The Colon Cancer Foundation (CCF) spoke with Dr. Rami James Aoun, 11th winner of the Dr. Thomas K. Weber Colorectal Cancer Research Scholar Award, for his work looking at biomarkers of radiation response in rectal cancer patients. He is a surgical resident at The Ohio State Wexner Medical Center. Instituted in 2011 by CCF and the Society of Surgical Oncology to recognize translational research focused on the molecular biology of colorectal cancer, the award was renamed in 2020 to honor CCF’s founder, the late Dr. Thomas K. Weber.
Born in West Palm Beach, Florida, Dr. Aoun was raised in Beirut, Lebanon, where he was a student at the American University of Beirut. After completing his undergraduate years and medical school, Dr. Aoun joined Columbia University in New York where he received a Master of Public Health degree in Healthcare Management and Policy. As part of his ongoing residency at The Ohio State Wexner Medical Center, he is completing a research fellowship with Dr. Matthew Kalady, a colorectal surgeon at The James Cancer Center.
Dr. Rami James Aoun
Q: What motivated you to work in the oncology research space, and colorectal cancer in particular?
Dr. Aoun: I am motivated to work in oncology research because I have seen some of my own family members suffer from cancer. However, what specifically interests me in colon cancer research are the patients that I encounter here at The James Cancer Center and my mentors. Their guidance when I was a junior resident was extremely important to set the direction for me as a future colorectal surgeon. That’s how I met Dr. Kalady, and now I am a part of his lab conducting research on colorectal cancer, with the goal of improving patient care outcomes.
Q: Can you summarize the significance of your findings for which you have received this award? Can you also share the prior work or observations that laid the foundation for this project?
Dr. Aoun: We observed a difference in how patients with rectal cancer reacted to neoadjuvant radiation therapy. Some of the patients who were exposed to neoadjuvant therapy had a complete response—the cancer disappeared. However, there were patients who had almost no response to the therapy. The response can be determined and graded by examining the tumor under a microscope. Patients who had a better response end up living longer without cancer.
We sought to identify the reason certain cancers responded to neoadjuvant radiation and certain cancers did not. To do that, we tried to understand these cancers at the genetic level by studying how a rectal cancer expressed particular genes, as measured by mRNA. By comparing the gene expression in both, patients who responded to radiation therapy and those who did not, we were able to obtain a gene signature that helps us identify patterns of gene expression that are different between responders and non-responders.
While this is just a starting point, it can help us develop a more predictive model to use clinically. Once we validate this model, we could be able to distinguish between a responder and non-responder to radiation based on the gene expression that we obtained from their biopsies even before any treatment is administered. This would allow us to provide individualized patient-specific therapy and avoid any unnecessary treatments and procedures.
We also think that certain genes in this signature can be further studied to see if they might be able to be blocked or changed to improve the response to treatment.
Q: What was the size of your current cohort and what is the ‘n’ that you are looking for to be able to validate your study results?
Dr. Aoun: Our ‘n’, or sample size, was 33 patients for this study. In genetic studies like this, it is difficult to design a statistical power needed to validate, but we hope to test this in about 100 different patients.
Q: Did you see any commonality in the gene signatures between rectal cancer and colon cancer?
Dr. Aoun: The gene signature we investigated was related to radiation resistance in rectal cancer, whereas colon cancer is not usually treated with radiation therapy. So, we did not study this for colon cancer. However, some of the pathways we identified are known to be relevant to colon cancer. In terms of the common pathways, what we know is the WNT pathway specifically is involved in the development and progression of colon cancer and rectal cancer. In the gene signature that we identified, six of the genes are involved in the WNT pathway. So, the question is whether the WNT pathway is also involved in radiation resistance in rectal cancer.
Q: Rectal cancer has been steadily increasing in the younger population. Do we know why that may be happening?
Dr. Aoun: An increasing number of younger patients are being afflicted with colorectal cancer and we don’t fully know why. There are lots of different theories about diet, lifestyle, and the microbiome (i.e. the bacterial content in the colon and rectum). This is a hot area of research and many groups are trying to figure out this question.
