, Aktan-Collan K, Aaltonen LA, Peltomaki P, et al. Controlled 15-year trial on screening for colorectalcancer in families (...) with hereditary nonpolyposis colorectalcancer. Gastroenterology 2000;118:829-34. Lerman C, Hughes C, Trock BJ, Myers RE, Main D, Bonney A, et al. Genetic testing in families with hereditary nonpolyposis coloncancer. JAMA 1999;281:1618-22. Myrhoj T, Bisgaard ML, Bernstein I, Svendsen LB, Sondergaard JO, Bulow S. Hereditary non-polyposis colorectalcancer: clinical features and survival. Results from the Danish HNPCC register. Scandinavian Journal of Gastroenterology 1997;32:572-6. Indexing Status Subject
adjuvant chemotherapy with oral carmofur in patients with curatively resected colorectalcancer. Oncology Reports 2001; 8(3): 697-703 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Administration, Oral; Adult; Aged; Antineoplastic Agents /therapeutic use; Chemotherapy, Adjuvant; ColonicNeoplasms /drug therapy /mortality /surgery; Disease-Free Survival; Female; Fluorouracil /analogs & Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Prognosis; Randomized Controlled Trials as Topic (...) , Ito K, Maehara Y, Takagi H, Sugimachi K, Nakazato H, Ohashi Y Authors' objectives To assess the effect of adjuvant chemotherapy with oral carmofur on survival and disease-free survival in people with curatively resected colorectalcancer. Searching MEDLINE, the PDQ database and conference abstracts were searched; the search terms and search dates were not reported. The authors also approached personal contacts for additional studies. Study selection Study designs of evaluations included
Oral contraceptives and colorectalcancer risk: a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Alpha-interferon does not increase the efficacy of 5-fluorouracil in advanced colorectalcancer Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
, the use of colonoscopic screening for colorectalcancer is preferable to the standard practice option examined. Source of funding None stated. Bibliographic details Vijan S, Hwang E W, Hofer T P, Hayward R A. Which coloncancer screening test: a comparison of costs, effectiveness, and compliance. American Journal of Medicine 2001; 111(8): 593-601 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Aged; Aged, 80 and over; ColonicNeoplasms /diagnosis /economics /mortality; Colonoscopy (...) Which coloncancer screening test: a comparison of costs, effectiveness, and compliance Which coloncancer screening test: a comparison of costs, effectiveness, and compliance Which coloncancer screening test: a comparison of costs, effectiveness, and compliance Vijan S, Hwang E W, Hofer T P, Hayward R A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results
Screening strategies for colorectalcancer: a systematic review of the evidence Screening strategies for colorectalcancer: a systematic review of the evidence Screening strategies for colorectalcancer: a systematic review of the evidence McLeod R S, Canadian Task Force on Preventive Care Authors' objectives The authors assessed the effectiveness of different screening techniques for colorectalcancer (CRC) in asymptomatic people at normal or an above average risk. Searching MEDLINE (...) for people with familial adenomatous polyposis; colonoscopy for people at risk of hereditary nonpolyposis coloncancer; or colonoscopy for people with immediate family history of polyps or CRC. Reference standard test against which the new test was compared The authors did not define a 'gold' standard comparator as an inclusion criterion. Some studies included in the review used colonoscopy as the gold standard comparator. Others used clinical follow-up to assess mortality and faecal occult blood testing
in screening for colorectalcancer. European Journal of Cancer 2001; 37(3): 398-401 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Adult; Aged; ColorectalNeoplasms /diagnosis /economics; Cost-Benefit Analysis; Female; Humans; Immunohistochemistry /economics /methods /standards; Male; Mass Screening /economics /methods /standards; Middle Aged; Occult Blood; Sensitivity and Specificity AccessionNumber 22001000612 Date bibliographic record published 28/02/2003 Date abstract record published (...) Evaluation of the optimum cut-off point in immunochemical occult blood testing in screening for colorectalcancer Evaluation of the optimum cut-off point in immunochemical occult blood testing in screening for colorectalcancer Evaluation of the optimum cut-off point in immunochemical occult blood testing in screening for colorectalcancer Nakama H, Zhang B, Zhang X Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each