By Deepthi Nishi Velamuri

Colon cancer is the third most common cancer in the U.S., and early detection is essential for improving survival rates. Colon capsule endoscopy (CCE) is a minimally invasive procedure that uses a small camera to examine the colon. It is a good alternative to colonoscopy for people who are unable to undergo traditional colonoscopy, such as those who are obese or have a history of bowel obstruction.

However, CCE can be time-consuming and labor-intensive to analyze. This is where artificial intelligence (AI) can help. AI-powered software can be used to automatically analyze CCE footage, identify potential polyps, and flag them for further review by a doctor.

A study published in the journal Colorectal Disease found that AI-powered software was able to detect polyps with a high degree of accuracy. The study also found that AI-powered software could reduce the time required to analyze CCE footage by up to 70%.

These findings suggest that AI-powered software could make CCE a more feasible option for wider use. This could lead to earlier detection of colon cancer and improved survival rates.

Here are some of the benefits of using AI-supported footage analysis in CCE:

  • Increased accuracy: The software can identify polyps with a high degree of accuracy, even those that are small or difficult to see.
  • Reduced time: The software can reduce the time required to analyze CCE footage by up to 70%. This frees up time for doctors to focus on other tasks, such as providing patient care.
  • Improved patient experience: The software can make CCE a more comfortable and convenient procedure for patients. This is because patients do not have to undergo sedation or gas insufflation, and they can return to their normal activities sooner.

Overall, AI-supported footage analysis is a promising approach for improving the accuracy, efficiency, and patient experience of CCE. It is a technology that is worth watching as it continues to develop.

 

Deepthi Nishi Velamuri is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Image by Gerd Altmann from Pixabay

Nutrition & Colorectal Cancer Prevention Series: Blog 2

The first installment of this blog series provided an overview of the molecular pathways that enable dietary interventions to prevent and reduce the spread of colorectal cancer (CRC) cells in the body. These pathways have laid the foundation for this week’s installment: addressing the systemic barriers that prevent individuals from accessing the nutrition they need to reduce CRC risk. 

Connecting the Dots: Access, Healthy Food, and CRC

The link between food deserts (areas with limited access to low-cost yet nutritious food) and health outcomes is well established. Like most health disparities in the U.S., black, brown, and low-income communities are more likely to live in locations with sparse options for fresh, healthy dietary choices. Individuals living in these food deserts often need to drive an extended distance to access fresh fruits and vegetables, as the options near their residences are canned, frozen, or unavailable. Additionally, food swamps are similarly deficient in healthy nutritional options but are marked by a high ratio of fast food to fresh food options. Lack of proximity to fresh and less processed foods contribute to the social determinants of health and make it far more difficult for individuals in these communities to engage in proactive prevention. 

In an article published in May of this year, researchers explored the epidemiologic links between counties with high food desert and food swamp scores and obesity-related cancer mortality rates. Individuals residing in counties with high food swamp scores were found to have significantly (77%) higher odds of obesity-related cancer mortality. The authors similarly identified a positive dose-response relationship between obesity-related cancer mortality and food desert and swamp scores. 

Improving Access to Fresh Foods in These Communities

While individuals living in these geographic locations have substantial barriers, local organizations can help provide services that bridge the gap. Many local food pantries have developed programs to bring fresh foods to communities in need. Volunteers will pack pre-selected boxes of fresh ingredients and set up a free farmer’s market in a community that lacks access to those ingredients, eliminating the transportation barrier and making dietary prevention, or the process of maintaining a balanced and nutritious diet to prevent disease, a more accessible goal. 

Feeding America has an online tool that locates mobile food pantries with a click and a zip code. Local food pantries may also provide delivery services to elderly or disabled individuals, so check in with your local organization to learn more!

Emma Edwards is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Picture credit OpenClipart-Vectors from Pixabay.

By Deepthi Nishi Velamuri

When someone you care about is diagnosed with colorectal cancer (CRC), it impacts the entire family. Taking on the role of caregiver can greatly affect your physical, mental, and emotional health. That’s why it’s so important for caregivers to have access to support and resources. This article summarizes information and services available specifically for those who provide care to CRC patients.

Understanding Caregiver Burden

  • Up to 90% of CRC patients rely on at least one caregiver for assistance with medical care and daily activities.
  • Common challenges faced by caregivers include disrupted sleep, poor diet, less exercise, and worsening health 
  • Major sources of caregiver strain include managing distressing symptoms, navigating complex healthcare, fulfilling practical duties, and processing difficult emotions
  • Identifying caregivers at high risk for burden and providing support early on is crucial for their wellbeing and ability to continue caring for the patient

Types of Caregiver Support Resources

Numerous resources have been developed that can help caregivers make informed decisions. Here are example of some of these resources:

Self-Care Tips for Caregivers

  • Ask family and friends for help with tasks like meals, errands, and household chores.
  • Take breaks each day to engage in activities you enjoy, even if just for 10-15 minutes.
  • Join an online or in-person support group to exchange advice and feel less alone.
  • Don’t neglect your own medical appointments and health screenings.
  • Identify signs of burnout like irritability, sadness, fatigue and seek counseling if needed.

