Author Interviews, Colon Cancer, Cost of Health Care / 25.10.2014

Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann ArborMedicalResearch.com Interview with: Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann Arbor Medical Research: What is the background for this study? Dr. Veenstra: Nearly 50,000 patients are diagnosed with stage III colorectal cancer each year. Chemotherapy is known to increase survival by up to 20% and is the standard recommendation for these patients after surgery. However, use of chemotherapy may be associated with financial strain. In order to better understand the financial burden and worry associated with colorectal cancer treatment, we surveyed 956 patients being treated for stage III colorectal cancer. We asked patients to answer questions about financial burden such as whether they had used savings, borrowed money, skipped credit card payments, or cut back on spending for food, clothing or recreational activities because of their cancer treatment. We also asked patients how much they worry about financial problems because of their cancer or its treatment. (more…)
Author Interviews, Colon Cancer, NEJM / 22.10.2014

Alfredo Falcone MD Chiara Cremolini Fotios Loupakis University of Pisa and Azienda-Ospedaliero Universitaria Pisana ItalyMedicalResearch.com Interview with: Alfredo Falcone MD Chiara Cremolini Fotios Loupakis University of Pisa and Azienda-Ospedaliero Universitaria Pisana Italy Medical Research: What are the main findings of the study? Dr. Falcone: In the TRIBE study the main findings are that the use of an initial more intensive therapy with a triplet of cytotoxics (FOLFOXIRI) plus bevacizumab vs a doublet (FOLFIRI) + bevacizumab improves the outcome of metastatic colorectal cancer patients with unresectable metastases. In particular FOLFOXIRI + bevacizumab vs FOLFIRI+bevacizumab improved RECIST response-rate (65% vs 53%, p=0.006), progression-free survival which was the primary endpoint (median 12,1 vs 9,7 months, HR=0,75, p=0.003) and overall survival (median 31,0 vs 25,8 months, HR=0.79, p=0.054). These results, also compared to those reported in previous phase III studies in molecularly unselected patients, represent an important advance in the treatment of this disease. (more…)
Author Interviews, Colon Cancer / 05.09.2014

Paula Berstad, PhD, postdoc Telemark Hospital c/o Cancer Registry of Norway Oslo, NorwayMedicalResearch.com Interview Invitation Paula Berstad, PhD, postdoc Telemark Hospital c/o Cancer Registry of Norway Oslo, Norway   Medical Research: What are the main findings of the study? Dr. Berstad: In general population of age 50-55 years, both those invited to bowel cancer screening in year 2001 by flexible sigmoidoscopy and those not invited improved their lifestyle from year 2001 to 2012. Lifestyle was measured as adherence to public health guidelines; non-smoking, daily physical exercise, healthy diet and normal body weight. However, the 11-year improvement was smaller in those who were screened for bowel cancer compared to those not screened. Further, among those who attended the screening, the improvement was smaller in those with findings at screening (positive screening result) compared to those without findings (negative screening result). Our interpretation of the findings is that bowel cancer screening may have a small unwanted effect on lifestyle. Particularly, attention should be given to lifestyle among those testing positive at screening. (more…)
Annals Internal Medicine, Author Interviews, Colon Cancer, Erasmus / 18.08.2014

Frank van Hees, MSc Researcher, Department of Public Health, Erasmus MC Rotterdam, The NetherlandsMedicalResearch.com Interview with: Frank van Hees, MSc Researcher, Department of Public Health, Erasmus MC Rotterdam, The Netherlands Medical Research:   What are the main findings of the study? Answer: Many U.S. elderly are screened for colorectal cancer more frequently than recommended: One in every five elderly with a negative screening colonoscopy result undergoes another screening colonoscopy within 5 years’ time instead of after the recommended 10 years. Moreover, one in every four elderly with a negative screening colonoscopy result at age 75 or older receives yet another screening colonoscopy at an even more advanced age. Our study shows that, in average risk individuals, these practices are not only a waste of scarce health care resources: often they are also associated with a balance among benefits, burden, and harms that is unfavorable for those being screened. (more…)
Author Interviews, Colon Cancer, JAMA, Transplantation / 15.08.2014

