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Why are Cancer Rates so Low in India?

If we were going to choose one plant-based product to start testing, we might choose curcumin, the pigment in the spice turmeric (the reason curry powder looks yellow). ...

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Colorectal cancer is killing more 20 to 30 year olds. We now have one clue about why.

It’s one of the mysteries that has puzzled cancer epidemiologists: Why are younger and younger people becoming sick with colorectal cancer?

In 2017, researchers at the American Cancer Society showed colorectal cancer is rising sharply in younger generations. For people in their 20s and 30s, colon cancer rates increased 1 to 2 percent between the mid-1990s to 2013. And rectal cancer rate shot up even more dramatically — rising 3 percent per year in the same age cohort. 

Overall, those born in 1990 have double the risk of developing colon cancer and four times the risk of getting rectal cancer compared to those born around 1950. So in response to the alarming trend, in 2018 the society lowered the age for routine colorectal cancer screening to 45 from 50. 

“It’s not like the problem is bad and has stabilized,” said Thomas Weber, the director of surgical oncology at New York’s Northwell Health, who organizes an annual summit for researchers trying to solve the mystery. “The problem has continued to worsen.”

But a new study published Thursday in JAMA offers one potential explanation: the rising rates of obesity. 

Since 1980, the obesity prevalence has doubled in more than 70 countries around the world. Thirty-nine percent of US adults, are now obese, along with 19 percent of children and adolescents

The JAMA study looked at 85,000 women and found a link between a higher body weight, particularly obesity, and a greater risk of colorectal cancer.

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Colon cancer is caused by bacteria and cell stress

Researchers at Technical University Munich have reported findings related to the development of colon cancer. "We originally wanted to study the role of bacteria in the intestines in the development of intestinal inflammation," explains Professor Dirk Haller from the Department of Nutrition and Immunology at the Weihenstephan Science Centre of the TUM. "However, the surprising result for us was the discovery that bacteria, together with stress in cells, caused tumours (exclusively in the colon) and without the involvement of inflammation."

The investigations were initially carried out using a mouse model. In germ-free animals in which the activated transcription factor ATF6 regulated stress in the intestinal mucosa (intestinal epithelium), no change could be observed. But as soon as the microbiota were transplanted back into germ-free animals, tumours developed in the colons of the mice. Using Koch's postulates, Haller and his team were able to show that microorganisms are involved in the development of cancer in the colon.

The transcription factor ATF6 regulates stress in cells, and the intensity and duration of activation is increased with diseases. "However, it is not cell stress alone that leads to tumour growth, but the combination of stress and microbiota that favours cancer growth," says Haller, head of ZIEL—the Institute for Food & Health at TUM.

ATF6 incidence found to be increased in colon cancer patients

Subsequently, in cooperation with the clinic on the right side of the Isar (Prof. Janssen), the data of 541 patients with colon cancer were examined. In those cases in which the level of transcription factor ATF6 was significantly increased, triggering stress, the recurrence rate after surgery increased: About 10 percent of patients were at risk of developing colon cancer a second time.

"In certain patients, the protein ATF6 could serve as a diagnostic marker for an increased risk of  and could indicate the start of therapy at an early stage," said Prof. Haller—a microbial therapy is conceivable, when we know more about the composition of the bacterial flora. What now became clear, however: Chronic inflammation has no effect on  development in the colon."

More information: O.I. Coleman et al, Activated ATF6 Induces Intestinal Dysbiosis and Innate Immune Response to Promote Colorectal Tumorigenesis, Gastroenterology (2018).  DOI: 10.1053/j.gastro.2018.07.028 

Journal reference: Gastroenterology search and more info website

Provided by: Technical University Munich

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Diagnosing colon cancer by dropping blood on a thin film

Asan Medical Center said its researchers have developed a technology to diagnose colorectal cancer by dropping a drop of blood on a hand-sized piece of ultra-thin plastic film.

The research team, led by Professor Park In-ja of Colon and Rectal Surgery Department and Professor Shin Yong of Convergence Medicine Department, was able to separate cell-free nucleic acid (CFNA) using the film, which allows a low-cost diagnosis of the disease, the hospital said.