Improving Colorectal Cancer Screening Rates in Mississippi
In past years, the rate of colorectal cancer (CRC) has become a serious public health problem in Mississippi. A study conducted in 2020 showed that Mississippi had one of the highest mortality rates from CRC as well as one of the CRC lowest screening rates between 2015 and 2019. The state also leads the nation in cardiovascular disease mortality rates as well as diabetes mortality. These are both known comorbidities for many types of cancers, including CRC.
One theory as to why the screening rates are so low in Mississippi is that about 55% of the state’s population resides in rural locations, which may make it hard for some individuals to access regular medical care. The rural population in Mississippi has a high rate of uninsured individuals making it hard for this population to afford regular screenings. In 2016, 14% of the population under 65 were uninsured.
Another theory as to why CRC rates are so prevalent in Mississippi is that the diet of many of the residents is high in red meat and low in fiber. This is in part due to a culture that relies on red meat and processed foods. This diet is also more prevalent in areas that have a low socioeconomic background, as it can be difficult to obtain healthy food if one lives in a food desert.
Colorectal cancer-related mortality in those over 50 (2014-2018).
Data source: https://statecancerprofiles.cancer.gov/map/map.noimage.php.
Fortunately, the Mississippi government recognized the issue and has developed a plan to help increase the screening rate of residents in Mississippi and decrease mortality rates —70X2020 was initiated in 2014. Since the start of the program, there has been an increase in individuals who got screened, specifically in minority communities. So far, screening rates have improved from 55% in 2014 to 69.9% in 2020. For white individuals there was a compliance rate of just under 70% and for black individuals there was a compliance rate of just above 70% in 2020.
From this case study, we are able to theorize that screening and diet play a crucial role in the development of CRC. We are also able to see that there is a strong correlation between screening rates and CRC mortality rates.
Researchers Focus on Equity to Improve Colorectal Cancer Screening Rates
A recent article published in the New England Journal of Medicine stressed the need to make health equity our national priority. The researchers identified significant differences in the screening rates between black and white Americans. Additionally, they found that improvements in screening rates, more timely treatments, as well as earlier detection of cancer significantly improved cancer outcomes.
The researchers evaluated the association between rates of colorectal cancer screening as well as age-standardized incidence rates between 2000 to 2019 among non-Hispanic black (hereafter black) and non-Hispanic white (hereafter white) persons 50 to 75 years of age who were members of the Kaiser Permanente Northern California (KPNC) health plan. The researchers then conducted follow-ups with participants until the age of 79 years to investigate screening patterns as well as incidence rates.
Between the years 2006 and 2008, KPNC began a population-based colorectal cancer screening program that utilized proactive mail-in fecal tests and colonoscopies upon request. The study found that screening rates for black individuals increased from 42% in 2000 to 80% in 2019 and those for white individuals increased from 40% in 2000 to 83% in 2019. The study also investigated colorectal cancer-specific mortality in both groups. Among black populations, there were 54 deaths per 100,000 in 2007, which dropped to 21 cases per 100,000 in 2019. Among white populations, colorectal cancer-specific mortality decreased from 33 per 100,00 in 2007 to 20 per 100,000 in 2019.
After evaluating the yearly trends, the researchers were able to hypothesize that one of the major reasons for this drop in incidence as well as mortality from colorectal cancer in both black and white individuals was the sustained delivery strategies across the care continuum, including advancements in prevention methods, earlier detection of treatable cancers, and more timely treatments. Overall, the results of this study showed that it is possible to increase screening and decrease the incidence and mortality of colorectal cancer when the correct methods are implemented.
Abigail Parker is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.
The Urban-Rural Divide in Colorectal Cancer Screening
Image source: anarosadebastiani (Pixaby)
Colorectal cancer and breast cancer screening programs, when implemented properly, have led to significant reduction in death. However, screening uptake varies greatly across the U.S. Rural communities, specifically in Appalachia, the Mississippi delta, frontier lands, and prairie lands face issues with access that are accentuated by poor health behaviors.
