Epidemiology of Colorectal Cancer and the Risk Factors in Kermanshah Province-Iran 2009-2014

Cross-cultural validation of stool Based Colorectal cancer screening methods in the North West of Iran

Background

Globally, colorectal cancer (CRC) is the third most common cancer and the second leading cause of death from cancer. Incidence and mortality from CRCboth can be reduced and prevented using screening and early detection programs. The current study aimed to assess the feasibility of the colorectal cancer screening program in Northwest of Iran.

Methods

The study designed as a cross-cultural analytic study, to evaluate the diagnostic accuracy of stool-based tests compared with colonoscopy, during 2016–2020. All individuals first were assessed with our CRC risk assessment tool, then eligible volunteers entered the study. Colonoscopy was performed on all participants, also stool-based tests including traditional guaiac, high-sensitivity guaiac-based, fecal immunochemical test (FIT), and multitarget stool DNA (Mt-sDNA) panel tests were performed.

Results

Mt-sDNA test panel had a sensitivity of 77.8% (95% CI: 40–97.2)for detecting colorectal cancer with a specificity of 91.2% (95% CI:85.4–95.2). The FIT test alone had a lower sensitivity (66.7%; 95% CI:29.9–92.5) and almost the same specificity of 93.9% (95% CI: 88.7–97.2) for cancer detection. Mt-sDNA test had better diagnostic accuracy than the FIT (AUC = 0.85 vs 0.80), and is a more useful screening test. Positive and negative predictive values for cancer detection for both Mt-sDNA and FIT tests were almost the same results, however Mt-sDNA test had better NPV results than the FIT test alone.

Conclusion

Our results showed that both Mt-sDNA panel and the FIT test had acceptable cut-off points for cancer detection, however, Mt-sDNA test had better diagnostic accuracy.

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A priority of Iranian health policy must be to develop an executive plan to identify the appropriate CRC screening method.

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This study provides a first step toward the design of a population-based CRC screening program in East Azerbaijan, Iran.

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The current study has been performed to evaluate the diagnostic accuracy of stool-based tests for CRC screening.

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Our results showed that both Mt-sDNA panel and the FIT test had acceptable cut-off points for cancer detection.

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Among four stool -based tests, Mt-sDNA test had the highest sensitivity for detection of cancer and advanced adenoma.

A Hypoxia-Induced SCFFBXL1 E3 Ligase Ubiquitinates and Degrades the MEN1 Tumor Suppressor to Promote Colorectal Cancer Tumorigenesis

Purpose

Emerging evidence has shown that SKP1-cullin-1-F-box-protein (SCF) E3 ligases contribute to the pathogenesis of different cancers by mediating the ubiquitination and degradation of tumor suppressors. However, the functions of SCF E3 ligases in the pathogenesis of colorectal cancer (CRC) remain obscure.

Materials and Methods

The cancerous and adjacent noncancerous tissues from CRC patients were collected, and protein levels were analyzed. Lentiviral short hairpin RNA (shRNA) and plasmid transfection were used to knock down and overexpress gene expression in CRC cell lines. Immunoprecipitation (IP), mass spectrometry, and co-IP analyses were used to determine protein interactions and the assembly of the SCF complex. Cell proliferation, migration, and tumor xenograft assays were performed to examine the effects of SCF members on CRC cell growth in vitro and in vivo.

Results

Hypoxia activated the docking of HIF1a onto the CUL1 promoter and induced CUL1 expression in CRC cells. CUL1 coupled with RBX1, SKP1, and FBXL1 to assemble the SCFFBXL1 complex in CRC biopsies and cells. The SCFFBXL1 E3 ligase specifically ubiquitinated and degraded the MEN1 tumor suppressor. Knockdown of HIF1a or SCFFBXL1 members, or blockage of SCFFBXL1 by two inhibitors (DT204 and SZLP1-41) caused the accumulation of MEN1 protein and led to a significant decrease in cell proliferation and migration in vitro and tumor growth in vivo.

Conclusion

The SCFFBXL1 E3 ligase is required for the ubiquitination of MEN1, and disruption of this complex may represent a new therapeutic strategy for the treatment of CRC.

