Colorectal cancer (CRC) is currently the fourth leading cause of cancer death worldwide. While mortality rates are in decline in most westernised countries, global estimates predict that CRC incidence rates and the overall number of CRC-related deaths are set to rise by 77% and 80%, respectively, by 2030. The development of CRC is multifactorial, and risk factors include various lifestyle, genetic, and environmental factors. It has been estimated that at least half of CRC cases could be prevented by a reduction in known modifiable lifestyle-related risk factors. Further reductions in CRC incidence and mortality can be achieved through screening, but the uptake of screening varies across different sectors of the population. This special issue comprises articles highlighting issues in the prevention, early diagnosis, and treatment of CRC

McQueen, A.

Miles, Anne

Raymond Oliphant, R.

van Duijnhoven, F.

BioMed Research International

PubMed

Name not available

EditorialColorectal Cancer: Advances in Prevention and Early DetectionAnne Miles,1 Fränzel van Duijnhoven,2 Amy McQueen,3 and Raymond Oliphant41Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK2Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EVWageningen, Netherlands3School of Medicine, Washington University in St. Louis, Campus Box 8005, 4523 Clayton Avenue, St. Louis, MO 63110, USA4West of Scotland Cancer Surveillance Unit, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UKCorrespondence should be addressed to Anne Miles; ae.miles@bbk.ac.ukReceived 14 September 2015; Accepted 14 September 2015Copyright © 2015 Anne Miles et al. This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Colorectal cancer (CRC) is currently the fourth leading causeof cancer death worldwide. While mortality rates are indecline in most westernised countries, global estimates pre-dict that CRC incidence rates and the overall number of CRC-related deaths are set to rise by 77% and 80%, respectively,by 2030. The development of CRC is multifactorial, and riskfactors include various lifestyle, genetic, and environmentalfactors. It has been estimated that at least half of CRC casescould be prevented by a reduction in known modifiablelifestyle-related risk factors. Further reductions in CRC inci-dence and mortality can be achieved through screening, butthe uptake of screening varies across different sectors of thepopulation. This special issue comprises articles highlightingissues in the prevention, early diagnosis, and treatment ofCRC.J. Sovich et al. provide a comprehensive review of theeffectiveness and adoption of existing technologies for CRCscreening.They review stool-based, endoscopic, radiological,and serum-based methods for screening, discussing bothcommonly used methods, such as gFOBT and colonoscopy,and newly emerging ones, such as faecal DNA testing, capsuleendoscopy, and serum-based tests. Colonoscopy remains thegold standard, but the authors highlight improvements in thesensitivity of the newer stool-based tests (FIT and faecal DNAtests) and raise the important point that “the best test is oftenthe one that patients will do.”J. Krok-Schoen et al. report the results of a randomisedtrial aimed at increasing CRC screening among adults livingin Ohio Appalachia, an area with higher than average ratesof both CRC incidence and mortality. The interventioncomprised both a media campaign (billboards, posters, andnewspaper articles) and a clinic intervention (brochures andposters). Randomisation was performed at the county level,with counties stratified by the proportion of people with late-stage diagnosis. The communication-focused interventionwas not effective in promoting the uptake of screening, andthe authors suggest that while such strategies may increaseknowledge and awareness of screening, additional interven-tions or resources may be needed to change behaviour.B. White et al. not only compared multiple interventionsto increase stool blood test uptake in a national screeningprogram but also examined multiple moderators of inter-vention effects to assess what is needed by whom. Only thecombined intervention group (endorsement flyer plus kitenhancement plus community advertisements) significantlyincreased screening rates compared with controls for allparticipants, whereas all other significant intervention effectswere conditional on other factors. More resources may beneeded to increase screening uptake among people not previ-ously screened, aged 70 and older, and living in economicallydeprived areas. Future research could examine the mediatorsof intervention effects in these population subgroups toreveal the mechanisms by which the interventions workand how they might be further enhanced. For example,all the interventions tested involved health communicationapproaches; however, individuals living in more deprivedareasmay need increasingly personal and novel interventionsto compete with the cognitive demands of scarcity (see [1]).Hindawi Publishing CorporationBioMed Research InternationalVolume 2015, Article ID 518068, 2 pageshttp://dx.doi.org/10.1155/2015/5180682 BioMed Research InternationalS. H. Lo et al. explored potential pathways of influenceon CRC screening uptake in a national screening programto better understand the processes that may influence behav-ior. Specifically, they explored factors that may explainsociodemographic