A 2021 cross-sectional study by Shete et al, which was recently published in JAMA found that urban women were significantly more likely to be adherent to colorectal cancer screening as compared to women residing in rural areas (82% vs 78%, respectively; P=.01). When they conducted a multi-variable mixed effects analysis, they found that rural women had 19% lower odds of being adherent to colorectal cancer screening guidelines.
Along with a difference in screening adherence, there was a significant difference in beliefs and understanding of cancer, health, and screening. When comparing the thoughts of women dwelling in rural vs. urban areas regarding cancer and cancer screening:
Despite the differences in beliefs and perception of cancer screening overall, rural and urban women were similarly adherent (81% vs 81%) to breast cancer screening. Here the authors hypothesize that the difference in colorectal cancer screening is likely due to the difference in screening diffusion in the rural areas.
Newer colorectal screening technologies like fecal immunochemical tests (FIT) may work better in a rural setting because rural women are 69% more likely to skip going to a doctor due to cost. Taking away the face to face component can reduce cost for insurance companies and by effect patients, which could increase screening uptake.
FIT tests can also be useful for working women. Among women over the age of 65, the adherence rate to colorectal cancer screening recommendations was significantly higher than among women ages 50-64 years. This difference in uptake due to age is likely because older/retired women do not have to take time off of work for screening tests such as a colonoscopy or a sigmoidoscopy.
Furthermore, patients with insurance were 2 to 3 times more likely to get screened, so changes in insurance care coverage—particularly, the removal of a copayment for a preventive service—through the Affordable Care Act would increase screening uptake. In order to increase rural colorectal cancer screening uptake, programs that identify and act on access issues are needed as are policies that can improve access at the local level.
Dr. Cynthia Sears Explains the Connection Between Our Diet, The Gut Microbiome and Colorectal Cancer
The Colon Cancer Foundation recently had the opportunity to speak with Dr. Cynthia Sears, Professor of Medicine and Oncology, Johns Hopkins University School of Medicine; Professor of Molecular Microbiology and Immunology at the Bloomberg School of Public Health. She is also the leader of the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins. Her current research focus is on the microbiome and how specific bacteria can contribute to colon cancer.
Dr. Sears, received her medical degree at Thomas Jefferson Medical College and completed her training in internal medicine at the Cornell Medical School, and trained in infectious diseases at The Memorial Sloan Kettering Cancer Institute and the University of Virginia. Over the past 20 years, Dr. Sears has conducted research on colonic microbiota and colon cancer, making her an expert in this field.
Q. What enticed you to start studying bacteria and the microbiome in relation to colon cancer.
Dr. Sears: I am an infectious disease doctor who got into internal medicine because of previous work I conducted. I conduct research on how the microbiome is impacted by organisms and bacteria. I am also looking at improving immunotherapy response among colon cancer patients, since, unfortunately, only 20% to 30% of colon cancer patients respond to immunotherapy—a majority of patients do not respond. I am currently working to help improve treatments for cancer patients.
Dr. Cynthia Sears
Q. Can you help us improve our understanding of the interaction between a person’s dietary habits and the gut microbiome and how it relates to colorectal cancer?
Dr. Sears: There’s been substantial research showing that diet is a major driver of the composition and function of the microbiome. Individuals who shifted from a meat based diet to a vegetarian diet can see a shift in their microbiome in the first 24 to 48 hours. This shows that we have the ability to impact our microbiome based on the foods we eat. It also shows that we all have the capacity to have a “good” microbiome. It is also important to note that each person is different in their response to a particular diet. For example, some individuals can eat ice cream and pizza and have no change in their physiology, while others may have a terrible response.
Q. Talking about the “ideal” diet, is there really an “ideal” diet? What impact does an individual’s genetics or environmental factors have on the gut microbiome?
Dr. Sears: We are not very good at targeting the individual level. As a society we can’t afford the type of testing it would require to figure out exactly what each individual should and should not be eating. We really must rely on public health and what’s best for most people. In relation to genetics, it’s published that less than 10% of the effect in our microbiome is related to our genetic makeup. There’s a lot of redundancy in the microbiome. We can have three perfectly healthy individuals and when we sequence their microbiomes, they would all look totally different. In one person a certain bug may be taking up a niche and promoting the production of short-chain fatty acids and in another individual, a totally different bug could be doing the exact same thing.