Meat and colorectal cancer in Middle Eastern and North African countries: update of literature review

Background

This review discusses the findings from epidemiological studies that have examined the possible role of meat and colorectal cancer (CRC) risk in Middle Eastern and North African (MENA) countries.

Methods

We conducted a literature search in the PubMed, Clinical Trials, Google Scholar, Science Direct, and Cochrane databases for observational studies that investigated the association between meat and CRC risk in adults from the MENA region.

Results

Eleven studies were included in this review. For red meat overall, significant associations were found. Regarding beef meat intake, the study included found controversial results with OR = 0.18 (95% CI 0.03–0.09). A positive association was observed between chicken and CRC risk, at OR = 2.52 (95% CI 1.33–4.77) to OR = 4.00 (95% CI 1.53–10.41) to OR = 15.32 (95% CI 3.28–71.45). A significant association was observed between processed meat intake and CRC risk, OR = 9.08 (95% CI 1.02–80.58).

Conclusion

This is the first literature review which illustrated the association between meat consumption and CRC risk in MENA region. We concluded that these studies included in this review have been controversial and not sufficient to establish a clear relationship between CRC and meat consumption in the MENA region. Further studies are necessary to be carried out in this region, with a larger sample size and submit to rigorous criteria. This review will help researchers to improve the quality of future studies about the association between CRC and nutritional diet in general and meat in particular.

Relationship Between Spiritual Health and Pain Self-Efficacy in patients with Chronic Pain: A Cross-Sectional Study in West of Iran

In recent years, the prevalence of chronic diseases has had a growing trend, which has resulted in many health problems. Level of belief in God is effective on people's attitudes to life concepts, social deviations and psychological disorders, and improves them. Therefore, the present research was conducted with the aim of determining the relationship between spiritual health (SH) and pain self-efficacy (PSE) in Ilam City in 2018. This study was a descriptive cross-sectional study in the group of patients with chronic pain (CP). In this study, the study population was patients with CP in Ilam City and the study sample was 150 patients with CP referring to public and private health centers in Ilam, which had all the criteria for participation in the study. The findings showed mean (SD) of the total score of SH variables was 65.16 (9.88), and PSE was 34.48 (4.08). According to Pearson statistical analysis, there is a significant relationship between SH and PSE (r = 0.442, P = 0.000). Also, the standard beta and non-standard beta coefficients for SH variables in PSE show that the non-standard beta coefficient in SH is equal to 0.183. The results of this study showed that SH is a predictor of pain acceptance, so that patients who were more religious were more likely to tolerate CP. For this reason, it is suggested that religious interventions be performed to reduce pain in patients with CP, in order to provide the necessary context for pain reduction in this group of patients.

The First Screening Program for Colorectal Cancer in the North of Iran

PURPOSE

Colorectal cancer (CRC) is the second leading cause of cancer deaths. This screening aimed to determine the positivity of the fecal occult blood test (FOBT) and the results of colonoscopy among a medium-risk population in the northern regions of Iran.

METHODS

This cross-sectional study was conducted in 2016 on 924 eligible samples from people over the age of 50. After completing the questionnaire, participants were referred to a laboratory for three immunochemical fecal occult blood tests (IFOBTs). If the result of at least one test was found to be positive, they were submitted to the state hospital for colonoscopy. Results were recorded according to the number of people with CRC, polyps, and other diseases.

RESULTS

Among a total number of 897 (97.1%) cases, at least two acceptable samples were sent to the laboratory and in 229 (25.5%) cases, at least one case was IFOBT-positive. Finally, 118 (64.1%) cases were referred to the hospital for colonoscopy; among these, 5 colonoscopies were incomplete, while 113 had complete colonoscopies with 42 healthy subjects, 3 cases of cancer, 28 cases of polyps, and other diseases identified in the remaining patients.

CONCLUSIONS

Based on the results, the prevalence of positive IFOBT, polyps, and cancer was high. The results of this study will play an important role in establishing a CRC screening program in the country. With reference to the status of the general population, the target group in the country should be reviewed and not limited to the first-degree relatives of patients.