Browsing by Subject "colorectal cancer (CRC)"

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    Acceptance of a Risk Estimation Tool for Colorectal Cancer Screening
    (Office of the Vice Chancellor for Research, 2016-04-08) Luckhurst, Cherie; Imperiale, Tom; Matthias, Marianne S.
    Abstract: While colonoscopy is the most prevalent screening test for colorectal cancer (CRC), it is often too expensive, too uncomfortable, or too time-consuming for patients. Non-compliance is common. Recently, fecal immunochemical testing (FIT) has become a guideline-recommended alternative. The FIT is a non-invasive, inexpensive method that requires no uncomfortable preparation by patients. The decision to recommend the colonoscopy or the FIT is based on the patient’s estimated risk for CRC. Several countries have created risk prediction tools to help identify patients at high risk for advanced colorectal neoplasia (the combination of CRC and advanced, precancerous polyps). A U.S.-based prediction tool was recently published1 that uses five easily and reliably measured factors (age, sex, a first degree relative with CRC, waist circumference, and cigarette smoking history) to quantify risk. We aimed to learn the impressions of clinicians and patients to this risk estimation tool. In the first phase of this study, we used a semi-structured format to interview clinicians at a VA medical center and a non-VA hospital. Using a paper prototype of the risk estimation tool, we asked about its usefulness to estimate risk and to aid their selection of a CRC screening tool. Using a grounded theory approach, we analyzed the interview transcripts and identified major themes. We found that clinicians thought the tool was clear and easy to use. However, they are unlikely to use it as a decision aid until FIT is more widely-endorsed as an acceptable alternative screening test. In phase two of the study, we will interview patients to assess their responses to the tool.
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    Genome-Wide Interaction Analysis of Genetic Variants With Menopausal Hormone Therapy for Colorectal Cancer Risk
    (Oxford, 2022) Tian, Yu; Kim, Andre E.; Bien, Stephanie A.; Lin, Yi; Qu, Conghui; Harrison, Tabitha A.; Carreras-Torres, Robert; Díez-Obrero, Virginia; Dimou, Niki; Drew , David A.; Hidaka, Akihisa; Huyghe, Jeroen R.; Jordahl, Kristina M.; Morrison , John; Murphy, Neil; Obón-Santacana, Mireia; Ulrich, Cornelia M.; Ose, Jennifer; Peoples, Anita R.; Ruiz-Narvaez, Edward A.; Shcherbina, Anna; Stern , Mariana C.; Su, Yu-Ru; van Duijnhoven, Franzel J. B.; Arndt, Volker; Baurley, James W.; Berndt, Sonja I.; Bishop, D. Timothy; Brenner, Hermann; Buchanan, Daniel D.; Chan, Andrew T.; Figueiredo, Jane C.; Gallinger, Steven; Gruber, Stephen B.; Harlid, Sophia; Hoffmeister, Michael; Jenkins, Mark A.; Joshi, Amit D.; Keku, Temitope O.; Larsson, Susanna C.; Marchand, Loic Le; Li, Li; Giles, Graham G.; Milne, Roger L.; Nan, Hongmei; Nassir, Rami; Ogino, Shuji; Budiarto, Arif; Platz, Elizabeth A.; Potter, John D.; Prentice, Ross L.; Rennert, Gad; Sakoda, Lori C.; Schoen, Robert E.; Slattery, Martha L.; Thibodeau, Stephen N.; Van Guelpen, Bethany; Visvanathan, Kala; White, Emily; Wolk, Alicja; Woods, Michael O.; Wu, Anna H.; Campbell, Peter T.; Casey, Graham; Conti, David V.; Gunter, Marc J.; Kundaje, Anshul; Lewinger, Juan Pablo; Moreno, Victor; Newcomb, Polly A.; Pardamean, Bens; Thomas, Duncan C.; Tsilidis, Konstantinos K.; Peters, Ulrike; Gauderman, W. James; Hsu, Li; Chang-Claude, Jenny; Community and Global Health, Richard M. Fairbanks School of Public Health
    Background: The use of menopausal hormone therapy (MHT) may interact with genetic variants to influence colorectal cancer (CRC) risk. Methods: We conducted a genome-wide, gene-environment interaction between single nucleotide polymorphisms and the use of any MHT, estrogen only, and combined estrogen-progestogen therapy with CRC risk, among 28 486 postmenopausal women (11 519 CRC patients and 16 967 participants without CRC) from 38 studies, using logistic regression, 2-step method, and 2– or 3–degree-of-freedom joint test. A set-based score test was applied for rare genetic variants. Results: The use of any MHT, estrogen only and estrogen-progestogen were associated with a reduced CRC risk (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.64 to 0.78; OR = 0.65, 95% CI = 0.53 to 0.79; and OR = 0.73, 95% CI = 0.59 to 0.90, respectively). The 2-step method identified a statistically significant interaction between a GRIN2B variant rs117868593 and MHT use, whereby MHT-associated CRC risk was statistically significantly reduced in women with the GG genotype (OR = 0.68, 95% CI = 0.64 to 0.72) but not within strata of GC or CC genotypes. A statistically significant interaction between a DCBLD1 intronic variant at 6q22.1 (rs10782186) and MHT use was identified by the 2–degree-of-freedom joint test. The MHT-associated CRC risk was reduced with increasing number of rs10782186-C alleles, showing odds ratios of 0.78 (95% CI = 0.70 to 0.87) for TT, 0.68 (95% CI = 0.63 to 0.73) for TC, and 0.66 (95% CI = 0.60 to 0.74) for CC genotypes. In addition, 5 genes in rare variant analysis showed suggestive interactions with MHT (2-sided P < 1.2 × 10−4). Conclusion: Genetic variants that modify the association between MHT and CRC risk were identified, offering new insights into pathways of CRC carcinogenesis and potential mechanisms involved.