Archives for the month of: October, 2013

The study included 647 patients aged 50 and older undergoing colorectal cancer screening at a gastroenterology clinic in Puerto Rico. In 70% of patients with polyps, the growths were on the right side of the colon. In white patients, polyps are typically found on the left side of the colon. This difference may result from underlying molecular differences in the two patient groups, said study author Dr. Marcia Cruz-Correa, an associate professor of medicine and biochemistry at the University of Puerto Rico Cancer Center. The finding about polyp location is important because it highlights the need to use colonoscopy when conducting colorectal cancer screening in Hispanics. This is the most effective method of detecting polyps on the right side of the colon. The study was to be presented Sunday at the Digestive Diseases Week meeting in New Orleans. “Colorectal cancer screening rates among Hispanics are dangerously low. Currently only 40% get screened despite the fact that colorectal cancer is the second leading cause of death among Hispanic women. As Hispanics become more acculturated to the U.S. lifestyle, they are losing the protective factor of their diet, which may account for the higher rates of colorectal cancer seen in U.S. Hispanics compared to the expected rates of cancer in their country of origin,” Cruz-Correa said. — Robert Preidt Copyright 2010 HealthDay .

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Choline May Promote Colon Polyps

Colon polyps are abnormal growths in the colon which may (or may not) develop into colon cancer . Choline is a nutrient found in foods including red meat, eggs, poultry, organ meats, and wheat germ, note Eunyoung Cho, ScD, and colleagues. Cho works in Boston, at Harvard Medical School and Brigham and Women’s Hospital. With seven other researchers, Cho investigated ties between choline and colon polyps. Choline Study Cho’s team studied data from more than 39,000 female U.S. nurses enrolled in the Nurses’ Health Study, a long-term study of women’s health. The women signed up for the study in 1976. At the time, they were 30-55 years old. Every two years, they completed dietary questionnaires and updated their medical records. All of the nurses studied by Cho and colleagues had a colonoscopy or sigmoidoscopy between 1984 and 2002. In colonoscopy and sigmoidoscopy, doctors guide a thin tube with a tiny camera through the rectum and colon to look for cancer and polyps. Colonoscopy involves the entire colon; sigmoidoscopy partially covers the colon. Choline and Colon Polyps The women’s most common dietary sources of choline were red meat, eggs, poultry, and milk. Compared with women with the lowest choline intake, those with the highest choline intake were 45% more likely to have a colon polyp.

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Algeria had the lowest survival rates for all four cancers. “This is the first direct comparison of so many countries as far as I am aware,” says Michel Coleman, MD, a professor of epidemiology and vital statistics at the London School of Hygiene and Tropical Medicine and the study’s lead author. Cancer Videos Common Adult Skin Problems Related to lymphoma , leukemia , chemotherapy , radiation , mammogram , PSA test , colonoscopy , herceptin , tamoxifen , breast cancer — Colposcopy , lung cancer , skin cancer , prostate cancer , cervical cancer , colon cancer 2008 WebMD, LLC. All rights reserved. While Coleman and other epidemiologists have long known that cancer survival rates vary country by country, and even within a country, the study lends hard numbers to the fact. Still, there were surprises. “I think the surprises were that the range in global survival is really quite wide,” Coleman tells WebMD. “Survival in the USA is high on a global scale but varies quite widely among individual states as well as between blacks and whites within the USA,” he tells WebMD. Cancer Survival by Country Coleman and colleagues drew on data from nearly 2 million cancer patients, ages 15 to 99, whose medical information was entered into 101 population-based cancer registries in 31 countries. The patients had been diagnosed with one of four cancers: breast, colon, rectum, or prostate cancers during the years 1990-1994. They were followed up to 1999, with the researchers comparing five-year survival rates. The highest survival rates were found in the U.S. for breast and prostate cancer , in Japan for colon and rectal cancers in men, and in France for colon and rectal cancers in women, Coleman’s team reports. In Canada and Australia, survival was also high for most cancers. The lowest cancer survival rates for all four cancers were found in Algeria.