Deepthi Nishi Velamuri is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation. 

Image credit: Tim Goedhart on Unsplash

Nutrition & Colorectal Cancer Prevention Series: Blog 1

The link between nutrition and colorectal cancer (CRC)  prevention is well established. Researchers have found that low-inflammation diets, such as Mediterranean diets, are associated with lower risk of CRC. This study also affirmed the link between sugar intake and CRC risk, with individuals who consume beverages high in sugar being more likely to develop rectal adenomas. 

Other studies have explored the links between highly processed foods and development of colorectal adenomas. In addition to highly processed foods, canned foods have also been shown to increase risk of colorectal polyps when measured against fresh fruits and vegetables.

These associations provide evidence that a low-inflammation diet that is low in sugar and processed foods can lower the risk of developing CRC; however, there is limited research on the impact of nutritional interventions on those who are already diagnosed. 

Can Dietary Interventions Improve CRC Outcomes?

A study published earlier this year explored the answers to that very question. 

In accordance with previous research, the authors found that the Mediterranean diet was effective in reducing CRC tumor growth. The mechanisms that are responsible for this inhibited tumor cell growth include the presence of beta-carotene, which is found in a number of fruits, vegetables, and fish. When beta-carotene interacts with fibroblast activation markers, the fibroblasts repress tumor cell growth in the colon. 

Additionally, anti-inflammatory diets can suppress the growth of CRC tumors via immune system pathways. Tea polyphenols, most commonly found in green tea, add diversity to the gut microbiota by often raising short-chain amino acid levels, which in turn promotes the growth of anti-inflammatory gut bacteria. Elevated levels of these “good bacteria” help to modulate the environment within which CRC develops, and aid the immune system in preventing tumor cell growth and spread.

While it is important to understand these pathways, successful, consistent implementation of preventative diets is the key to unlocking the benefits that come from the pathways. The chart below, adapted from this study, provides a framework for workable diet and lifestyle interventions during the various stages of colorectal cancer treatment, from diagnosis to surgery. Key elements of these interventions involve exercise, protein intake, and supplementation of key nutrients such as omega-3 fatty acids. 

 

Blog 2 in this series can be found here: Tackling Fresh Food Inequality.

Emma Edwards is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

By Parker Lynch

In a recent study conducted in Korea, it was found that higher levels of alcohol consumption increase an individual’s risk of early-onset colorectal cancer (early-onset CRC), specifically distal colon and rectal cancers. Using data from the Korean National Health Insurance Service, investigators retrospectively compared the drinking habits of 5.7 million Korean adults (all younger than fifty years old) and their corresponding CRC risk. 

The study’s population was split into four groups (after being adjusted for age, sex, smoking status, exercise, income, and comorbidities): 

  1. Nondrinkers (no alcohol consumption)
  2. Light drinkers 
  3. Moderate drinkers 
  4. Heavy drinkers.

During the mean follow-up period of 7.4 years, there were 8,314 cases of early-onset CRC overall. When being compared with the light drinking group, those in both the moderate and heavy drinking categories had a significantly higher CRC risk, though the most intense discrepancy was demonstrated among men. Among men, there was a:

  • 26% increase in risk of distal colon cancer 
  • 17% higher risk of rectal cancer 
  • 29% higher risk of unspecified colon cancer when comparing the heavy versus light drinking group. 

Among women, there was a: 

  • 47% increased risk of distal colon cancer among moderate drinkers 
  • 14% reduced risk of rectal cancer among the light drinkers. 

Overall, this study provides strong evidence that higher levels of alcohol consumption can increase one’s risk of early-onset CRC. 

What Are the Implications of These Findings?

Although the aforementioned study is limited to generalizability among Korean citizens, its findings are still very important to consider when looking at the diverse American population.

In fact, the dangers of excessive alcohol use and its connection to increased CRC risk are not something that American researchers or doctors are unfamiliar with. In an article published by the Ocean Endosurgery Center, less than half of Americans are even aware that alcohol consumption has an impact on cancer risk at all. Additionally, the official Dietary Guidelines for Americans strongly suggests that men should not consume more than two alcoholic drinks per day, while women should drink no more than one. In terms of what is best for an individual’s health, researchers have determined that people really should only be drinking on special occasions.

Many Americans don’t know this information, and there must be a push for increased education and awareness so that people are able to make informed decisions about their own health. Regardless of whether or not people choose to drink after discovering the risks involved, everyone deserves to know the implications of potential lifestyle choices. 

 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

 Photo credit: CHUTTERSNAP on Unsplash

By Deepthi Nishi Velamuri

Colorectal cancer (CRC) is a disease that typically affects older adults, but it is becoming increasingly common in young adults. In fact, data indicate that 15% of patients diagnosed with CRC in the U.S. are under the age of 50 years and the mean age at diagnosis is 42.5 years.

