New research has discovered how a genomic approach to understanding bowel (colorectal) cancer could improve the prognosis and quality of life for patients.
Bowel cancer is the fourth most common cancer in the UK, with 41,200 people newly diagnosed each year. A number of treatment options are available but mortality rates remain high, with bowel cancer the second most common cause of cancer death in the UK.
Researchers at Queen’s University Belfast, in collaboration with the University of Oxford and the University of Leeds have made a significant advance in the treatment of bowel cancer. The study, which has been published in the journal Nature Communications, has shown how defining precise gene signatures within bowel cancer cells can allow us to develop novel prognostic and predictive markers for bowel cancer and help to drive personalised medicine approaches.
Everyone who has colorectal cancer diagnosed should be tested for an inherited genetic condition called Lynch syndrome, new guidance states | BMJ
The National Institute for Health and Care Excellence (NICE) recommends microsatellite instability testing or immunohistochemistry to detect abnormalities that may indicate the syndrome.
Lynch syndrome, the most common cause of hereditary bowel cancer, has also been linked to an increased risk of developing other cancers including womb, ovarian, and stomach. People with the condition who develop colorectal cancer generally do so at a younger age, usually 40-50.
Testing for the condition helps to identify whether the patient’s family are also at increased risk of cancer so that they can be monitored more closely if needed, says NICE. Where these tests show that a person has a risk of the syndrome, the guidance recommends further tests to confirm the diagnosis. Because it is an inherited condition, a positive test can also lead to testing of family members.
Diagnosing Lynch syndrome may also help with the choice of treatment for colorectal cancer—for example, to direct chemotherapy or surgery.
It has been estimated that the new test will increase screening uptake by around 10% – meaning an additional 200,000 people could be tested each year. This means that hundreds of lives could be potentially saved, the Department of Health said.
The National Bowel Cancer Audit Report 2015 has been published by the Royal College of Surgeons in partnership with the Association of Coloproctology of Great Britain and Ireland. The report shows that the number of people surviving bowel cancer following major surgery has increased significantly in recent years. The results presented in this report are based upon patients diagnosed with bowel cancer between 1 April 2013 and 31 March 2014.
UK researchers claim living a healthy lifestyle before diagnosis could improve a person’s chances of surviving bowel cancer.
Findings from Imperial College London suggest eating a balanced diet, keeping physically active and maintaining a healthy weight were associated with an improved likelihood of survival.
The large European Prospective Investigation into Cancer and Nutrition (EPIC) study, published in BMC Medicine, analysed data from 520,000 men and women from 10 countries over six years. Of these men and women from the study, 3,292 were diagnosed with bowel cancer.
Lead researcher, Dora Romaguera, from Imperial College London wanted to investigate if the same healthy lifestyle choices that help prevent bowel cancer could also improve the survival rates of people diagnosed with the disease.
The study participants completed questionnaires about their medical history, diet and lifestyle at the start of the study, while height and weight measurements were also taken.
Having a healthy weight and high consumption of plant foods had the strongest associations with survival. There was also an association seen with women who breastfed and improved survival.
Being very overweight in your teens may double the risk of developing bowel cancer by the time you are middle aged, suggests research published online in the journal Gut.
During the monitoring period, which spanned an average of 35 years, researchers tracked the health of almost 240,000 Swedish men who had been conscripted into the military between the ages of 16 and 20 in 1969-76.
At enlistment, the men had a health check, which included weight and height, and ESR levels. The men were then monitored for bowel cancer up to 2010, using national cancer registry data.
The study found that Obesity in young adulthood, classified as a BMI of more than 30, was associated with a 2.38 higher risk of developing bowel cancer.
This is an observational study so no definitive conclusions can be drawn about cause and effect, but the researchers say that the findings suggest that both BMI and inflammation during adolescence may have a role in the development of bowel cancer.
A person’s genetic make-up might determine whether they could benefit from taking aspirin to prevent bowel cancer, according to a US study. The findings also suggest that the drug could even increase cancer risk in a minority of people – although experts cautioned that more research was needed to confirm this.
The team combined the results of several previous studies on aspirin and other similar drugs – collectively called non-steroidal anti-inflammatory drugs, or NSAIDs – comprising more than 8,600 people who went on to develop bowel cancer, and a similar number who remained healthy.
They then analysed participants’ DNA records, and looked at whether certain genetic variants, known as single-nucleotide polymorphisms, were more or less common in each group.
As well as confirming the overall benefits of aspirin in preventing the disease, they found that nearly one in 10 study participants (nine per cent) who had a particular genetic variation received no benefit from the drug.
And a further four per cent – one in 25 – who carried one of two other DNA variants appeared to have an increased likelihood of going on to develop bowel cancer after taking aspirin.
New figures released by the charity Beating Bowel Cancer show the majority of bowel cancer patients are still diagnosed too late, costing the NHS millions. There is currently a large variation within the NHS across England in terms of early diagnosis of bowel cancer, with the best performing Clinical Commissioning Groups diagnosing 63% of patients early, compared with only 30% in the worst. The figures show that if every NHS region in England performed as well as the best at diagnosing bowel cancer early (stages 1 and 2), 3,200 lives could be saved and £34 million could be diverted to other bowel cancer services and treatments.