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Colon Cancer Survival Rate: Racial Gap

The racial gap may be due to a mix of factors including racial differences in colon cancer screening and treatment, note the researchers. They included Chyke Doubeni, MD, MPH, of the University of Massachusetts’ department of family medicine and community health. They studied data on nearly 14,000 U.S. adults diagnosed with colon cancer or rectal cancer between 1993 and 1998. The group included more than 10,500 whites, nearly 1,500 blacks, 985 Hispanics, and about 900 Asians/Pacific Islanders. All had health insurance through any of six health care systems across the country. Tracking Colon Cancer Survival Rates The patients were followed through December 2003. During that time, 4,024 patients in the study died of colorectal cancer . Blacks were the most likely to die of colorectal cancer. Hispanics and whites tied for second place, followed by Asians/Pacific Islanders. Blacks were more likely to be diagnosed with advanced tumors and less likely than whites to undergo colorectal cancer surgery. Those two factors — tumor stage and treatment — appeared to account for much of the racial gap in survival, but the link between race and survival was “complex,” the researchers write. They note that while the patients were insured, their out-of-pocket medical expenses and ability to get time off from work for doctor’s appointments may have varied.

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Colon cancer survival rate increases with lymph node removal says UT

The findings of the study show that the more lymph nodes that are taken out of the patients body, the slower the colon cancer spread, and the higher the survival rate of those that contracted the disease. This development came after a survey of 17 different studies from around the world. The results were similar across the board. During a national clinical trial of 3,200 patients suffering from stage II colon cancer in the United States it was found that patients that had 20 or more lymph nodes taken out of their body had a 14 percent improvement in their survival rate when compared with those who had 11 or fewer lymph nodes removed. Studies of stage III colon cancer showed that as the disease progressed, so did the potential for survival through lymphadenectomy. If 40 or more nodes were removed, patients were 23 percent more likely to survive than those with just 11 or excised. Most of the studies were focused on stage II, but of those that examined more advanced cancer gave similar indications, often with ever increasing numbers of lymph node removal showing respectively positive results. Many cancer treatments are still in the dark ages, with a hack-and-slash, salt-the-earth mentality still pervading in the industry as even the most conservative oncologists often take a cut first stance. But it could be that for now, in the choice between rapid, aggressive surgical intervention to save a life and allowing a form of cancer as progressive and pervasive as colon cancer to kill a patient is barely one that can be debated. Watch the video below for an overview of colon cancer from MD Anderson: The study is an encouragement to doctors to include lymph node removal when operating on colon cancer . Currently this is only done in approximately 1/3rd of cases. Many doctors opt not to take the time to trace blood vessels nearest to the tumor back to the lymphatic nodes associated with them.

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Cancer Cells

Virtually all colon cancers begin with these growths. When found early, colon cancer is approximately 90% treatable. Colon cancer risk factors The lifetime risk for developing colon cancer is 1-in-18 and over 90% of these cases occur after the age 50. Increasing age, a family history of colon polyps, colon cancer or other early cancers can double or triple your risk for developing this disease. If any of these risk factors run in your family, you need to start the discussion about screening at age 40 or even earlier depending on when your family members were diagnosed. Persons with ulcerative colitis , Crohns disease or a personal history of cancer are also at increased risk for colon cancer and need to tailor regular, more frequent colonoscopies. Studies also indicate that diet and smoking may increase the risk of developing colon polyps and colon cancer. While family history and other risk factors matter, not having risk factors does not eliminate your need for screenings. What polyps tell us As we age, about 1-in-4 of us develop polyps in our colon and about 10% of these polyps eventually turn from a benign growth into colon cancer. For the most part, these polyps take about 10 years to transform into colon cancer. Polyps and early colon cancers often have no symptoms and can be detected only by screening exams. How can colon cancer best be prevented? There are several effective ways to reduce your colon cancer risk, but none more important than getting timely screenings and removing polyps before they become malignant. Refraining from smoking, maintaining healthy weight and regular exercise, managing normal body levels of nutrients, especially vitamin D also appear to lower risk factors. Diets high in fiber are good for you, but have not been definitively shown to reduce colon cancer risk. What are the symptoms of colon cancer?

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People with type 2 diabetes had a 53 percent higher risk of dying from any cause and a 29 percent higher risk of dying from colorectal cancer.