MedicalResearch.com Interview with: Øyvind Holme, MD Department of Medicine, Sorlandet Hospital Kristiansand, Kristiansand, Norway Institute of Health and Society, University of Oslo, Oslo, Norway Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Harvard-MIT Division of Health Sciences and Technology Boston, Massachusetts Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway Medical Research: What are the main findings of the study? Dr. Holme: In this population-based trial, we found that once-only flexible sigmoidoscopy screening in asymptomatic 50-64 year old individuals reduces colorectal cancer mortality by 27% and colorectal cancer incidence by 20% after 11 years of follow-up. We found that the incidence reduction is as great in 50-54 year old individuals as in 55-64 old individuals. Addition of a once-only fecal occult blood test to flexible sigmoidoscopy did not lead to a larger reduction in colorectal cancer incidence or mortality compared to flexible sigmoidoscopy screening alone. (more…)
Author Interviews, Colon Cancer, JNCI / 01.07.2014

Kaspar Truninger, MD, FMH Gastroenterology and Internal Medicine Langenthal, SwitzerlandMedicalResearch.com Interview with: Kaspar Truninger, MD, FMH Gastroenterology and Internal Medicine Langenthal, Switzerland MedicalResearch: What are the main findings of the study? Dr. Truninger: In our study, we investigated the effect of lifestyle exposure on DNA methylation. We measured genome-wide promoter CpG methylation in 1092 normal colon biopsies from 546 healthy females. We observed that fewer CpGs acquired age-dependent methylation in users of aspirin and hormonal replacement therapy compared with nonusers, whereas more CpGs were affected in smokers and individuals with a body mass index > 25 compared with nonsmokers and less obese females. Half of the CpGs showing age-dependent methylation gain were hypermethylated in tissue of colorectal cancer. These loci gained methylation with a higher rate and were particularly susceptible to lifestyle exposure compared to age-only methylated CpGs. In addition, these CpGs were enriched for polycomb regions.  Finally, all effects were different according to the anatomic location along the colon. (more…)
Annals Internal Medicine, Author Interviews, Colon Cancer, Erasmus, Sloan Kettering / 03.06.2014

MedicalResearch.com Interview with: Frank van Hees MSc Erasmus University Medical Center Rotterdam, the Netherlands and Ann G. Zauber PhD Memorial Sloan Kettering Cancer Center, New York MedicalResearch: What are the main findings of the study? Answer: The main finding of our study is that colorectal cancer screening of individuals without previous screening is worthwhile well beyond age 75, which is the recommended age to stop screening in individuals with an adequate screening history. The exact age up to which screening should be considered in unscreened elderly depends on an individual's health status: in healthy individuals screening remains worthwhile up to age 86, whereas in individuals with a severe illness, such as heart failure, screening remains worthwhile up to age 80. (more…)
Author Interviews, Colon Cancer, JAMA, Surgical Research / 16.04.2014

MedicalResearch.com Interview Invitation Dorna Jafari, M.D. and Michael J Stamos, MD Professor of Surgery John E. Connolly Chair, Department of Surgery University of California, Irvine Orange, CA 92868 MedicalResearch.com: What are the main findings of the study? Answer: Surgeons are faced with an aging population and data regarding outcomes is rare given that many studies preclude the elderly from the study population. Therefore, it is difficult to accurately discuss risk of surgical resection given the lack of data. Therefore we aimed to report the national trends and outcomes of colorectal cancer treatment in the elderly population. We demonstrated that the majority of resections are performed in patients >65yeras old. There is a trend towards a decrease in incidence of colorectal resection and a decrease in rate of mortality during 2001-2010.  However, the unique physiological changes associated with aging contribute to increase morbidity and morality as demonstrated by our findings. In fact patients >85 years have a 472% increase in risk-adjusted mortality during a hospital admission compared to younger patients. However, despite the substantially higher mortality and morbidity associated with age, there has been a marked improvement in surgical outcomes in the elderly population. (more…)
Author Interviews, Colon Cancer, JAMA / 31.03.2014

