A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK

Background Colorectal cancer (CRC) is an illness strongly influenced by sex and gender, with mortality rates in males significantly higher than females. There is still a dearth of understanding on where sex differences exist along the pathway from presentation to survival. The aim of this review is to identify where actions are needed to improve outcomes for both sexes, and to narrow the gap for CRC. Methods A cross-sectional review of national data was undertaken to identify sex differences in incidence, screening uptake, route to diagnosis, cancer stage at diagnosis and survival, and their influence in the sex differences in mortality. Results Overall incidence is higher in men, with an earlier age distribution, however, important sex differences exist in anatomical site. There were relatively small differences in screening uptake, route to diagnosis, cancer staging at diagnosis and survival. Screening uptake is higher in women under 69 years. Women are more likely to present as emergency cases, with more men diagnosed through screening and two-week-wait. No sex differences are seen in diagnosis for more advanced disease. Overall, age-standardised 5-year survival is similar between the sexes. Conclusions As there are minimal sex differences in the data from routes to diagnosis to survival, the higher mortality of colorectal cancer in men appears to be a result of exogenous and/or endogenous factors pre-diagnosis that lead to higher incidence rates. There are however, sex and gender differences that suggest more targeted interventions may facilitate prevention and earlier diagnosis in both men and women

Wise Up To Cancer - can it make a difference? Executive Summary.

A summary of the evaluation of Wise Up To Cancer. A Community Health Initiative funded by Yorkshire Cancer Research, aiming to improve cancer outcomes

Wise Up To Cancer - can it make a difference?

This document reports the findings of 'Wise Up To Cancer' a Community Health Initiative, funded by Yorkshire Cancer Research. The aims of Wise Up To Cancer were to; decrease behaviours associated with cancer risk, increase awareness of cancer signs and symptoms,, increase cancer screening rates and increase signposting to other services

Advancing newborn health: The Saving Newborn Lives initiative

Until recently, newborn health was virtually absent from the global health agenda. Now, assistance agencies, national governments and non-governmental organisations are increasingly addressing this previously neglected issue of close to four million newborns dying every year. The experience of the Saving Newborn Lives initiative documents some of the progress that has been made and the challenges and opportunities that lie ahead. Since the start of the initiative in 2000, targeted research, focused on overcoming the key barriers to improved newborn survival, has demonstrated low-cost, community-based interventions and strategies that can significantly reduce newborn mortality. Building on what has been learned from this and other efforts to date, the challenge now is to reach the millions of newborns still at risk

Effect of intermittent hypoxic training on cardiovascular responses to altitude

Introduction: Intermittent hypoxic exposure (IHE) prior to ascent to high altitude is postulated as a beneficial pre-conditioning strategy in the prevention of high altitude illness. Variations in arterial stiffness and endothelial function (vascular tone) may also be important in the pathogenesis of altitude related illness. The influence of IHE pre-conditioning on cardiovascular adaptations (notably arterial stiffness and vascular tone) to altitude is less clear. This study explored the impact of normobaric IHE pre-conditioning on acute cardiovascular adaptations to high altitude. Method: Participants were assigned to one of three intervention groups: control (no IHE), IHE at rest (IHE-rest) or IHE with training (IHE-training) matched for fitness, age and sex. In the 14- day period prior to a high altitude expedition IHE groups completed 10×2 hour hypoxic exposures in an environmental chamber (12.2% O2 equivalent to 4300 m), at rest (IHE-rest) or rest plus 20 minutes running at 80% heart rate reserve (calculated from individual predetermined VO2max at altitude). Arterial stiffness (SI) and vascular tone (RI) responses were recorded using a non-invasive finger photoplethysmography technique at sea-level (baseline), pre and post IHE intervention period, 12 and 72 hours post arrival at altitude (Lukla, Nepal, 2800 m). Results: Thirty apparently healthy participants (18 male, 12 female, age range 20-62 years) free from cardiovascular disease were recruited (n = 10 per condition). Two-way repeated measures (intervention x time) ANOVA revealed no main effect for intervention for SI (control_1.07±1.41 m.s-1, IHE-rest _0.50±0.65 m.s-1, IHE-training_1.07±0.81 m.s-1; P = 0.083) or RI (control_3.3±4.4%, IHE-rest_7.6±25.6%, IHE-training 7.2±18.1%; P = 0.174). There were no between-group interaction effects for any cardiovascular measurements (P = 0.059 for RI; P = 0.112 for SI) Conclusion: Intermittent hypoxic exposure prior to ascent to high altitude does not significantly alter vascular tone or arterial stiffness in apparently healthy adults. The impact of IHE preconditioning on endothelial function at higher altitudes and in the prevention of altitude related illness remains to be elucidated

Interventions targeting children and young people's physical activity behavior at home: A systematic review.

Background and purposeIncreased time at home during the COVID-19 pandemic significantly decreased children's physical activity. This systematic review aimed to evaluate the effectiveness of children's home-based physical activity interventions, and identify 'active ingredients' underpinning these.MethodsDatabases searched-AMED, PsychINFO, CINAHL, Cochrane, EMBASE, PubMed/Medline, Scopus, SPORTDiscus and Web of Science, from inception until June 2022. Eligibility criteria-children aged 2-16 years, targeting home-based physical activity, a control group, and physical activity measured pre- and post- intervention. Studies were excluded if it was not possible to identify change in physical activity at home. The review was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Study quality was evaluated using the quality assessment tool for quantitative studies. Study design, intervention characteristics, outcome data, behavior change theory, Behavior Change Techniques (BCTs) and process evaluation data were extracted and discussed using narrative syntheses.Results13 studies (including 1,182 participants) from 25,967 were included. Interventions primarily involved active video games, with the addition of coaching or telehealth support (n = 5). Three of the 13 studies significantly increased children's physical activity (1 = Moderate to vigorous physical activity, 2 = total volume, PConclusionCOVID-19 emphasized the importance of the home for physical activity. Whilst effectiveness of interventions was limited, building social support and self-efficacy are mechanisms that should be explored further. The review provides recommendations to improve the design and evaluation of future interventions.Trial registrationProspero registration number: CRD42020193110