Risk of colorectal cancer for fecal immunochemistry test‐positive, average‐risk patients after a colonoscopy

Kawamura, Takuji; Nakamura, Shiho; Sone, Daiki; Sakai, Hiroaki; Amamiya, Kana; Inoue, Naonori; Sakiyama, Naokuni; Shiozaki, Atsushi; Okada, Yusuke; Sanada, Kasumi; Nakase, Kojiro; Mandai, Koichiro; Suzuki, Azumi; Morita, Atsuhiro; Tanaka, Kiyohito; Uno, Koji; Yasuda, Kenjiro

doi:10.1111/jgh.14517

Cited by 10 publications

(17 citation statements)

References 17 publications

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“…A study found that the incidence and mortality of colon cancer have gradually increased in recent years (Bray et al, 2018). The current diagnostic strategies for colon cancer mainly include biopsy, laboratory examination, and colonoscopy (Cross et al, 2019;Kawamura et al, 2019). Therefore, establishing a reliable risk assessment model is urgently needed to assess the survival prognosis of patients with colon cancer and optimize clinical treatment decisions.…”

Section: Introductionmentioning

confidence: 99%

Identification of an Immune-Related Nine-lncRNA Signature Predictive of Overall Survival in Colon Cancer

et al. 2020

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Growing evidence suggests that immune-related genes (IRGs) and long non-coding RNAs (lncRNAs) can serve as prognostic markers of overall survival (OS) in patients with colon cancer. This study aimed to identify an immune-related lncRNA signature for the prospective assessment of prognosis in these patients. Gene expression and clinical data of colon cancer patients were downloaded from The Cancer Genome Atlas (TCGA). Immune-related lncRNAs were identified by a correlation analysis between IRGs and lncRNAs. In total, 447 samples were divided into a training cohort (224 samples) and a testing cohort (223 samples). Univariate, lasso and multivariate Cox regression analyses identified an immune-related nine-lncRNA signature closely related to OS in colon cancer patients in the training dataset. A risk score formula involving nine immunerelated lncRNAs was developed to evaluate the prognostic value of the lncRNA signature in the training dataset. Colon cancer patients with a high risk score had poorer OS than those with a low risk score. A multivariate Cox regression analysis confirmed that the immune-related nine-lncRNA signature could be an independent prognostic factor in colon cancer patients. The results were further confirmed in the testing cohort and the entire TCGA cohort. Furthermore, a gene set enrichment analysis revealed several pathways with significant enrichment in the high-and low-risk groups that may be helpful in formulating clinical strategies and understanding the underlying mechanisms. Finally, a quantitative real-time polymerase chain reaction assay found that the nine lncRNAs were significantly differentially expressed in colon cancer cell lines. The results of this study indicate that this signature has important clinical implications for improving predictive outcomes and guiding individualized treatment in colon cancer patients. These lncRNAs could be potential biomarkers affecting the prognosis of colon cancer.

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Section: Introductionmentioning

confidence: 99%

Identification of an Immune-Related Nine-lncRNA Signature Predictive of Overall Survival in Colon Cancer

et al. 2020

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“…1 We studied the clinical application of a new type of laser thermoablation: the mixed thulium-herbium laser. 2,3 On the basis of previous success on animal models, 3 we compared thulium laser coagulation (TLC) and argon plasma coagulation (APC), and we enrolled 11 patients (7 female, 4 male, mean age 83 years) in the TLC group and 10 patients (6 female, 4 male, mean age 85 years) in the APC group. All patients were receiving antiplatelet/ anticoagulant therapy.…”

Section: Thulium Laser Coagulation: a New Effective Endotherapy To Trmentioning

confidence: 99%

Should we perform repeated colonoscopy for fecal immunochemistry test-positive, average-risk patients after a recent colonoscopy with negative results?