MedicalResearch.com Interview with: M.S. ReimersM.S. Reimers, MD PhD Student and Dr. Jan Liefers MD Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands MedicalResearch.com: What are the main findings of the study? Answer: Aspirin use was associated with an improved survival, as we have published before when investigating this cohort (Bastiaannet et al, Brit J Cancer 2012/ Reimers et al. J Am Geriatr Soc. 2012. In this study we have focused on investigating which patients will benefit from aspirin treatment by investigating some tumor markers, such as PTGS2 expression, HLA class I expression and PIK3CA mutation status. Interestingly, only patients with HLA class I expression on their tumor membrane will benefit from aspirin treatment and have a better outcome. We raise the hypothesize that aspirin inhibits platelet aggregation to circulating tumors cells. By interfering with this process, the metastatic potential of these circulating tumour cells is inhibited, thereby preventing metastasis and colon cancer death.HLA class I expression might be needed for signalling between platelets and circulating tumor cells. If this hypothesis is confirmed by others or in vitro studies, than this might explain the finding that aspirin seems not only beneficial as an adjuvant therapy for colorectal cancer patients, but also for patients with other malignancies (oesophagus, breast, etc). Interestingly, preliminary findings from our team investigating aspirin use in oesophageal cancer also showed that aspirin use in these tumors was associated with an improved survival. (more…)
Author Interviews, Biomarkers, Colon Cancer, NEJM / 19.03.2014

Dr. Thomas Imperiale MD Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and CommunicationMedicalResearch.com Interview Invitation with: Dr. Thomas Imperiale MD Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and Communication MedicalResearch.com: What are the main findings of the study? Dr. Imperiale: The main findings are the performance characteristics of the multi-target test (sensitivity of 92.3%, specificity of 86.6%) and its performance as compared with the commercial FIT: more sensitive for colorectal cancer and advanced precancerous polyps, but less specific. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease, JNCI / 22.02.2014

MedicalResearch.com Interview with: Jiyoung Ahn, PhD Assistant Professor of Epidemiology Department of Population Health NYU School of Medicine New York, NY 10016Jiyoung Ahn, PhD Assistant Professor of Epidemiology Department of Population Health NYU School of Medicine New York, NY 10016 MedicalResearch.com: What are the main findings of the study? Dr. Ahn: Before we did our research, it was suspected that gut bacteria were related to colorectal cancer. We, for the first time, found colorectal cancer patients have a different gut bacteria composition than healthy subjects. (more…)
Author Interviews, Colon Cancer, General Medicine, PLoS, University of Michigan, Weight Research / 09.02.2014

Jenifer I Fenton Assistant Professor Department of Food Science and Human Nutrition Michigan State University East Lansing, MI 48824MedicalResearch.com Interview with: Jenifer I Fenton Assistant Professor Department of Food Science and Human Nutrition Michigan State University East Lansing, MI 48824 MedicalResearch.com: What are the main findings of the study? Dr. Fenton: This was a cross-sectional study, and thus, a snapshot in time. Although it cannot infer cause or temporality of obesity and colon polyp risk in men, it does show that obese men were more likely to have a polyp than their lean counterpart. In addition, there were serum biomarkers also associated with this risk. This could eventually lead to future blood tests to identify individuals at greater risk for polyps and inform screening recommendations. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease / 31.12.2013

MedicalResearch.com Interview with: Chia-Hung Kao, MD Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taiwan. MedicalResearch.com: What are the main findings of the study? Answer: Colonic diverticular disease and colorectal cancer shared certain characteristics. Some previous studies aimed to identify their epidemiological correlation. However, their results were discrepant and insufficiently strong to draw firm conclusion. In our nationwide population-based retrospective cohort study, we found that the previously diagnosed colonic diverticular disease is not associated with an elevated risk of colorectal cancer after the first year of a diagnosis of colonic diverticular disease (adjusted HR, 0.96). The increased risk in the first year may be due to misclassification and screening effect. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease / 25.11.2013

