Application of the Parametric Regression Model with the Four-Parameter Log-Logistic Distribution for Determining of the Effecting Factors on the Survival Rate of Colorectal Cancer Patients in the Presence of Competing Risks

Associated Factors of Survival Rate and Screening for Colorectal Cancer in Iran: a Systematic Review

PURPOSE

Colorectal cancer (CRC) is one of the most important cancers, which has various patterns in the world. The aim of this study was to determine the factor associated to survival and looking for screening in Iran.

METHODS

A literature search was conducted using PubMed, Web of Science, Scopus, SID, and Magiran on June 30, 2018. Studies that performed survival analysis and the barrier of screening for colorectal cancer were included in this review.

RESULTS

Fifty-three articles for survival and 11 for screening were included and examined. The important factors of survival are the age, cancer stage, tumor grade, ethnicity, marital status, family history of cancer, smoking, metastasis, and obesity. For barrier of screening, the cost, shame, fear of diagnosis the cancer, absence of clinical symptoms, and time limit were determined.

CONCLUSION

Remarkably, knowledge, attitude, and behaviors about CRC screening in Iran are very moderate to poor. According to diversity of survival rates and low tendency to screening, we need to further and deepen studies of barrier and facilitators of screening.

The impact of anthropometric parameters on colorectal cancer prognosis: A systematic review and meta-analysis

BACKGROUND & AIMS

Our study aims to clarify the relationship between weight parameters and colorectal cancer outcomes.

METHODS

NCBI, Embase, Cochrane, and Web of Science were searched from inception to December 2019. Studies reporting colorectal cancer (CRC) mortality, recurrence, disease-free survival, overall survival, overall mortality stratified by pre-diagnosis BMI or post-diagnosis weight change, were included in the analysis. Random effects analysis was performed for all outcomes, with heterogeneity assessed by the I² statistic.

RESULTS

Our meta-analysis included 45 studies encompassing 607,266 patients. Obesity was associated with increased odds of overall mortality and CRC-specific mortality compared to normal weight (p < 0.001). Patients with underweight BMI had increased odds of CRC-specific mortality compared to normal BMI but were not significantly different from obese BMI.

CONCLUSIONS

Obese and underweight BMI are associated with increased CRC-specific and overall mortality compared to normal BMI. Long term prognosis was similar for patients with obese and underweight BMI.

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.