Q. There has been a lot of research comparing the Mediterranean diet with the Western Diet, with the Mediterranean diet being rich in grains, fiber, fruit, vegetables, and fish meanwhile the Western diet is high in fat and red meat. Do you have any advice for individuals on what diet they should follow?
Dr. Sears: People should try and follow a Mediterranean diet or the DASH [Dietary Approach to Stop Hypertension] diet. I’m a big fan of the idea that food is medicine.
Q. What would you like the public to know about the gut microbiome?
Dr. Sears: We are at least as many microbes as we are human cells but the microbes are just much smaller so the human cells are more evident. Microbes are critical to our overall health. Individual’s should strive to foster a good microbiome whether it’s on your skin, your mouth, or in your colon. There is also literature about the impact that exercise and physical activity can have on your gut microbiome as well as brain health and vascular health. The more an individual is focused on healthy living, the better they will be overall.
Q. What do you think is the future of this field?
Dr. Sears: The future direction in this field is immunotherapy, where we can use the microbiome as a biomarker. When you do a stool test or a plasma test the doctors will be able to tell you if you are more or less likely to respond to this therapy based on a microbial signal. This can relate to colorectal cancer because early-age onset colorectal cancer [EAO-CRC] is becoming frighteningly common but it is still rare enough that we are not doing colonoscopies on everyone under the age of 50. We can hopefully do something to see if a person is at a higher risk and then we can focus our care and try to prevent EAO-CRC.
Here are some additional resources on diet and lifestyle and how they can influence your colon health and overall wellness:
In Conversation With Dr. Rami James Aoun: Biomarkers for Radiation Response in Rectal Cancer
The Colon Cancer Foundation (CCF) spoke with Dr. Rami James Aoun, 11th winner of the Dr. Thomas K. Weber Colorectal Cancer Research Scholar Award, for his work looking at biomarkers of radiation response in rectal cancer patients. He is a surgical resident at The Ohio State Wexner Medical Center. Instituted in 2011 by CCF and the Society of Surgical Oncology to recognize translational research focused on the molecular biology of colorectal cancer, the award was renamed in 2020 to honor CCF’s founder, the late Dr. Thomas K. Weber.
Born in West Palm Beach, Florida, Dr. Aoun was raised in Beirut, Lebanon, where he was a student at the American University of Beirut. After completing his undergraduate years and medical school, Dr. Aoun joined Columbia University in New York where he received a Master of Public Health degree in Healthcare Management and Policy. As part of his ongoing residency at The Ohio State Wexner Medical Center, he is completing a research fellowship with Dr. Matthew Kalady, a colorectal surgeon at The James Cancer Center.
Dr. Rami James Aoun
Q: What motivated you to work in the oncology research space, and colorectal cancer in particular?
Dr. Aoun: I am motivated to work in oncology research because I have seen some of my own family members suffer from cancer. However, what specifically interests me in colon cancer research are the patients that I encounter here at The James Cancer Center and my mentors. Their guidance when I was a junior resident was extremely important to set the direction for me as a future colorectal surgeon. That’s how I met Dr. Kalady, and now I am a part of his lab conducting research on colorectal cancer, with the goal of improving patient care outcomes.
Q: Can you summarize the significance of your findings for which you have received this award? Can you also share the prior work or observations that laid the foundation for this project?
Dr. Aoun: We observed a difference in how patients with rectal cancer reacted to neoadjuvant radiation therapy. Some of the patients who were exposed to neoadjuvant therapy had a complete response—the cancer disappeared. However, there were patients who had almost no response to the therapy. The response can be determined and graded by examining the tumor under a microscope. Patients who had a better response end up living longer without cancer.
We sought to identify the reason certain cancers responded to neoadjuvant radiation and certain cancers did not. To do that, we tried to understand these cancers at the genetic level by studying how a rectal cancer expressed particular genes, as measured by mRNA. By comparing the gene expression in both, patients who responded to radiation therapy and those who did not, we were able to obtain a gene signature that helps us identify patterns of gene expression that are different between responders and non-responders.