differences in screening behaviour. Theircross-sectional results support future research to confirmcognitive determinants such as knowledge, perceived barriersto screening, and social norms as mediators of the effects ofsociodemographic predictors on screening uptake. Eluci-dating the mechanisms and interrelations between knowndeterminants of screening behaviour will enable improvedmessage development and intervention design to increasescreening rates and decrease disparities across sociodemo-graphic subgroups.A. Anderson et al. investigated the awareness of lifestylerisk factors associated with CRC in patients who had beendiagnosed with a colorectal adenoma through a colorectalscreening programme in Scotland, UK. Their study showsthat the knowledge of relevant CRC risk factors was low inpeople at increased risk of the disease. The authors suggestexploring opportunities within routine CRC screening set-tings to raise awareness about lifestyle and prevention andto provide further guidance and personalised support toenhance the translation of improved knowledge into effectivebehavioural changes to reduce CRC risk.C. Mojica et al. present the results of a large population-based study examining the relationship between populationcharacteristics, English proficiency, and the diagnosis ofadvanced CRC in California, USA.This cancer registry basedstudy found that late-stage CRC diagnosis was higher in areaswith a greater proportion of recent immigrants and those oflimited financial means. However, it suggests that amongstHispanic groups a lower proportion of English proficiencywas associated with lower odds of advanced disease. Thisinteresting original paper highlights the complexity of therelationship between the patient, socioeconomic and neigh-bourhood characteristics, and CRC risk.L. A. Siminoff et al. examine the patient and medicalcorrelates of a missed diagnostic opportunity (MDO) amongpatients diagnosed with CRC in Virginia and Ohio, USA.Patients had experienced symptoms prior to diagnosis andwere not diagnosed through routine screening. This studyinvolved the review of patient medical records and foundthat a third of patients with symptoms presumptive of CRCexperienced a delay in the diagnostic process for CRC. AnMDOwasmore likely to occur among patients under 50 yearsof age, women, and patients who had seen a greater numberof physicians. In addition to reminders and educationalinterventions for patients and providers about CRC andscreening options, future applications of electronic medicalrecords may reduce MDOs through systematic symptomrecording and analysis.M. Hav et al. present a comprehensive review of the prog-nostic implications in the pathological assessment of rectalcancer after treatment with chemoradiotherapy. The reviewhighlights many of the challenges encountered in the inter-pretation and prediction of outcome after surgical resectionin patients who have already undergone neoadjuvant therapy.The authors emphasize the importance of careful specimenhandling in addition to accurate microscopic pathologicalassessment to achieve optimal prognostication in this groupof patients and highlight several key areas of note.In conclusion, CRC remains a significant health problemacross the world. This special issue highlights the contribu-tion different disciplines can make towards tackling CRC,through developments in screening technologies and treat-ment and understanding and encouraging lifestyle changesand participation in screening, as well as determining thoseat risk from late-stage at diagnosis. Innovations in methodsof diagnosis and treatment can make vital contributions toCRC incidence and mortality; however, more research isneeded to reduce disparities in access to and uptake of thebest screening, diagnostic, and treatment methods that areavailable.Anne MilesFra¨nzel van DuijnhovenAmy McQueenRaymond OliphantReferences[1] A. Mani, S. Mullainathan, E. Shafir, and J. Zhao, “Povertyimpedes cognitive function,” Science, vol. 341, no. 6149, pp. 976–980, 2013.Submit your manuscripts athttp://www.hindawi.comStem CellsInternationalHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014MEDIATORSINFLAMMATIONofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Behavioural NeurologyEndocrinologyInternational Journal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Disease MarkersHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014BioMed Research InternationalOncologyJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Oxidative Medicine and Cellular LongevityHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014PPAR ResearchThe Scientific World JournalHindawi Publishing Corporation http://www.hindawi.com Volume 2014Immunology ResearchHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Journal ofObesityJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014 Computational and  Mathematical Methods in MedicineOphthalmologyJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Diabetes ResearchJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Research and TreatmentAIDSHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Gastroenterology Research and PracticeHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Parkinson’s DiseaseEvidence-Based Complementary and Alternative MedicineVolume 2014Hindawi Publishing Corporationhttp://www.hindawi.com