Kawamura

Uno

2019

Gastrointestinal Endoscopy

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We read with great interest the article by Kim et al 1 reporting that risk of colorectal cancer (CRC) was relatively high in fecal immunochemistry test (FIT)positive patients after recent colonoscopy. They stated that repeated colonoscopy should be offered to patients with positive FIT results and recent colonoscopy, consistent with the U.S. Multi-Society Task Force on CRC Screening recommendation. However, as an important limitation of this study, the results of baseline or prior colonoscopy (eg, no adenoma, low-risk adenoma, or high-risk adenoma) were unknown, as the authors acknowledged. The 5-year cumulative incidence of advanced adenoma reported in a meta-analysis was 3.3% for the no-adenoma group at baseline, with 4.9% for the low-risk adenoma group. 2 According to Kim et al, 1 detection rates for advanced neoplasia (advanced adenoma þ invasive cancer) in FIT-positive and FIT-negative patients within 3 years were relatively high (10.9% [56/514] and 6.0% [82/1365], respectively), indicating that increased-risk patients were included in this study. Furthermore, detection rates for invasive cancer in FIT-positive and FIT-negative patients were 2.1% (11/514) and 0.7% (10/1365), respectively. We recently reported that risk of CRC is low, even when average-risk patients without a history of high-risk neoplasms are found to have a positive FIT result after recent colonoscopy. 3 In our cohort, detection rates for advanced neoplasia and invasive cancer in FIT-positive patients after colonoscopy within 5 years were 3.9% (13/330) and 0.3% (1/330), respectively. We agree that interval FIT (ie, repeated FIT during recommended colonoscopy intervals) may be useful for populations with increased-risk patients to detect missed or rapidly growing colorectal neoplasms. However, our findings suggested that interval FIT would not be useful for average-risk patients without adenoma or with only low-risk adenoma on baseline colonoscopy.

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“…In Japan, repeating annual FIT is often performed according to the recommendations of the Ministry of Health, Labour and Welfare, even 1 year after negative colonoscopy. Nevertheless, we have reported the risk of CRC or advanced neoplasia (defined as any tubular adenoma measuring ≥10 mm or with features of villous histology, high‐grade dysplasia, or invasive cancer) to be low in FIT‐positive, average‐risk patients subjected to colonoscopy within 5 years in our Japanese hospital . According to the European Society of Gastrointestinal Endoscopy guidelines, if there is no high‐risk lesion in colonoscopy, rescreening with FIT or colonoscopy is recommended after 10 years .…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, we have reported the risk of CRC or advanced neoplasia (defined as any tubular adenoma measuring ≥10 mm or with features of villous histology, high-grade dysplasia, or invasive cancer) to be low in FIT-positive, averagerisk patients subjected to colonoscopy within 5 years in our Japanese hospital. 11 According to the European Society of Gastrointestinal Endoscopy guidelines, if there is no high-risk lesion in colonoscopy, rescreening with FIT or colonoscopy is recommended after 10 years. 12 Furthermore, it is not recommended to repeat FIT within 10 years; however, if the FIT is found to be positive within 10 years unexpectedly, it is up to the clinician to decide whether to repeat the colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

“…14 In this study, we investigated the correlation between the prevalence of advanced neoplasia or invasive cancer and fecal hemoglobin concentration in examinees who previously underwent a colonoscopy. Because we reported that FIT might be ineffective in patients with a history of colonoscopy within 5 years, 11 we aimed to evaluate whether raising the cut-off value of FIT would be useful to detect postcolonoscopy CRC in patients.…”

Section: Introductionmentioning

confidence: 99%

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Significance of fecal hemoglobin concentration for predicting risk of colorectal cancer after colonoscopy

et al. 2020

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Background and Aim: As the significance of the quantitative fecal immunochemical test (FIT) in patients who previously underwent a colonoscopy is unknown, this study aimed at investigating the association between fecal hemoglobin concentration and the risk of colorectal cancer (CRC). Methods and Results: We retrospectively analyzed FIT-positive patients who underwent a colonoscopy through our opportunistic annual screening program from April 2010 to March 2017 at the Kyoto Second Red Cross Hospital. We stratified them into no colonoscopy and past colonoscopy (>5 years or ≤5 years) groups based on whether they had a history of undergoing a colonoscopy and analyzed the correlation between fecal hemoglobin concentration and advanced neoplasia or invasive cancer detection in each group. We analyzed 1248 patients with positive FIT results. There were 748 (59.9%), 198 (15.9%), and 302 (24.2%) patients in the no colonoscopy, past colonoscopy (>5 years), and past colonoscopy (≤5 years) groups, respectively. In the no colonoscopy group, the advanced neoplasia detection rate significantly increased with the fecal hemoglobin concentration (P < 0.001). However, no significant trend was observed in the past colonoscopy (both >5 years and ≤5 years) group (P = 0.982). No invasive cancer was detected in the past colonoscopy (≤5 years) group. Conclusion: The risk of CRC might be low even if fecal hemoglobin concentration was high, especially in those who underwent colonoscopy within 5 years.

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Risk of colorectal cancer for fecal immunochemistry test‐positive, average‐risk patients after a colonoscopy

Cited by 10 publications

References 17 publications

Identification of an Immune-Related Nine-lncRNA Signature Predictive of Overall Survival in Colon Cancer

Identification of an Immune-Related Nine-lncRNA Signature Predictive of Overall Survival in Colon Cancer

Should we perform repeated colonoscopy for fecal immunochemistry test-positive, average-risk patients after a recent colonoscopy with negative results?

Significance of fecal hemoglobin concentration for predicting risk of colorectal cancer after colonoscopy

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