While this is just a starting point, it can help us develop a more predictive model to use clinically. Once we validate this model, we could be able to distinguish between a responder and non-responder to radiation based on the gene expression that we obtained from their biopsies even before any treatment is administered. This would allow us to provide individualized patient-specific therapy and avoid any unnecessary treatments and procedures.
We also think that certain genes in this signature can be further studied to see if they might be able to be blocked or changed to improve the response to treatment.
Q: What was the size of your current cohort and what is the ‘n’ that you are looking for to be able to validate your study results?
Dr. Aoun: Our ‘n’, or sample size, was 33 patients for this study. In genetic studies like this, it is difficult to design a statistical power needed to validate, but we hope to test this in about 100 different patients.
Q: Did you see any commonality in the gene signatures between rectal cancer and colon cancer?
Dr. Aoun: The gene signature we investigated was related to radiation resistance in rectal cancer, whereas colon cancer is not usually treated with radiation therapy. So, we did not study this for colon cancer. However, some of the pathways we identified are known to be relevant to colon cancer. In terms of the common pathways, what we know is the WNT pathway specifically is involved in the development and progression of colon cancer and rectal cancer. In the gene signature that we identified, six of the genes are involved in the WNT pathway. So, the question is whether the WNT pathway is also involved in radiation resistance in rectal cancer.
Q: Rectal cancer has been steadily increasing in the younger population. Do we know why that may be happening?
Dr. Aoun: An increasing number of younger patients are being afflicted with colorectal cancer and we don’t fully know why. There are lots of different theories about diet, lifestyle, and the microbiome (i.e. the bacterial content in the colon and rectum). This is a hot area of research and many groups are trying to figure out this question.
mt-sDNA is More Cost-Effective than FIT or FOBT for Colorectal Cancer Screening
A study published in the Journal of Medical Economics simulating a cohort of one million Medicare patients—US adults aged 65 years and older—with average risk of colorectal cancer, investigated the cost-effectiveness of non-invasive fecal tests (fecal immunochemical test (FIT), fecal occult blood test (FOBT), and multi target stool DNA test (mt-sDNA)). The researchers used the Colorectal Cancer and Adenoma Incidence and Mortality Microsimulation Model (CRC-AIM) with test-specific adherence data to estimate the cost-effectiveness of the various options.
Assuming 100% adherence follow-up colonoscopies and using real-world screening adherence data, the researchers found that mt-sDNA was cost-effective when compared to FOBT but not FIT. Cost-effectiveness was defined at the $100,000/quality adjusted life-year (QALY) threshold.
The assumption of100% adherence to follow-up colonoscopies is not a significant limitation to this study because this is just one scenario and also because follow-up colonoscopies are covered under Medicare. Since follow-up colonoscopies are covered under Medicare there is not a financial disincentive to get a colonoscopy and therefore most people under Medicare do get the colonoscopy. Moreover, when the authors ran the model using real-world follow up-colonoscopy and screening adherence rates, they found that mt-sDNA was even more cost-effective:
Generally an incremental cost-effectiveness ratio (ICER) of less than $100,000 is considered good value, and those under $61,000/QALY is considered cost-effective. Therefore, when real-world adherence rates were considered, mt-sDNA was the more cost-effective option compared to both FIT and FOBT and resulted in greater reductions in CRC incidence and mortality.
Cost-effectiveness analyses are important for determining which screening test performs better than the others, and where to relocate resources to achieve the best health outcomes for the lowest possible cost. These types of studies on Medicare populations are important because they help policy makers make informed decisions on resource allocation.
Gargi Patel is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.
A Note from Nick Weber on Saving Lives from Colon Cancer
My late father Dr. Thomas Weber founded the Colon Cancer Foundation (CCF) because he recognized the power of preventing colorectal cancer and diagnosing it early through screenings. The screenings identify precancerous polyps and early stage growths that doctors can remove.
The CCF has now led the mission of raising awareness and increasing screenings for 19 years.
