Author Interviews, Cancer Research, JAMA, Vitamin D / 09.04.2019

MedicalResearch.com Interview with: Mitsuyoshi Urashima MD, PhD, MPH Professor of Molecular Epidemiology Jikei University School of Medicine Tokyo, JAPAN MedicalResearch.com: What is the background for this study?   Response: Serum levels of vitamin D, increase in response to exposure to sunlight, a vitamin D-rich diet, or vitamin D supplementation. In 1989, the risk of colon cancer was estimated to be 70% lower in people with serum vitamin D levels ≥ 20 ng/mL, compared with those < 20 ng/mL. In a cohort study, higher vitamin D levels were associated with lower total cancer incidence and lower total cancer mortality, particularly digestive system cancer mortality. However, because of the studies’ observational nature, whether lower levels of vitamin D is merely a precursor to relapse and death or causally related to shorter survival cannot be determined. To clarify this, a randomized, double-blind, placebo-controlled trial using vitamin D supplement was performed in patients with digestive tract cancer from esophagus to rectum; this is the first trial designed to evaluate the effect of vitamin D on survival of these patients. 
Author Interviews, Colon Cancer, Gastrointestinal Disease / 23.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47628" align="alignleft" width="200"]Dr. Michael Epstein Dr. Michael Epstein[/caption] Dr. Michael Epstein MD Dr. Epstein has over 30 years of experience in the field of Gastroenterology with extensive medical training as a practicing clinician, including treating patients with a range of gastroenterological conditions, such as Inflammatory Bowel Disease (IBD), Crohn’s disease, Ulcerative Colitis, Hepatology and Liver diseases. Dr. Epstein is also the founder and principle physician at Digestive Disorders Associates and is the president of the Maryland Diagnostic and Therapeutic Endo Center, both in Annapolis, Maryland. He is board certified by the American Board of Internal Medicine with a sub-specialty in Gastroenterology. He is a fellow of the American Gastroenterology Association and the American College of Gastroenterology, and a member of the Society of Gastrointestinal Surgeons.  MedicalResearch.com: What is the importance of colonoscopy Response: We lose more people to colon cancer each year than who have died in the Vietnam WarI believe that colon cancer has become a public health issue and there is a great need to increase public awareness around screening. It is so important for patients to take part in routine screenings as the symptoms of colon cancer are often silent. Sadly, often times people do not know they have colon cancer until the cancer is in an advanced state. A colonoscopy is important because it is the only test that can currently detect and treat this type of cancer that is also one of the leading killers in the United States. Not only can we often detect pre-cancerous polyps, but we can often remove these polyps during the procedure. 
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 14.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45196" align="alignleft" width="200"]Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania Dr. Mahmud[/caption] Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process. We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence. 
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 11.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45202" align="alignleft" width="133"]Nathaniel Ernstoff, MD University of Miami Dr. Ernstoff[/caption] Nathaniel Ernstoff, MD University of Miami MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the best efforts of all healthcare providers, colon cancer screening is underutilized with screening rates ranging anywhere from 58-76% based on the state (American Cancer Society 2017). At best we are still failing to screen 25% of the population.  Patients have serious concerns about colorectal cancer (CRC) screening with the most common barriers to screening being fear of colonoscopy and of the bowel preparation, amongst others. These barriers coupled with the lack of understanding of the risks, benefits, and the efficacy of screening contribute to our inadequate screening. This study aims to prove that through education, and most importantly comprehension, patients will choose one of the 6 recommended colorectal cancer screening tests that best fits their preferences. In this study we had 24 patients who previously refused colonoscopy on 3 separate occasions, and had no other CRC screening, undergo a virtual reality (VR) demonstration, created by TheBodyVR, to see if education would improve the uptake of screening. Prior to the virtual reality demonstration, the patients completed a 5-item questionnaire which evaluated their baseline knowledge of CRC risk, polyps and screening as well as determining barriers to prior screening. The patient then viewed the VR demonstration which starts with an overview of colorectal cancer, followed by a tour through a virtual colon explaining and showing the viewer polyps and cancer. Finally, the demonstration reviews and compares the strengths and weaknesses of all USPSTF-recommended CRC screening tests.  After the study, the patients complete the same questionnaire, and in this study there was a statistically significant improvement in knowledge in all questions.  Ultimately, 23 of 24 patients who previously refused colorectal cancer screening on 3 separate occasions chose to undergo screening after the VR demonstration, and about 50% have performed the screening 60 days out from the study's completion.
Author Interviews, Cancer Research, Colon Cancer, Genetic Research, University Texas / 10.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45179" align="alignleft" width="200"]Mohammad Bilal, MD University of Texas Medical Branc Dr. Bilal[/caption] Mohammad Bilal, MD University of Texas Medical Branch MedicalResearch.com: What is the background for this study? Response: Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer among adults in the United States and the second leading cause of cancer related deaths. Recent studies have shown an increasing incidence of CRC in younger patients. This has led to increasing interests in identifying patient populations who might be at increased risk of developing CRC. The U.S. Multi-Society Task Force of Colorectal Cancer (MSTF) recommends that CRC screening should begin at age 50 in average-risk persons. However, recently the American Cancer Society (ACS) have published recommendations to begin CRC screening at age 45 years in average risk patient population. These recommendations were primarily based of modeling studies since there is little outcomes data in younger age groups in regards to prevention and detection of CRC. Despite these new recommendations from the ACS, there is limited direct evidence to support CRC screening at a younger age. In our study, we have evaluated the predictors of increased prevalence of adenomas in the 40 to 49-year-old individuals undergoing colonoscopy. 
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.