Colorectal cancer: advances in prevention and early detection

Anne Miles

Fränzel van Duijnhoven

Amy McQueen

Raymond Oliphant

Crossref

Colorectal Cancer: Advances in Prevention and Early Detection

van Duijnhoven, Franzel

McQueen, Amy

Oliphant, Raymond

Digital Commons@Becker

Washington University School of MedicineDigital Commons@BeckerOpen Access Publications2015Colorectal cancer: Advances in prevention andearly detectionAnne MilesFranzel van DuijnhovenAmy McQueenRaymond OliphantFollow this and additional works at: https://digitalcommons.wustl.edu/open_access_pubsEditorialColorectal Cancer: Advances in Prevention and Early DetectionAnne Miles,1 Fränzel van Duijnhoven,2 Amy McQueen,3 and Raymond Oliphant41Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK2Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EVWageningen, Netherlands3School of Medicine, Washington University in St. Louis, Campus Box 8005, 4523 Clayton Avenue, St. Louis, MO 63110, USA4West of Scotland Cancer Surveillance Unit, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UKCorrespondence should be addressed to Anne Miles; ae.miles@bbk.ac.ukReceived 14 September 2015; Accepted 14 September 2015Copyright © 2015 Anne Miles et al. This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Colorectal cancer (CRC) is currently the fourth leading causeof cancer death worldwide. While mortality rates are indecline in most westernised countries, global estimates pre-dict that CRC incidence rates and the overall number of CRC-related deaths are set to rise by 77% and 80%, respectively,by 2030. The development of CRC is multifactorial, and riskfactors include various lifestyle, genetic, and environmentalfactors. It has been estimated that at least half of CRC casescould be prevented by a reduction in known modifiablelifestyle-related risk factors. Further reductions in CRC inci-dence and mortality can be achieved through screening, butthe uptake of screening varies across different sectors of thepopulation. This special issue comprises articles highlightingissues in the prevention, early diagnosis, and treatment ofCRC.J. Sovich et al. provide a comprehensive review of theeffectiveness and adoption of existing technologies for CRCscreening.They review stool-based, endoscopic, radiological,and serum-based methods for screening, discussing bothcommonly used methods, such as gFOBT and colonoscopy,and newly emerging ones, such as faecal DNA testing, capsuleendoscopy, and serum-based tests. Colonoscopy remains thegold standard, but the authors highlight improvements in thesensitivity of the newer stool-based tests (FIT and faecal DNAtests) and raise the important point that “the best test is oftenthe one that patients will do.”J. Krok-Schoen et al. report the results of a randomisedtrial aimed at increasing CRC screening among adults livingin Ohio Appalachia, an area with higher than average ratesof both CRC incidence and mortality. The interventioncomprised both a media campaign (billboards, posters, andnewspaper articles) and a clinic intervention (brochures andposters). Randomisation was performed at the county level,with counties stratified by the proportion of people with late-stage diagnosis. The communication-focused interventionwas not effective in promoting the uptake of screening, andthe authors suggest that while such strategies may increaseknowledge and awareness of screening, additional interven-tions or resources may be needed to change behaviour.B. White et al. not only compared multiple interventionsto increase stool blood test uptake in a national screeningprogram but also examined multiple moderators of inter-vention effects to assess what is needed by whom. Only thecombined intervention group (endorsement flyer plus kitenhancement plus community advertisements) significantlyincreased screening rates compared with controls for allparticipants, whereas all other significant intervention effectswere conditional on other factors. More resources may beneeded to increase screening uptake among people not previ-ously screened, aged 70 and older, and living in economicallydeprived areas. Future research could examine the mediatorsof intervention effects in these population subgroups toreveal the mechanisms by which the interventions workand how they might be further enhanced. For example,all the interventions tested involved health communicationapproaches; however, individuals living in more deprivedareasmay need increasingly personal and novel interventionsto compete with the cognitive demands of scarcity (see [1]).Hindawi Publishing CorporationBioMed Research InternationalVolume 2015, Article ID 518068, 2 pageshttp://dx.doi.org/10.1155/2015/5180682 BioMed Research InternationalS. H. Lo et al. explored potential pathways of influenceon CRC screening uptake in a national screening programto better understand the processes that may influence behav-ior. Specifically, they explored factors that may explainsociodemographic differences in screening behaviour. Theircross-sectional results support future research to confirmcognitive determinants such as knowledge, perceived barriersto screening, and social norms as mediators of the effects