Li-Shu Wang, PhD Department of Medicine, Medical College of Wisconsin, Milwaukee, WisconsinMedicalResearch.com Interview with: Li-Shu Wang, PhD Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin MedicalResearch.com: What are the main findings of the study? Answer: Ulcerative colitis (UC) is frequently an intermediate step to colon cancer.  The interleukin-10 knock-out (KO) mouse is a genetic model of this progression.  We have now shown that KO mice fed 5% black raspberries (BRBs) had significantly less colonic ulceration as compared to KO mice that consumed the control diet.  Dysfunction of the Wnt signaling pathway is a key event in UC-associated colon carcinogenesis.  We investigated the effects of BRBs on the Wnt pathway and found that the BRB-fed KO mice exhibited significantly decreased promoter methylation of Wnt antagonists and a significantly lower level of β-catenin nuclear translocation.  Our results suggest that BRBs inhibit colonic ulceration partly through inhibiting aberrant epigenetic events that dysregulate Wnt signaling. (more…)
Author Interviews, Colon Cancer, Nature, Race/Ethnic Diversity, Stanford / 18.11.2013

James Murphy, M.D. Assistant Professor Department of Radiation Medicine and Applied Sciences Center for Advanced Radiotherapy Technologies UC San Diego Moores Cancer Center 3855 Health Sciences Drive La Jolla, CA 92093MedicalResearch.com Interview with: James Murphy, M.D. Assistant Professor, Department of Radiation Medicine and Applied Sciences, Center for Advanced Radiotherapy Technologies ,UC San Diego Moores Cancer Center La Jolla, CA 92093 MedicalResearch.com: What are the main findings of the study? Dr. Murphy: This study evaluated racial disparity in metastatic colorectal cancer. In a large population-based cohort we found of over 11,000 patients we found that black patients were less likely to be seen in consultation by a cancer specialist, and were less likely to receive treatment with chemotherapy, surgery, or radiation. Furthermore, we found that this disparity in treatment accounted for a substantial portion of the race-based differences between black and white patients. (more…)
Author Interviews, CMAJ, Colon Cancer, NEJM / 19.09.2013

Aasma Shaukat, M.D., M.P.H. Dept. of Medicine GI Division, MMC 36 University of Minnesota Minneapolis, MN 55455MedicalResearch.com Interview with: Aasma Shaukat, M.D., M.P.H. Dept. of Medicine GI Division, MMC 36 University of Minnesota Minneapolis, MN 55455 MedicalResearch.com: What are the main findings of the study? Dr. Shaukat: The study showed that screening for colon cancer using stool cards consistently reduces risk of death from colon cancer by one-third through thirty years. The benefit of screening in larger in men compared to women, and for women the benefit seems to start at age 60. However, screening did not make people live longer. (more…)
Author Interviews, Colon Cancer / 10.09.2013

Dr. Bettina Scholtka Universität Potsdam Institut für Ernährungswissenschaft Abt. Ernährungstoxikologie Arthur-Scheunert-Allee 114-116 14558 Nuthetal, Germany.Dr. Bettina Scholtka Universität Potsdam Institut für Ernährungswissenschaft Abt. Ernährungstoxikologie Arthur-Scheunert-Allee 114-116 14558 Nuthetal, Germany. MedicalResearch.com: What are the main findings of the study? Answer: The extremely high sensitivity of the WTB-HRM technique allows to find very low amounts of different types of colon cancer initiating gene mutations even in stool samples of patients. The method is able to find the expected mutations as well as unknown mutations. So, by applying WTB-HRM to a panel of especially selected marker genes, it is possible to detect cancer precursors in feces before they progress into a malignant stage. (more…)
Author Interviews, Colon Cancer, JAMA / 07.08.2013

MedicalResearch.com: Interview with: Samir Gupta, MD, MSCS San Diego Veterans Affairs Healthcare System Associate Professor of Clinical Medicine Division of Gastroenterology, Department of Internal Medicine Moores Cancer Center University of California San Diego MedicalResearch.com: What are the main findings? Dr. Gupta: In a randomized, comparative effectiveness study among uninsured individuals not up to date with screening, we found that mailed outreach invitations to complete colonoscopy outreach, and mailed outreach to complete a non-invasive fecal immunochemical test (FIT) tripled screening rates compared to usual care. Additionally, we found that outreach was almost twice as effective with offers for FIT versus colonoscopy screening. (more…)