As we enter Colorectal Cancer Awareness Month in March, you can take direct action today to solve the colorectal cancer problem and save lives:
Talk to your doctor about getting a colonoscopy if you are 45 years or older. If you are younger than 45 but have one or more family members that were diagnosed with colorectal cancer, ask your doctor if you should start screening earlier.
Participate and help increase visibility for CCF’s awareness campaigns and fund colorectal cancer screenings.
Donate Now: The funds collected through your fundraising efforts enable us to reach more people with life saving public awareness, prevention, and research programs.
Two Reasons to Show Your Support
Reason #1: Screenings were down due to COVID-19 but are beginning to pick up again. That’s great news, but it is critical that colonoscopy rates grow past pre-pandemic levels to save lives.
Reason #2: Deaths from colorectal cancer in people ages 0-49 are increasing. Educating our friends and family with high risk factors can help identify and treat the disease in young people.
CCF’s March Awareness events, tools, and resources are designed to maximize the impact of your donations.
Thank you for taking action!
Sincerely,
Nick Weber
P.S. Your support, plus our ongoing work to mobilize the medical community to address colorectal cancer in young people with the Early-Age Onset Colorectal Cancer Summit, will make a difference!
Healthy Inside and Out: How Diet and Lifestyle Impact Colorectal Cancer
Diet and lifestyle play a large role in colorectal cancer (CRC) prevention and prognosis. Dietary factors such as consumption of meat, sugary drinks, and alcohol, and lifestyle factors such as western diet patterns, being overweight or obese, physical inactivity, and smoking can add to the risk of CRC.
Diet and the Risk of CRC
A systematic review of multiple research studies has shown that a diet high in red and processed meats and low in fiber is a prominent risk factor for CRC and can lead to DNA damage, gut epithelial damage, cell proliferation, and genotoxicity from the nitrates that are added as a preservative. A diet high in red meat and processed food can be damaging for CRC patients and survivors and can increase the risk of mortality.
Including fiber, vegetables, and fruits in the diet is definitely healthy and can also prevent CRC. The Mediterranean diet—which includes fruits, vegetables, fish, and whole grains is a healthy preventive option to adopt in your food habits.
Research also points to a significant relationship between the consumption of processed meat and the development of early-age onset CRC (EAO-CRC), which developed among those younger than 50 years. A rapidly rising cancer across the globe, about 20% of EAO-CRC cases can be attributed to family history, and the remaining to other factors including diet and lifestyle.
Lifestyle Habits and the Risk of CRC
It is a well-known fact that a healthy lifestyle promotes health and well-being, while an unhealthy lifestyle can lead to health problems. Physical activity is important for overall health and studies point to physical inactivity and a sedentary lifestyle as major risk factors for CRC. Women who reported little to no physical activity after the age of 20 had a heightened risk of developing EAO-CRC.
Reduced physical activity can contribute to several different health problems, the most evident being obesity. Obesity modifies the gut microbiota leading to an increase in inflammation that damages the intestinal barrier. Obese and overweight individuals have a 42% higher risk of developing EAO-CRC than those at a healthy weight (an individual is considered to be a healthy weight if their BMI is between 18.5 and 24.9). There is also a correlation between obesity and the development of metabolic syndrome, which is a combination of multiple conditions that increase the risk of heart disease, stroke, and diabetes. Metabolic syndrome has been identified as a leading comorbidity in the development of EAO-CRC.
Smoking is also a significant risk factor in multiple cancers including CRC. Current smokers are at a higher risk of developing EAO-CRC, while past smokers may find their risk reduced.
It is important to understand the significant role of diet and lifestyle in disease development. Maintaining a healthy diet, such as increasing fruit, vegetable, and fiber intake as well as decreasing one’s consumption of red meat, processed meat, and sugary beverages can prevent CRC. This, coupled with a healthy and active lifestyle can significantly reduce the risk of developing CRC.
Abigail Parker is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.
How Bourbon Enthusiasts Support Colorectal Cancer Awareness
In 2013, The Bourbon Mafia was formed when a group of bourbon enthusiasts and industry professionals came together in their search for rare bourbon. About a year in, they realized that they could utilize their platform to raise money for causes that are near and dear to their hearts. With 42 members spanning 11 U.S. states, and two members in Australia, the organization has raised approximately $150,000 since 2014 for various charities, including the Colon Cancer Foundation (CCF). The Bourbon Mafia raises money through events, including bourbon raffles, dinners, and bottle auctions.