Even after adjusting the data, obesity increased the risk of dying. “In and of itself, obesity does seem to have some effect,” Meyerhardt said. In the second study, researchers recruited 2,278 people who’d been diagnosed with non-metastatic colon or rectal cancer between 1992 and 2007. In this group, there were 842 deaths. Of those, 377 were from colorectal cancer and 152 were from heart disease, according to the study. People with type 2 diabetes had a 53 percent higher risk of dying from any cause and a 29 percent higher risk of dying from colorectal cancer compared to people without type 2 diabetes. The risk of dying from heart disease was 2.16 times higher in people with type 2 diabetes and nearly four times higher in people with type 2 diabetes who used insulin, compared with people without type 2 diabetes, the study found. “Insulin use in type 2 diabetes usually indicates longer-standing diabetes, which is usually associated with worse outcomes,” Meyerhardt noted. Obesity, elevated body-mass index and diabetes are associated with worse disease states across the board,” said Dr. David Bernstein , chief of gastroenterology at North Shore University Hospital in Manhasset, N.Y. “But, we don’t know if you lose weight if that risk will go down. I don’t counsel patients who’ve been diagnosed with colorectal cancer to lose weight, because weight loss tends to be a worry in people undergoing cancer treatment anyway. I do counsel my patients that haven’t been diagnosed with cancer to lose weight.

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Smokers have worse colon cancer prognosis: study

Seaman NEW YORK | Wed Apr 3, 2013 4:44pm EDT NEW YORK (Reuters Health) – Smokers are less likely to be alive and cancer-free three years after having surgery for colon cancer than people who have never smoked, according to a new study. Out of about 2,000 people who had part of their colon surgically removed, researchers found 74 percent of those who had never smoked were cancer-free three years later, compared to 70 percent of smokers. Amanda Phipps, the study’s lead author from the Fred Hutchinson Cancer Research Center in Seattle, said the results provide another reason why people should quit smoking. “It’s nice when you have findings that portray a consistent public health message,” said Phipps. According to the American Cancer Society (ACS), certain ingredients in cigarettes can dissolve into a person’s saliva and cause colon and other cancers. The ACS estimates about 102,500 Americans will be diagnosed with colon and rectal cancers in 2013, and over 40,000 will die from those diseases. Phipps and her colleagues previously found smokers with colon cancer were more likely to die than non-smokers from any cause and specifically from their cancers. But the researchers wanted to take a closer look at what smoking meant for colon cancer recurrence. For the new study, they analyzed surveys that were given to about 2,000 people between 2004 and 2005 after they had colon cancer surgery but before they received additional treatment. Overall, 931 people said they had never smoked and 1,028 said they had smoked at least 100 cigarettes during their lifetime. Phipps and her colleagues found people who reported smoking were 23 percent more likely to die or have their cancer return within three years, based on ongoing surveillance of those patients. The difference was even more pronounced for the 140 people who said they were smoking at the time they were diagnosed with colon cancer. They were 47 percent more likely to have a cancer recurrence or to die than people who had never smoked. “There is a difference. Certainly we see those current smokers have a poorer prognosis,” Phipps told Reuters Health. The researchers found smoking was tied to worse outcomes in people with tumors with certain genetic patterns but not others.


