Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009402 (colorectal cancer)
 53,228 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study examines three faecal occult blood tests, Haemoccult, Fecatwin and E-Z Detect, each with different sensitivities, to determine which is best suited for use in symptomatic patients--both for the detection of cancer and of non-malignant mucosal disease of the large bowel. A test was completed by 1025 patients before double-contrast barium enema and the performance of each test was determined from the result of this investigation. The study was completed by 969 patients. There were 49 patients with colorectal cancer, 92 patients with a cancer or a polyp greater than 5 mm, and 130 with some mucosal abnormality. The test most sensitive for blood, Fecatwin, detected 14 of 15 (93 per cent) cancers and 29 (69 per cent) of 42 patients with mucosal disease (including inflammatory bowel disease) but gave three times as many false positive results as the Haemoccult test, which is less sensitive for blood. The chance of a patient with a positive Haemoccult result having mucosal disease on barium enema was 24 of 47 patients (51 per cent) (two-thirds of these having colorectal cancer). A negative Haemoccult result, however, was unreliable and should not influence patient management. A test less sensitive for blood than Haemoccult was found to be of little value in symptomatic patients.
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PMID:Faecal occult blood testing in symptomatic patients: comparison of three tests. 235 34

Forty seven patients with suspected malignant disease (mainly colorectal cancer) were studied with 111In labelled F(ab')2 fragments of an anti-CEA monoclonal antibody (BW 431/31). The kinetic data revealed a long whole body retention of the label (62% after 4 days) and a rapid blood clearance (77% within 24 h, 89% within 48 h) leading to an early positive tumour contrast 24 h p.i. and optimal scintigrams 48 h p.i. Diagnostic results were promising in local recurrences of colorectal cancer (8/10 positive = 80%) though false positive findings in patients with inflammatory bowel disease occurred probably due to cross-reaction with a human granulocyte antigen. Liver metastases and tumours neighbouring liver and spleen were often missed (10/27 = 37%) because of high nonspecific uptake in these organs. Thus BW 431/31 proved to be a suitable compound for radioimmunodetection, however, further improvements to optimize tumour affinity and specificity of the antibody are mandatory.
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PMID:Radioimmunoscintigraphy with 111In labelled monoclonal antibody fragments (F(ab')2 BW 431/31) against CEA: radiolabelling, antibody kinetics and distribution, findings in tumour and non-tumour patients. 261 3

In the US, the cumulative lifetime risk of developing carcinoma of the upper gastrointestinal tract is less than 1 per cent, premalignant conditions are uncommon, and esophageal and gastric malignancies are rarely curable even when identified early. Endoscopic screening of the upper gastrointestinal tract in asymptomatic persons thus cannot be justified. Surveillance of persons with certain uncommon conditions associated with a higher risk of upper gastrointestinal cancer may be of benefit. These conditions include achalasia, Barrett's esophagus, chronic atrophic gastritis with intestinal metaplasia, familial polyposis coli, gastric polyps, lye stricture, Plummer-Vinson syndrome, and tylosis. In the lower gastrointestinal tract, however, the lifetime risk of developing carcinoma is 5 per cent, premalignant conditions and lesions are common, and carcinoma is curable when detected at an early stage. Sigmoidoscopic screening of asymptomatic adults has been advocated by the American Cancer Society but has not become widely practiced because of its cost, required physician effort, low overall yield, and poor patient compliance. Surveillance by flexible sigmoidoscopy is recommended for persons at slightly increased risk of colorectal carcinoma who have prior breast or gynecologic malignancy or a family history of colorectal malignancy. Colonoscopic surveillance is recommended for patients with high risk of colorectal cancer who have had prior colorectal carcinoma or adenoma or who have inflammatory bowel disease or a ureterosigmoidostomy.
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PMID:Endoscopic screening and surveillance for gastrointestinal malignancy. 268 51

It is important to know the risk of cancer in inflammatory bowel disease and to know the magnitude of the problem. It then becomes possible to answer some questions on the management of patients. It is useful to have a surveillance procedure and follow all patients considered at risk of developing cancer? Should prophylactic surgery be recommended for all patients with long-standing extensive disease, and what will be its impact on the quality of life? There is a wide range of reported incidence of colorectal cancer in inflammatory bowel disease. This is likely to be due to selection bias and problems with generalization and validity of the results rather than any real differences in the underlying cancer incidence. Rigorous methodologic standards must be used to measure the risk of cancer in inflammatory bowel disease.
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PMID:Risk of cancer in inflammatory bowel disease: why are the results in the reviewed literature so varied? 269 48

An asymptomatic population of 37,000 people in the Nottingham area were offered faecal occult blood tests in a screening study for colorectal cancer. Seventeen thousand nine hundred and thirty people completed the tests and 481 individuals with positive tests underwent full investigation of the colon. Eight people with previously undiagnosed inflammatory bowel disease were identified. In five cases there was total ulcerative colitis; in one a proctitis and in two Crohn's disease. Two further patients with ulcerative colitis were identified; they had been lost to follow up for 25 and 45 years respectively. The combined prevalence of inflammatory bowel disease was 56/10(5) and it is likely that current studies of the epidemiology of these conditions may underestimate the true prevalence by between 27% and 38%.
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PMID:Epidemiological study of asymptomatic inflammatory bowel disease: the identification of cases during a screening programme for colorectal cancer. 278 74