Moreover, the new technology’s diagnosis of the colorectal cancer is more precise than conventional diagnostic devices that use blood, Asan Medical Center said.

Cancer patients tend to have high concentrations of CFNA than ordinary people. Existing devices for the separation of CFNA require other equipment such as a centrifuge, a vacuum pump, and a direct current power supply.

However, the researchers’ new technology, which uses the characteristics of a substance called “DTBP” that binds selectively to CFNA in the blood, separates CFNA when a drop of blood is placed on an ultra-thin plastic film half a size of a grown-up man’s hand. The technology does not need any extra equipment, saving costs for patients.

The research team divided 14 colorectal cancer patients into two groups and compared the new technology’s diagnostic accuracy with that of conventional devices. The results showed a meaningful difference.

The researchers took tissue samples from 14 colon cancer patients and comparing the next generation sequencing (NGS) test results with the new diagnostic method using blood. The conventional CFNA separation technique showed 57 percent diagnostic accuracy, while the newly developed platform technology achieved 71 percent accuracy.

While it took about one hour to isolate CFNA from blood to diagnose colon cancer using the conventional method, the research team’s technique took only about 20 minutes because of the simplicity of placing a drop of blood on to the thin film, the hospital said.

“Korea ranks first in colorectal cancer incidence in the world. But early detection of the disease can raise cure rate significantly. Patients with colon cancer show a high recurrence rate, so it is imperative to keep track of the disease,” said Shin. “We developed a technology that costs less than a biopsy and has higher accuracy than existing devices that diagnose colorectal cancer with blood.”

Shin said the new technology could be applied to other types of cancer. “It will take some time to commercialize it, but we will continue our research so that physicians can easily and accurately diagnose cancer with the CFNA isolation platform technology and that cancer patients can receive the treatment quickly,” he added.

The research has been published in the online version of the international journal, Advanced Science.

Kwak Sung-sun  Published 2018.10.02  11:14  Updated 2018.10.02 12:48

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EuropaColon expands into Digestive Cancers Europe (DiCE)

“Our objective is to save the lives of an additional 250,000 Europeans every year”

EuropaColon is expanding its activities to all digestive cancers: oesophageal, stomach, colon, rectum, pancreas and rare digestive cancers. The new organisation will be called Digestive Cancers Europe and will be based in Brussels.

Since its foundation in 2004 EuropaColon has gradually expanded geographically and now represents 44 patient organisations in 32 countries. It has set up alliances with existing patient organisations or set up new organisations to make sure that the voice of the patient is heard in every European country. We feel that it is the right time to also include other digestive cancer patients whose voice has not been represented so far. 

The number of patients dying from digestive cancers is excessively high. More than 800,000 people in Europe get diagnosed every year with a digestive cancer and approximately 500,000 patients die every year[1]. Colorectal cancer is highly preventable and when detected early the overall survival rates are approximately 90%. Unfortunately, only 16% of patients get diagnosed at an early stage which demonstrates the strong need of population-based screening campaigns. With the best possible screening 380,000 extra lives could be saved annually and 14 billion euro saved.

It is our objective that through a combination of improvements in the healthcare systems, we can  reduce the number of digestive cancer deaths  by 250,000 per year by 2028. Digestive Cancers Europe will advocate for the following key initiatives:

  prevention: raise awareness among citizens about the importance of lifestyle choices, self-diagnosis through symptom recognition, knowing the family history of cancers and asking to be tested

-   screening: today only 8 countries in Europe have population-based screening campaigns, despite the demonstrated massive benefits of saving lives and saving money. Some regions in Europe manage to have more than 75% of the population older than 50 years screened. In only 5 EU Member States, more than 50% of the population between 50 and 74 years old has been screened in the last three years.

-   adoption of the best healthcare systems: some countries achieve very high overall survival rates. If all countries in Europe applied the current approach of the countries with the best outcomes, more than 120,000 patients would survive every year additionally. 