Oxaliplatin Improves Colon Cancer Survival Rates

20 in The Journal of the National Cancer Institute reveals that individuals in the general population with stage III colon cancer showed improved survival rates when they were administered with 5-fluorouracil (5FU), a commonly used cancer treatment, in combination with oxaliplatin. Colon cancer is one of the leading causes for illness and death worldwide. In 2011, an estimated 101,340 individuals in the U.S. were affected by the disease. Approximately one-third of individuals are diagnosed with stage III or node-positive colon cancer. Although randomized human trials have demonstrated that 5FU administered with oxaliplatin enhanced outcomes among individuals with stage III colon cancer, researchers do not know what effect this combined therapy has outside human trials. Furthermore, less than 2% of individuals with colon cancer participate in randomized clinical trials, and they are often healthier, less racially diverse and younger than the overall cancer patient population. Hanna K. Sanoff M.D., and assistant professor of Medicine, Hematology and Oncology at the University of Virginia School of Medicine and her team, set out to determine what effects combined therapy might have on individuals with stage III colon cancer in the general population. The team collected data from patients using the Surveillance, Epidemiology, and End Results registry linked to Medicare claims (SEER-Medicare), as well as addition cancer registries. All patients were aged 75 or younger, had stage III colon cancer and received chemotherapy within 120 days of surgery. The researchers then compared overall survival (OS) between patients who received standard chemotherapy with those who received combined therapy. They discovered that combined therapy was just as effective for individuals with stage III colon cancer in the general population as in participants from randomized clinical trials. Furthermore, the team found that oxaliplatin demonstrated improved survival rates in patients with greater comorbidity, and older and minority patients. The researchers explain: “Physicians and patients should be reassured from our findings that oxaliplatin is associated with marginally but consistently superior survival for patients diagnosed before 75 years in community settings.” The researchers feel that in light of the evidence that combined therapy has proven efficacious in the general population, it is now important to concentrate on high-risk subgroups, such as individuals over the age of 75 years, racially diverse minorities, and patients with co-morbid conditions.

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Sign in to YouTube Sign in with your Google Account (YouTube, Google+, Gmail, Orkut, Picasa, or Chrome) to dislike ColonCancerInfo’s video. Add to Sign in to YouTube Sign in with your Google Account (YouTube, Google+, Gmail, Orkut, Picasa, or Chrome) to add ColonCancerInfo’s video to your playlist. Information about colon cancer as well as common symptoms. Colorectal cancer, also called colon cancer or bowel cancer, includes cancerous growths in the colon, rectum and appendix. It is the third most common form of cancer and the second leading cause of cancer-related death in the Western world. Colorectal cancer causes 655,000 deaths worldwide per year.[1] Many colorectal cancers are thought to arise from adenomatous polyps in the colon. These mushroom-like growths are usually benign, but some may develop into cancer over time. The majority of the time, the diagnosis of localized colon cancer is through colonoscopy. Therapy is usually through surgery, which in many cases is followed by chemotherapy. Colon cancer often causes no symptoms until it has reached a relatively advanced stage. Thus, many organizations recommend periodic screening for the disease with fecal occult blood testing and colonoscopy. When symptoms do occur, they depend on the site of the lesion. Generally speaking, the nearer the lesion is to the anus, the more bowel symptoms there will be, such as: * Change in bowel habits o change in frequency (constipation and/or diarrhea), o change in the quality of stools o change in consistency of stools * Bloody stools or rectal bleeding * Stools with mucus * Tarry stools (melena) (more likely related to upper gastrointestinal eg stomach or duodenal disease) * Feeling of incomplete defecation (tenesmus) (usually associated with rectal cancer) * Reduction in diameter of feces * Bowel obstruction (rare) Category

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Colon Cancer: Symptoms and Treatment of Colorectal Cancer

Through the tube, the cancer cells can be cut out, and no abdominal surgery is required. In a resection a surgeon may remove the portion of the colon that is affected, and sew the healthy portions back together (National Cancer Institute). Radiation therapy uses high-energy radiation such as X-ray to destroy the cancerous cells before they can spread. The type of radiation used depends greatly on the stage of the cancer. Drugs can also be used to destroy cancer cells or cease their division. The use of drugs to fight cancer is known as chemotherapy. Chemotherapy can use drugs generally by placing them in the blood stream, which will flow to the affected cancer area, or by directly injected drugs into the affected region (National Cancer Institute). Targeted therapy is a type of cancer treatment that uses substances that are proven to inhibit cancer cells. These substances, such as antibodies often developed specifically for cancer destruction, are targeted to the site of the cancerous region. This therapy is designed to limit the harmful destruction of normal cells while trying to destroy cancerous cells. Many cancer treatments inadvertently destroy healthy portions of the body while trying to target cancer cells.

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Colon Cancer Right & Left Symptoms

Surgeons prepare to operate on a patient with bowel obstruction.