Brian Gelfo, one of the founding members and the treasurer and secretary of the Bourbon Mafia, spoke with the Colon Cancer Foundation about their organization’s motivation for donating to CCF. Omar Marshall was one of the first classes brought into The Bourbon Mafia. Following his diagnosis of colorectal cancer (CRC) in 2020, he and his wife, Pam Marshall, decided they wanted to raise awareness around this disease. The initial goal of The Bourbon Mafia was to donate in his honor while Omar was still with them. Unfortunately, Omar lost his battle with CRC on January 18, 2021.
Robert Diaz (second from left) receiving a donation from The Bourbon Mafia on behalf of the Colon Cancer Foundation.
Nevertheless, a $30,000 donation was made to CCF in April 2021. Before Omar passed, he participated in a selection of a Four Roses Bourbon barrel that would be used for the donation. Mr. Gelfo highlighted an impactful statement by Robert Diaz who represented CCF at the engagement event: “This $30,000 donation can fund 1,000 colon cancer screenings.” Members of The Bourbon Mafia were gratified that their efforts could impact the lives of a thousand people. “Even if one finds out early and gets treated, it’s well worth it,” Mr. Gelfo said.
According to Mr. Gelfo, many members in the bourbon industry, including fans and supporters, are predominantly older men. Through these events, The Bourbon Mafia hopes to raise awareness in the community for them to get screened.
This year, their event was held on 25th February, 2022, in Louisville, Kentucky, where they expected to raise a minimum of $10,000. Barrels will be hand selected from Starlight Distillery and guests will receive a sample of bourbon, a beer, and a bottle of bourbon to take home. Silent auction items will be donated by Mrs. Marshall and the family as well as other distilleries.
Mr. Marshall was buried on the farm under an oak tree from where he can watch over the farm, as he always wanted to. Mrs. Marshall emphasized the importance of early detection and being proactive for any type of cancer. “The Bourbon Mafia and bourbon itself has brought me into contact with so many wonderful people who share the same passion for bourbon and helping others,” she said.
Kenadi Kaewmanaprasert is an intern with the Colon Cancer Foundation.
Have You Had Your Fiber Yet? Food Habits and the Risk of Colorectal Cancer
We learn time and again that prevention is the best medicine, and this holds true for colorectal cancer (CRC). It is estimated that 50% of CRC cases can be prevented with diet and lifestyle modifications. Previous studies that looked at the relationship between CRC development and nutrition concluded that there is a strong correlation between diet and the development of certain types of cancer, specifically CRC.
A recent study published in Preventive Medicine Reports investigated the impact that an insufficient diet plays in the development and prevalence of certain cancers as well as the effect that race and ethnicity has on diet. Wholegrains, dietary fiber, non-starchy fruits, and vegetables, dairy products, milk, cheese, dietary calcium, coffee, and calcium supplements were found to be associated with preventing cancer development. The study examined population attributable factors and the number of excessive cases diagnosed in Texas in 2015 that were attributed to an inadequate diet, defined as a diet that does not meet or conform to the national or global dietary recommendations.
With a diverse study population, the researchers had the opportunity to explore how race and ethnicity play into diet and thus contribute to the prevalence of cancers, specifically colorectal cancer (CRC).
The study found:
There has been additional research conducted to show that there is a link between dietary fiber intake, and dietary calcium intake and the prevention of CRC. Looking at the racial and ethnic difference the study found that Non-Hispanic Whites consumed higher than the recommended dietary intake of red and processed meats. While it was found that Non-Hispanic Blacks were the most likely to have insufficient fiber and calcium intake.
In the Texas population, the authors found:
The authors describe a similar correlation identified in an Australian population, where:
This study along with multiple other studies conducted in relation to dietary factors and their contribution to cancer highlight the importance of diet—especially insufficient fiber intake and excess red or processed meat intake—on overall cancer burden.
Abigail Parker is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.