-   adoption of the best medical practices: today, the overall survival rate is highest when patients are treated in the most specialised hospitals, and live in countries where new technologies find early adoption. Even in the wealthiest countries, the difference in mortality three months after surgery is 13 times higher in the best hospitals than in the less specialised hospitals. 

-   research: despite the high incidence and mortality of digestive cancers, there is a marked under-investment in basic and applied research compared to other types of cancer. 

There is absolutely no excuse not to invest in better healthcare: it saves a huge number of lives and it saves significant amounts of money in the healthcare system. Digestive Cancers Europe will engage with the political world and show them the way forward.



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Half of over 60s 'ignore bowel cancer screening in England'

Half of people in England sent a home-testing kit for bowel cancer in 2015 did not use it, according to research in the European Journal of Cancer.

Fewer men than women returned the kits, which are designed to detect the disease before symptoms appear.

The current screening kit requires small stool samples to be posted for screening in specially sealed envelopes.

Cancer Research UK said it was very concerned by the figures.

In 2015, only 49% of people aged 60-64 who received a home test kit for the first time returned their samples, down from 53% in 2010.

Anne Parmenter, 63, from south London, received a bowel cancer testing kit in the post on her 60th birthday.

"I wasn't going to do it but, in the end, I thought it was daft not to and sent it back. 

"The following Tuesday I received a letter asking me to go to hospital for more tests. 

"I had no symptoms before and didn't feel unwell, so I feel that kit saved my life," she says.

She was diagnosed with bowel cancer and had surgery and chemotherapy. 

"The cancer has changed how I look at life because none of us know what is around the corner. 

"Three years ago, I had no idea of what was to come but I am now slowly recovering and getting back to normal."

New test potential

The research, from University College London, looked at data from 4.4 million men and women sent the bowel cancer screening kits over five years in England.

Those living in poorer areas were less likely to take part than those in wealthier areas.

Among women, 56% returned samples, compared with 47% of men.

Cancer Research UK said people were missing out on a test that could reduce their risk of dying from bowel cancer by up to 25%.

The charity said it hoped a new screening test already in the pipeline for an autumn introduction in England would lead to more people choosing to take up the opportunity.

The Faecal Immunochemical Test (FIT) is easier to use because it requires only one stool sample instead of three. And it is more accurate at detecting potential cancers.

It was recently announced that bowel cancer screening in England would start 10 years earlier, at age 50, to allow more cancers to be picked up earlier.

The change brings England in line with Scotland, where bowel screening is automatically offered from 50. 

'Extremely effective'

Dr Christian von Wagner, lead researcher from UCL, said: "The fact fewer and fewer people are returning their kits and that inequalities in the system are widening is very worrying. 

"There is an urgent need to revolutionise bowel cancer screening because the earlier cancer is spotted, the more lives can be saved."

He said research had shown that the new FIT test could increase uptake by 7%.

Sara Hiom, director of early diagnosis at Cancer Research UK, said: "Our bowel cancer screening programme is extremely effective at detecting early disease before symptoms show themselves, so it's very concerning that so many people are missing out on this potential health benefit."

She also said there was "good evidence" the new test would help reduce barriers and lead to more people taking part.

"So, the sooner it is introduced and made available to everyone eligible the better," she added.

Every year about 28,500 people aged 60 and over are diagnosed with bowel cancer in England.

Bowel cancer is the fourth most common cancer in the UK, with 42,000 people diagnosed every year.

More than 16,000 people die from the cancer annually in the UK.

What are the symptoms of bowel cancer?

  • bleeding from your bottom and/or blood in your faeces
  • a persistent and unexplained change in bowel habit 
  • unexplained weight loss
  • extreme tiredness for no obvious reason
  • a pain or lump in the stomach

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Fungal toenail drug able to eliminate sleeping bowel cancer cells immune to chemotherapy, finds study

Treatment wakes up dormant tumour cells which can allow cancer to come back after chemotherapy before slamming on an irreversible ‘stop’ button.

A medication more commonly used to treat fungal toenail infections may help in fighting off persistent bowel cancers, which kills 16,000 people in the UK each year, a study found.