The symptoms of anemia include weakness, easy fatigability, shortness of breath and palpitations. These symptoms are explained by the anatomy of ascending colon. The ascending colon is wider than its descending counterpart, which allows for more growth of tumor before the tumor causes symptoms. Also the tumors that develop in the ascending colon tend to grow along the wall of the colon instead of directly outward into the lumen. Symptoms on the left side of the colon are usually caused by growth outward into the lumen, obstructing the flow of feces. Descending Colon Symptoms The symptoms of left-sided colon cancer are attributed the anatomy of that area of the colon. The lumen of the colon is smaller than that of its counterpart on the right and as such the symptoms experienced are due to obstruction of the lumen. The primary symptom is a change in bowel habits. People experience increasing bouts of constipation. They may also notice a change in the caliber of the stool. The stool may also be coated with streaks of blood.


During a colonoscopy, a doctor uses a long flexible tube equipped with a tiny video camera to see the interior of the colon. According to the study authors, the incidence of colon cancer in the U.S. has dropped by about 6 percent since the first national colonoscopy guidelines were introduced in 2000 – mostly due to doctors catching and removing precancerous polyps during screening. Still, the U.S. Centers for Disease Control and Prevention reports that about 22 million people are not up-to-date with their colon cancer screenings. For the new study, Dr. Ramzi Amri and colleagues from Massachusetts General Hospital and Harvard Medical School in Boston analyzed data on all people who underwent colon cancer surgery at their hospital from 2004 through 2011. Their goal was to see whether those diagnosed with colon tumors after colonoscopy screenings had better outcomes than patients diagnosed after going to their doctors because they were experiencing symptoms, such as bleeding from the rectum. Amri and his colleagues had data on 217 people diagnosed after screening and 854 who were diagnosed based on symptoms or other tests. They found that in addition to being more likely to die, patients diagnosed with colon cancer based on symptoms were far more likely to have advanced disease, to have cancer that spread to other parts of their bodies and to have cancer that recurred. Seventy-five percent of patients diagnosed based on their symptoms had advanced disease, compared to about 38 percent of those diagnosed after colonoscopy screenings.

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Past colon cancer tied to future cancer risks

“The most common cancer among these individuals is another colorectal cancer, but there are potentially other cancer sites that we need to be aware of,” said Amanda Phipps at the Fred Hutchinson Cancer Research Center in Seattle, who led the study. According to the American Cancer Society, about one in 20 people will be diagnosed with colon or rectal cancer during their lifetime. The new study included about 170,000 people diagnosed with those cancers between 1992 and 2009. During that span, 15,000 of them – or about nine percent – were found to have a second cancer. Compared to the average American, people in the study with a history of colon cancer were twice as likely to develop a second colon cancer. They also had four times as many cancers of the small intestine as would be expected in a typical population and were 42 percent more likely to be diagnosed with kidney cancer and 14 percent more likely to get lung cancer. Those risks varied by where in the colon or rectum a person’s first tumor had been found, according to findings published in the journal Cancer. “We have this growing knowledge that colorectal cancer isn’t just one disease,” Phipps told Reuters Health. “We saw the greatest increased risk among individuals whose first cancer was located in sort of the central portions of the colon.” Although it’s not clear why that was the case, she said the finding could help researchers in the future target patients who are most likely to get a second cancer. “The general message is very consistent now over several papers, that colorectal cancer patients have good outcomes, however even when cured they have an excess risk” of future cancers, said Dr. Jason Zell, who has also studied the topic at the University of California, Irvine. He said there are a few possible explanations for the findings. First, treatment of colon cancer – whether with surgery, radiation or chemotherapy – could raise or lower the risk of cancer in nearby organs. Another possibility is that more cancers are caught among people with a history of disease simply because they undergo more tests than the average patient. Or, he told Reuters Health, “Maybe we’ve been underestimating the effects of common risk factors, like genetics and also just diet and lifestyle.” Zell, who wasn’t involved in the new research, said current studies are looking into whether second cancers can be prevented through exercise or healthier eating. He said the findings shouldn’t change treatment of colon cancer survivors, including how closely they are watched for other diseases.

