No abstract

The serum levels of CA 19-9 were determined in the follow-up of 370 patients with colorectal cancer and compared with CEA. An increase in CA 19-9 preceded clinical diagnosis of recurrence in 25% of 72 patients. The mean time between the rise in CA 19-9 and clinical diagnosis of relapse was 3.7 months (median 3). Sensitivity of CA 19-9 in the early diagnosis of recurrence was much lower than that obtained for CEA (75%). Only 1 patient had elevated CA 19-9 levels and normal CEA.

Background Colon capsule endoscopy (CCE) and CT colonography (CTC) are minimally invasive techniques for colorectal cancer (CRC) screening. Our objective is to compare CCE and CTC for the identification of patients with colorectal neoplasia among participants in a CRC screening programme with positive faecal immunochemical test (FIT). Primary outcome was to compare the performance of CCE and CTC in detecting patients with neoplastic lesions. Methods The VICOCA study is a prospective, single-centre, randomised trial conducted from March 2014 to May 2016; 662 individuals were invited and 349 were randomised to CCE or CTC before colonoscopy. Endoscopists were blinded to the results of CCE and CTC. Results Three hundred forty-nine individuals were included: 173 in the CCE group and 176 in the CTC group. Two hundred ninety individuals agreed to participate: 147 in the CCE group and 143 in the CTC group. In the intention-to-screen analysis, sensitivity, specificity and positive and negative predictive values for the identification of individuals with colorectal neoplasia were 98.1%, 76.6%, 93.7% and 92.0% in the CCE group and 64.9%, 95.7%, 96.8% and 57.7% in the CTC group. In terms of detecting significant neoplastic lesions, the sensitivity of CCE and CTC was 96.1% and 79.3%, respectively. Detection rate for advanced colorectal neoplasm was higher in the CCE group than in the CTC group (100% and 93.1%, respectively; RR = 1.07; p = 0.08). Both CCE and CTC identified all patients with cancer. CCE detected more patients with any lesion than CTC (98.6% and 81.0%, respectively; RR = 1.22; p = 0.002). Conclusion Although both techniques seem to be similar in detecting patients with advanced colorectal neoplasms, CCE is more sensitive for the detection of any neoplastic lesion. Trial registration ClinicalTrials.gov Identifier: NCT02081742. Registered: September 16, 2013.

Cancer-related fatigue (CRF) is one of the most prolonged discomforts suffered by people who have had cancer. Seventy-eight to ninety-six percent of cancer patients experience fatigue, especially while undergoing treatment. CRF is related to insomnia, anxiety, depression, and also varies depending on age. However, little is known about the factors contributing to CRF and better understanding of determinants of CRF makes it easier to identify early patients at risk and in designing intervention planning. The aim of this study was to assess the influence of precipitating factors (diagnosis of breast cancer and other clinical aspects) and perpetuating factors (social network, quality of life, mental disorders) on the presence of chronic fatigue in women from our cultural context, by social class each other determinants. Methods It was carried out a mixed cohort study (prospective and retrospective) using a convenience sample of women diagnosed with breast cancer. The information sources were data from the Brief Fatigue Inventory questionnaire and hospital medical records. The dependent variable was fatigue and the independent variables were age, social class, time since diagnoses, cohabitation, comorbidity, relapse, body mass index, mental health (anxiety and depression), social network, social support, and quality of life. Results Seventy-two percent of the women in the DAMA cohort reported moderate to severe fatigue. Risk of suffering from severe fatigue was greatest among individuals with low social class, those aged under 50 years, those with chronic disorders who

Background and study aims: current guidelines recommend genetic counseling and intensive colonoscopy surveillance for patients with ≥10 colorectal adenomas based on scarce data. We investigated the prevalence of this condition in a FIT (fecal immunochemical test)-based colorectal (CRC) screening program and the incidence of metachronous lesions during follow-up. Patients and methods: we retrospectively included all FIT-positive participants with ≥10 adenomas at index colonoscopy between 2010 and 2018. Surveillance colonoscopies (SVC) were collected until 2019. Patients with inherited syndromes, serrated polyposis syndrome, total colectomy or lacking surveillance data, were excluded. Cumulative incidence of CRC and advanced neoplasia (AN) were analyzed by Kaplan-Meyer analysis. Risk factors of metachronous AN were investigated by multivariable logistic-regression analysis. Results: 215/9,582 (2.2%) participants had ≥10 adenomas. Germline genetic testing was performed in 92% of patients with ≥20 adenomas identifying 2 (3.3%) inherited syndromes. 3-year cumulative incidence of CRC and AN was 1%, and 16%, respectively. In 39 (24.2%) patients no polyps were found at first SVC. The presence of advanced adenoma was independently associated with a higher risk of AN at first SVC (OR: 3.91, 95% confident interval : 1.12-13.62; p=0.03). Beyond the first SVC, the risk of metachronous AN was lower. Conclusions: the prevalence of ≥10 adenomas in a FIT-based CRC screening program is 2.2% and a small proportion of inherited syndromes are detected even amongst those with ≥ 20 adenomas. Low rate of post-colonoscopy CRC is observed and the risk of AN beyond the first SVC tends to progressively decrease throughout successive follow-up.