Changes in diet from ancient times until the present are described. Previously relatively low in energy and animal products yet high in fibre-containing foods, diets are now high in energy and animal products (particularly fat), yet contain less fibre. The changing incidences of bowel disorders and diseases are described, with assessments of the role of diet. Clearly, diet is implicated as regards predisposition to constipation, appendicitis, colorectal cancer and diverticular disease; however, a meaningful dietary role in irritable bowel syndrome, ulcerative colitis and Crohn's disease is doubtful. In South Africa the rarity of bowel diseases in rural blacks compared with whites affords valuable aetiological information about some bowel diseases. The low occurrence thereof (except inflammatory bowel disease) in Indian and coloured populations is not readily explicable. While dietary changes in whites are being widely urged in order to combat degenerative diseases, the magnitude of changes made is unlikely to reduce the occurrence of bowel diseases. The progressive westernization of the diets and lifestyles of less-privileged populations is likely to be associated with increases in the incidences of these diseases.
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PMID:Diet and bowel diseases--past history and future prospects. 299 4

The short and long-term effects of postoperative total parenteral nutrition (TPN) on body composition were studied in a randomised series of patients undergoing major colorectal surgery. Ninety-two patients (colorectal cancer: 50, ulcerative colitis or Crohn's disease: 42) were grouped according to diagnosis and clinical inflammatory activity. TPN was given for 9.7 +/- 1.1 days. The complication rate was not changed by the TPN. Nitrogen balance was studied during the first week. Body weight, total body potassium, triceps skinfold, serum albumin and body water were measured before and at intervals up to 24 weeks after the operation. Cumulative nitrogen balance in control patients at 7 days after surgery was -47.3 g. Patients given TPN balanced nitrogen intake and output (cancer patients and patients with quiescent inflammatory bowel disease, IBD) or were in positive balance (patients with active IBD). Weight loss at 1 week after surgery was less in TPN patients compared to controls and this difference remained statistically significant up to 6 months after termination of the nutritional treatment. A similar, although not statistically significant, difference was noted in total body potassium and triceps skinfold. Patients with active IBD regained pre-operative body composition earlier than cancer patients and patients with quiescent IBD. It is concluded that TPN after major colorectal surgery reduces postoperative weight loss and that this effect lasts after termination of the nutritional treatment. In the absence of increased body potassium and increased body water, we conclude that the long-term effect of TPN on body weight is most likely due to preservation of fat.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The immediate and long-term effects of postoperative total parenteral nutrition on body composition. 311 32

Plasminogen activators were determined in intestinal tissue, obtained after surgery from patients with Crohn's disease and ulcerative colitis, and compared with normal intestinal tissue from colorectal cancer patients. The activity and quantity of tissue-plasminogen activator (t-PA) was found to decrease with the severity of inflammation in the patients with inflammatory bowel disease. Urokinase (u-PA) activity, however, was not changed compared with controls or in relation with severity of inflammation. In contrast, the level of u-PA antigen was found to be increased significantly in the inflammatory bowel disease tissues and was also related with severity of inflammation. The difference between u-PA activity and antigen in inflammatory bowel disease tissue could be attributed to an increase in inactive pro-u-PA and u-PA-inhibitor complexes. This increase in u-PA and the concomitant decrease in t-PA, are similar to those found in premalignant colonic adenomas, and might be related to the known increased cancer risk in inflammatory bowel disease.
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PMID:Plasminogen activators in the intestine of patients with inflammatory bowel disease. 314 42

In developed populations colorectal cancer, which after lung cancer is the commonest of cancers, accounts for up to 6% of all deaths. It occurs most frequently in populations in prosperous industrialised countries, save Japan, and is rare in Third-World populations pursuing a traditional lifestyle. Peak occurrence is in the 7th decade. Colon cancer affects the sexes equally, but males are much more prone to rectal cancer. The precise causation is uncertain. Risk factors include genetic or familial predisposition, inflammatory bowel disease, diet (especially high fat and low dietary fibre intakes), and possibly alcohol intake. Surgery remains the treatment of choice. Stage is by far the most important factor influencing prognosis. Major refinements in both surgical and therapeutic measures have had disappointingly little effect on survival time. Overall median mortality occurs in 1-1 1/2 years; only one-third to one-half of patients survive for 5 years. While effective screening for very early detection could increase survival time, this will result only from further education. Since little avoiding action is practicable, the outlook for patients will remain daunting until help is sought far earlier.
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PMID:Colorectal cancer. Some aspects of epidemiology, risk factors, treatment, screening and survival. 337 29

Six patients, with overt Crohn's disease of the small bowel developed colorectal cancer. Three distinct clinical patterns were observed. Three patients had advanced rectal adenocarcinoma and a relatively long duration of Crohn's disease, two patients had an early adenocarcinoma and a short antecedent history, and a sixth patient had advanced cloacogenic cancer of the anorectum. The prognosis for a patient with carcinoma in association with regional enteritis was poor when there was advanced disease at the time of diagnosis. The late diagnosis of the cancer may have been the result of three erroneous assumptions. First, scepticism as to the association of Crohn's disease and cancer despite the evidence to the contrary; second, misinterpretation of the intestinal symptoms of the carcinoma as those of the underlying inflammatory bowel disease; and third, confusing the clinical picture of colorectal cancer with that of benign perianal disease with stricture formation. Increased awareness of the association of cancer and Crohn's disease, particularly the development of cancer in apparently normal bowel, and careful evaluation of all new symptoms should improve the prognosis of this potentially lethal complication of inflammatory bowel disease.
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PMID:Colorectal cancer in regional ileitis. 342 5


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