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However, the results state that your doctor found a colon polyp during your procedure. What exactly is a colon polyp and what does this mean? According to a colon polyp is a fleshy abnormal growth that occurs on the inside lining of the large intestine (colon). These growths can appear either raised or flat, and one or more growths (polyps) can be found at the same time. states that colon polyps are common, and that approximately 50% of people over the age of 60 will have at least one. Certain types of polyps can lead to colon cancer . Colon cancer is a leading cause of death in the United States, which makes it important to screen for polyps and remove them before they become cancerous. For this reason, the current recommendation is to have a colonoscopy at the age of 50 – or sooner if you fall into a high-risk category. People who fall into the high-risk category for developing colon polyps include those with the following factors: A family history of colon polyps someone in your family has had polyps (individuals with a first degree family member parent, sibling or child – are at the greatest risk) A family history of colon cancer someone in your family has had colon cancer A personal history of colon polyps you have had polyps before Age over 50 You have had ovarian or uterine cancer before the age of 50 Individuals that fall into this category should have a colonoscopy well before the age of 50 and this should be discussed with a board certified gastroenterologist. Certain lifestyle habits can predispose people to develop colon polyps and these include: Obesity A diet high in fatty foods Sedentary lifestyle – lack of exercise Recommendations are to eat a diet low in fat and high in fiber, fruits and vegetables, maintain a normal weight and avoid smoking and excessive alcohol use. There are many types of colon polyps but the most common are: Hyperplastic polyps these are the type that will never turn cancerous Adenomatous polyps – these are the type that have the ability to turn cancerous if not removed and are left to grow Serrated adenoma polyps these are the type of polyps that have both hyperplastic and adenomatous components and rarely turn cancerous Malignant polyps these are the type that are cancerous If your doctor found polyps during your colonoscopy, they were removed and sent to a lab for analysis. After a board certified pathologist has viewed the polyps under a microscope, a report was sent to your doctor listing what type of polyps were found. Depending on the type found, your doctor has made recommendations on what you will need to do next. If the lab reports that your polyp was hyperplastic, the recommendation will be to repeat your colonoscopy in 10 years for continued surveillance, unless you develop or have a family history of adenomatous polyps or colon cancer in a first degree relative. Then the recommendation will be to repeat colonoscopy in 5 years.

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Colon Polyps

They vary greatly in size from a few millimeters to several centimeters in length. Also read Colorectal Cancer Prevention Michael Koger Polyps that occur in the colon may carry the risk of malignant transformationthat is, they may become cancerous. Colon polyps occur most often in the rectum and lower colon and decrease in frequency toward the cecum. (The Merck Manual, 18th Edition 2006:173-74) Incidence and mortality rates for colon cancer have been decreasing steadily for over a decade, most likely due to the increase in screening colonoscopies and the removal of polyps during these procedures. Current guidelines recommend that otherwise healthy people begin screening for colon cancer at age 50. Although many people neglect this opportunity to detect cancer at an early stage, many others are undergoing screening colonoscopy at the advice of their physicians. Because it is not uncommon to discover polyps during screening examinations, and since different types of polyps confer differing levels of cancer riskand possibly because instructions for followup are often conveyed when patients have not fully recovered from sedationmany people are confused about the results of their screenings. A basic understanding of how polyps behave and the guidelines for reexamination will help to clarify when an individual should plan to return to his/her physician. Types of Colon Polyps Adenomatous (neoplastic) polyps: These polyps are of greatest concern, as they are most likely to change from benign to malignant. This process apparently occurs over seven to fifteen years, although it is likely that many adenomatous polyps regress and never become cancerous. Adenomatous polyps are further sub-classified into the following types based upon their microscopic appearance: Tubular adenomas Tubulovillous adenomas Villous adenomas Cancer risk is higher for larger polyps and for those exhibiting more dysplasia; in general, tubular adenomas carry the lowest risk, tubulovillous adenomas carry an intermediate risk, and villous adenomas carry the highest risk.