ofsociodemographic predictors on screening uptake. Eluci-dating the mechanisms and interrelations between knowndeterminants of screening behaviour will enable improvedmessage development and intervention design to increasescreening rates and decrease disparities across sociodemo-graphic subgroups.A. Anderson et al. investigated the awareness of lifestylerisk factors associated with CRC in patients who had beendiagnosed with a colorectal adenoma through a colorectalscreening programme in Scotland, UK. Their study showsthat the knowledge of relevant CRC risk factors was low inpeople at increased risk of the disease. The authors suggestexploring opportunities within routine CRC screening set-tings to raise awareness about lifestyle and prevention andto provide further guidance and personalised support toenhance the translation of improved knowledge into effectivebehavioural changes to reduce CRC risk.C. Mojica et al. present the results of a large population-based study examining the relationship between populationcharacteristics, English proficiency, and the diagnosis ofadvanced CRC in California, USA.This cancer registry basedstudy found that late-stage CRC diagnosis was higher in areaswith a greater proportion of recent immigrants and those oflimited financial means. However, it suggests that amongstHispanic groups a lower proportion of English proficiencywas associated with lower odds of advanced disease. Thisinteresting original paper highlights the complexity of therelationship between the patient, socioeconomic and neigh-bourhood characteristics, and CRC risk.L. A. Siminoff et al. examine the patient and medicalcorrelates of a missed diagnostic opportunity (MDO) amongpatients diagnosed with CRC in Virginia and Ohio, USA.Patients had experienced symptoms prior to diagnosis andwere not diagnosed through routine screening. This studyinvolved the review of patient medical records and foundthat a third of patients with symptoms presumptive of CRCexperienced a delay in the diagnostic process for CRC. AnMDOwasmore likely to occur among patients under 50 yearsof age, women, and patients who had seen a greater numberof physicians. In addition to reminders and educationalinterventions for patients and providers about CRC andscreening options, future applications of electronic medicalrecords may reduce MDOs through systematic symptomrecording and analysis.M. Hav et al. present a comprehensive review of the prog-nostic implications in the pathological assessment of rectalcancer after treatment with chemoradiotherapy. The reviewhighlights many of the challenges encountered in the inter-pretation and prediction of outcome after surgical resectionin patients who have already undergone neoadjuvant therapy.The authors emphasize the importance of careful specimenhandling in addition to accurate microscopic pathologicalassessment to achieve optimal prognostication in this groupof patients and highlight several key areas of note.In conclusion, CRC remains a significant health problemacross the world. This special issue highlights the contribu-tion different disciplines can make towards tackling CRC,through developments in screening technologies and treat-ment and understanding and encouraging lifestyle changesand participation in screening, as well as determining thoseat risk from late-stage at diagnosis. Innovations in methodsof diagnosis and treatment can make vital contributions toCRC incidence and mortality; however, more research isneeded to reduce disparities in access to and uptake of thebest screening, diagnostic, and treatment methods that areavailable.Anne MilesFra¨nzel van DuijnhovenAmy McQueenRaymond OliphantReferences[1] A. Mani, S. Mullainathan, E. Shafir, and J. Zhao, “Povertyimpedes cognitive function,” Science, vol. 341, no. 6149, pp. 976–980, 2013.Submit your manuscripts athttp://www.hindawi.comStem CellsInternationalHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014MEDIATORSINFLAMMATIONofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Behavioural NeurologyEndocrinologyInternational Journal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Disease MarkersHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014BioMed Research InternationalOncologyJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Oxidative Medicine and Cellular LongevityHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014PPAR ResearchThe Scientific World JournalHindawi Publishing Corporation http://www.hindawi.com Volume 2014Immunology ResearchHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Journal ofObesityJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014 Computational and  Mathematical Methods in MedicineOphthalmologyJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Diabetes ResearchJournal ofHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Research and TreatmentAIDSHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Gastroenterology Research and PracticeHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014Parkinson’s DiseaseEvidence-Based Complementary and Alternative MedicineVolume 2014Hindawi Publishing Corporationhttp://www.hindawi.com

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