Bowel cancer is the UK’s fourth most common cancer but its second biggest killer and scientists hope that antifungal medication, itraconazole, could help prevent it coming back after treatment.

Researchers from the Cancer Research UK Cambridge Institute found that the drug was able to kill off tumours in mice, but also wiped out “dormant” cells which can allow a tumour to recur later.

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Diets 'devoid of vegetable matter' may cause colon cancer

A new study emphasizes the importance to gut health of eating plenty of vegetables such as cabbage, broccoli, and kale.

Researchers from the Francis Crick Institute in London, United Kingdom, found that keeping mice on a diet rich in a compound known as indole-3-carbinol (I3C) — which comes from such vegetables — prevented the animals' intestines from becoming inflamed and developing colon cancer.

They report the study in a paper now published in the journal Immunity.

"Seeing the profound effect," says study senior author Dr. Brigitta Stockinger, a group leader at the Francis Crick Institute, "of diet on gut inflammation and colon cancer was very striking."

Our digestive system produces I3C when we eat vegetables from a "large and diverse group" of plants known as brassicas.

Brassicas include, but are not limited to: broccoli, cabbage, collards, Brussels sprouts, cauliflower, kale, kohlrabi, swede, turnip, bok choi, and mizuna.

Colon cancer typically starts as a growth, or polyp, in the lining of the colon or large intestine. It can take many years for the cancer to develop from a polyp and not all polyps become cancerous.

Cancer of the colon or rectum is the third most commonly diagnosed in both women and men in the United States, not counting skin cancer.

The American Cancer Society (ACS) estimate that there will be 97,220 new cases of diagnosed colon cancer in the U.S. in 2018.

Click here to continue reading this article from Medical News Today. 

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Israeli smart software flags patients at risk for colon cancer

Medial EarlySign, an Israeli startup, has developed machine learning-based software that analyzes standard blood test results to identify patients at high risk of colon cancer.

The product, called ColonFlag, does not directly diagnose colon cancer, but it is currently being used by doctors at Israel’s healthcare provider Maccabi to flag patients at high risk of the cancer, enabling the system to be proactive about getting these patients tested.

The firm was set up by Ori Geva, Ofer Arieli and Nir Kalkstein in 2009. Kalkstein is an expert in big data and machine learning algorithms, who also co-founded Final Israel Ltd., an algorithm-based trading company.

“In Final, Kalkstein’s technology used AI to crunch financial data to predict where assets are going,” said Geva in a phone interview with The Times of Israel. “Now, we are using medical algorithms with that same modeling method to look at medical records data and predict where people are going.”

“We can tell health providers which patients to focus on and which would benefit from an early intervention, and how best to do this,” he said.

The artificial intelligence market for healthcare applications is expected to expand rapidly globally, with revenues growing at 40 percent annually through 2021 and reaching $6.7 billion by that year, a report by the Frost & Sullivan research and consulting firm says.

AI has the potential to “improve outcomes by 30 to 40 percent” while reducing the costs of treatment by as much as 50%, the report says.

“Already playing a critical role in other industries, AI systems are poised to transform how we think about disease diagnosis and treatment,” said Frost & Sullivan transformational health industry analyst Harpreet Singh Buttar in a statement. “Augmenting the expertise of trained clinicians, AI systems will provide an added layer of decision support capable of helping mitigate oversights or errors in care administration.”

Medial EarlySign taps into the databases of healthcare organizations to scan blood tests for signs of people who are at high risk of developing colon cancer by comparing them to the blood patterns of patients afflicted with the illness. The startup has studied the medical records of some 20 million individuals in Israel, the UK, the US and Asia Pacific through databases holding the information and trained the algorithms to learn the patterns and identify them in high-risk patients.

“There are a lot of untold stories within our records data” that often get overlooked by overworked professionals, said Geva. But “computers do not tire,” he said. The algorithms scour millions of data points and flag for risk factors, getting the medical system to take a closer look at certain individuals.

The colorectal cancer solution is the first application of the technology the company has started marketing. “We have dozens of models at different stages of development” for other illnesses, he said, including flu, diabetes and hypertension

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