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Heavy people more likely to have colon polyps

Polyps, also called adenomas, are clumps of cells that grow from the colon’s lining. Although less than 10 percent become cancerous, most colon cancers are thought to develop from polyps. Previous studies have made the connection between obesity and colon cancer – a link recognized by the National Cancer Institute – but the new study is the first to point to a higher risk of adenomas in heavy people. By focusing on “precancerous” cell changes, researchers were hoping to shed more light on whether cancer screening recommendations should take a person’s weight into account. “Because there is a known association between obesity and cancer, there is a logical extension to expect a connection between obesity and the step before cancer, which is adenoma,” said Dr. Hutan Ashrafian from Imperial College, London, who co-authored the study. The findings can’t say whether obesity causes polyps by itself. But if it does, that could be bad news for a world where obesity is on the rise. According to the World Health Organization, about 500 million people worldwide are obese; colon cancer killed more than half a million people worldwide in 2008, the most recent figures from the WHO show. For the new research, Ashrafian and his colleagues analyzed data from 23 studies involving more than 100,000 people across the U.S., Asia and Europe, looking at the relationship between polyps and body mass index, or BMI, a measure of weight relative to height. All the studies followed World Health Organization guidelines that define people with a BMI over 25 as overweight and above 30 as obese. In most studies, polyps were identified during colonoscopy procedures in which a flexible tube tipped with a camera is guided though the rectum and into the colon. Self-reported questionnaires were used in two large studies. Overall, researchers found that 22 percent of overweight and obese people had colon polyps, compared to 19 percent in people of normal weight, and the polyp risk grew with increasing BMI. “The findings suggest that obesity may be having an effect (on cancer development) much earlier than we thought,” said Ashrafian. Most polyps don’t cause any symptoms so they are usually not picked up before routine colonoscopy.

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Action Points Colorectal cancer screening, be it colonoscopy, sigmoidoscopy, or fecal occult-blood testing, reduced risks of colorectal cancer mortality. Note that although fecal occult-blood screening was associated with a reduced relative risk of colorectal cancer mortality both annually and biennially, there were no associations seen with all-cause mortality. Colorectal cancer screening — be it colonoscopy, sigmoidoscopy, or fecal occult-blood testing — reduced risks of colorectal cancer mortality, researchers reported in two studies. Screening with colonoscopy and sigmoidoscopy were associated with 68% (95% CI 0.24-0.45) and 41% (95% CI 0.45-0.76) reduced risks, respectively, of colorectal cancer mortality over 22 years of follow-up, and reduced mortality from proximal colon cancer by 53% (95% CI 0.29-0.76) in those who received colonoscopy, according to Andrew Chan, MD, MPH , of Massachusetts General Hospital in Boston, and colleagues. Results of another long-term trial showed that over 30 years of follow-up, annual fecal occult-blood testing was associated with a 32% (95% CI 0.56-0.82) reduced risk of colorectal cancer mortality, while bi-annual screening reduced risks by 22% (95% CI 0.65-0.93), Aasma Shaukat, MD, MPH, of Minneapolis Veterans Affairs Health Care System in Minn., and colleagues wrote in the New England Journal of Medicine. Past research has shown that screening based on patient characteristics rather than as a one-size-fits-all approach to treatment may provide optimal effects on life expectancy. Other research has shown that reaching out to underserved patients — such as minorities and the uninsured — can increase participation in colorectal cancer screening . Editorialist Theodore R. Levin, MD, of Kaiser Permanente Walnut Creek and Antioch Medical Centers in California, noted that the most important new finding in these studies was that the effects of screening persisted well after the initial screen. “The challenge with both of these studies is that they were done using technology that has largely been supplanted by new methods of testing,” Levin said in an interview with MedPage Today. Although no head-to-head data exists comparing fecal occult-blood testing with colonoscopy, “randomized trials are ongoing,” and regardless of which proves to be the superior form of screening, both are presently effective in reducing colorectal cancer mortality and support current screening guidelines, Levin and co-editorialist Douglas Corley, MD, PhD, of Kaiser Permanente Medical Center San Francisco in California, wrote in the New England Journal of Medicine. In the study by Chan and colleagues, the authors gathered biennial data on endoscopy via colonoscopy and sigmoidoscopy and their association with colorectal cancer incidence and mortality from 1988 to 2012 among a population of 88,902 participants in the Nurses’ Health Study and the Health Professionals Follow-Up Study. Data showed 1,815 incidents of colorectal cancer and 474 deaths from colorectal cancer.

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