Dépistage du cancer colorectal en 2006

peer reviewedColorectal cancer is the second leading cause of death in Northern countries and needs a national screening program to reduce mortality and improve quality of life. Screening has to be cost-effective and acceptable for patients. Many screening tools, invasive or not, are existing and often debated: FOBT, sigmoidoscopy and complete colonoscopy. New tools are in development and have to be evaluated in current practice: virtual colonoscopy, new endoscopic technologies, DNA on faeces or proteomics with markers in serum

screening for Colorectal Cancer

peer reviewedColorectal cancer is the second leading cause of death in Northern countries and need a national screening program to reduce mortality and improve quality of life. Screening has to be cost-effective and acceptable for patients. Many screening tools, invasive or not, are existing and often debated: FOBT, sigmoidoscopy and complete colonoscopy. New tools are in development and have to be evaluated in current practice: virtual colonoscopy, new endoscopic technologies, DNA on faeces or proteomics with markers in serum

Primary and Secondary Prevention of Colorectal Cancer

peer reviewedColorectal cancer is really a public health problem. The authors review the literature about the environmental factors leading to colorectal cancer. Chemoprevention of colorectal cancer is also discussed, particularly by aspirin and non steroidal anti-inflammatory drugs. Development of specific cyclooxygenase-2 inhibitors constitutes a promising research's field. Secondary prevention by coloscopy and polypectomy must lead to a lower rate of colorectal cancer disease and improvement of mortality

Cardiac decompensation, renal function and non-steroidal anti-inflammatory agents

peer reviewedThanks to a case report of heart failure in an old people with a cardiovascular history treated by the new coxib-inhibitors, we would like to remember and insist to the risk of renal and cardiac complications which appear to be the same as those with the non specific antiinflammatory drugs. Old age, diuretic or converting enzyme inhibitor treatment, heart failure, liver insufficiency, nephrotic syndrome are risk factors for acute renal failure and cardiac failure during such treatment

Epidemiology of Crohn's disease in Europe: a review

La maladie de Crohn, une maladie inflammatoire chronique du tube digestif, a une incidence relativement élevée, surtout parmi les sujets jeunes, variant de 0,3 à 9,8 nouveaux cas pour 100 000 personnes en Europe. Les données concernant les variations géographiques, l'incidence au cours des décennies, l'âge de début de la maladie, le délai avant le diagnostic et la localisation de la maladie ont été résumées parmi des travaux effectués en Europe ces dernières années

Screening for colorectal cancer in 2006

Le cancer colorectal est un cancer fréquent dans nos pays du Nord de l’Europe ; la mortalité reste élevée malgré de nombreuses et nouvelles possibilités thérapeutiques. Le dépistage de masse, dont le but est de réduire la mortalité de ce cancer, devrait être une priorité politique à l’échelon national. Les techniques de dépistage sont nombreuses, plus ou moins invasives mais aucune ne fait l’objet de recommandations unanimes. A l’avenir, les progrès de la technologie médicale dans les domaines de l’imagerie, de l’endoscopie et de la biologie moléculaire devraient permettre un dépistage plus efficace tout en restant tolérable par le patient ainsi que sur le plan du coût

Monoclonal antibodies therapies for colorectal cancer: cetuximab, panitumumab and bevacizumab

peer reviewedColorectal cancer is the third most common form of cancer in Europe, Its prognosis is poor, since median survival time for metastatic patients is about 20 months. Progresses in molecular biology have lead to significant improvement in the management of metastatic colorectal cancer with targeted therapies. The monoclonal antibodies anti-EGFR and anti-VEGFR improve the overall and the progression-free survival. The anti-EGFR antibodies (cetuximab and panitumumab) have been marketed in Belgium, as monotherapy or in association with chemotherapy (FOLFIRI) for third line use in patients with wild type K-ras. The anti-VEGFR bevacizumab is the standard first line treatment in metastatic colorectal cancer with irinotecan based chemotherapy. For the future, the place of monoclonal antibodies therapies in adjuvant or in first line settings and the value of combining targeted therapies have to be further defined

Evolution of the prevalence and characteristics of anemia in inflammatory bowel diseases between 1993 and 2003

Introduction : Anemia has been considered as an overlooked complication of inflammatory bowel disease. Studies dating back to the 80ties and the 90ties have shown 30% of anemia among inflammatory bowel disease (IBD) patients. More recently, the broader use of immunosuppressive drug and infliximab allowing better mucosal healing as well as a more aggressive treatment of anemia, including the use of safer form of IV iron, may have influenced the prevalence of anemia among IBD patients. Our aim was to asses the prevalence and characteristics of anemia among two cohorts of IBD patients at 10 years interval and to look for associated clinical or demographic factors. Methods: using the IBD patients register of one senior gastroenterologist, we identified IBD patients he had consecutively seen and who had blood test at the outpatient clinic during the years 1993 and 2003. Demographic and clinical characteristics, treatment for Crohn's disease, blood test results and treatment of anemia were recorded and compared between these two cohorts. Anemia was defined as an hemoglobin level lower than the normal value of the laboratory of our hospital. Results : 80 and 90 patients were identified in 1993 and 2003, respectively. There was no significant difference between the two cohorts, according to age, gender, disease type, duration or location. There were 27/80 (33.8%) and 15/90 (16.7%) anemic patients in 1993 and 2003, respectively (P = 0.013). The prevalence of severe anemia (hemoglobin level < 10.5 g/100 ml) was similar in the two cohorts (6.3% and 5.6%). Characteristics of the anemia were similar in the two cohorts with a majority of iron deficiency anemia and inflammatory anemia. Ferritin and CRP levels were not significantly different in the two cohorts. The only significant difference was a more frequent use of immunosuppressive treatment and infliximab in 2003 than in 1993 (33.3% vs. 13.8%; P = 0.0038, RR :0.41, 0.22-0.77) Conclusions : Prevalence of mild to moderate anemia has significantly decreased in our population over the last 10 years. The only difference detected between the two cohorts was the increased use of immunosuppressive drug (mainly azathioprine)