There are a number of factors that may contribute to the rising risk of CRC in young adults. These include:

  • Changes in diet and lifestyle: Young adults are more likely to eat a diet high in processed foods and red meat, and to be less physically active than previous generations. These factors can increase the risk of developing CRC. Young adults with CRC are more likely to be obese. This suggests that obesity may be a modifiable risk factor for the disease in young adults.
  • Genetics: Some people have a genetic predisposition to CRC. If you have a family history of the disease, you are at an increased risk.
  • Inflammatory bowel disease: People with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, are also at an increased risk of CRC.

Prevention, Genetics, and Disease Outcomes

The good news is that CRC is often preventable. If you are at an increased risk, you should talk to your doctor about getting screened for the disease. Screening can help identify polyps, which are growths that can develop into cancer. If polyps are found, they can be removed before they have a chance to turn cancerous.

Young adults diagnosed with CRC are more likely to have advanced-stage disease at the time of diagnosis. This suggests that young adults are less likely to be screened for the disease—often despite showing symptoms such as rectal bleeding, abnormal or changing bowel patterns, fatigue, etc—which can lead to later-stage diagnosis and poorer outcomes.

A number of genetic mutations associated with CRC in young adults have been identified. These mutations can help identify people who are at an increased risk of the disease, and they can also be used to develop new targeted therapies.

Need for Improved Management of Young Adults

While we are still trying to understand the mechanism of CRC development in young adults, it is clear that this is a serious and growing problem. By understanding the risk factors for the disease and getting screened, young adults can protect themselves from CRC.

Here are some tips to reduce your risk:

  • Eat a healthy diet that is low in processed foods and red meat
  • Get regular exercise
  • Maintain a healthy weight
  • Don’t smoke
  • Limit your alcohol intake
  • Talk to your doctor about getting screened for CRC if you are at an increased risk

 

Deepthi Nishi Velamuri is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Fecal immunochemical testing (FIT) is a commonly used method for screening and diagnosis of colorectal cancer (CRC) in patients who are exhibiting typical signs and symptoms of the disease. FIT testing is widely used in preventing CRC as test kits can be mailed to patients to collect the sample and shipped back for laboratory analysis. This allows patients who may be ambivalent about more invasive testing to engage in a safe and effective preventative method in the comfort of their home. This form of testing, while an effective way of assessing and prioritizing patients with the highest risk, exhibits low levels of sensitivity (approximately 87%). 

Double FIT More Sensitive

In order to improve the sensitivity levels of FIT assessments, researchers from Scotland conducted two sequential, prospective cohort studies to measure and compare the sensitivity levels of both single and double FIT. Following a general practitioner referral, patients selected for the study were shipped either one or two FIT kits depending on their assigned study group, and results were analyzed following kit return. 

In the single FIT cohort, assessments were able to detect the presence of CRC with 84.1% sensitivity and advanced colorectal neoplasia with 64.4% sensitivity. These results were significantly lower than the sensitivity levels of the double FIT strategy, with this strategy being able to detect colorectal cancer with 96.6% sensitivity. Double FIT testing was also able to significantly improve detection of advanced colorectal neoplasia, with this strategy detecting disease at 81.6% sensitivity. 

This research reveals that double FIT may be an effective way to increase the accuracy of preventative testing measures, especially in symptomatic populations. 

While double FIT testing can provide increased accuracy and sensitivity when screening for CRC, obtaining two FIT submissions from patients is more difficult than obtaining a single test result. In this specific study, 22% of patients in the double FIT cohort only returned a single test, which reveals that this strategy may require innovative follow-up methods. 

A 2017 study by researchers within a hospital system in Texas found that mailed outreach literature and free testing kits increased rates of preventative screening measures, including FIT completion. In order to ensure that double FIT is an effective strategy, hospitals and clinics can develop and mail out literature that invites and encourages patients to complete two consecutive FIT’s tests. Other strategies could include social media, email, and notifications in patient portals.

 

Emma Edwards is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

By Parker Lynch

Image credit: Mary Pahlke from Pixabay

Every year, The Great Plains Colon Cancer Task Force holds a bike ride event called the “Rollin’ to Colon” to raise money and awareness towards colon cancer research within the state of Nebraska. This year, the 15th annual event was held on the morning of June 11th, and was open to riders of all experience levels and ages. 

Ten, twenty, thirty, and 53-mile routes were available to the public as well as virtual riders, who wanted to contribute to the cause from their stationary bikes at home. Every year, all proceeds from the event go towards bringing awareness to colon cancer prevention and early detection.

Fundraising for CRC: Why is it Important?

This organization is one of many that host fantastic events to support the colorectal cancer (CRC) cause. Despite the numerous array of fundraising endeavors that already exist, more can always be done to support the continuous research and development behind CRC preventative measures as well as treatment options for patients. When someone hosts a fundraiser for CRC, they are not just making monetary contributions, they are raising awareness, and in turn, saving lives. 

According to Marcline St-Germain, the operations manager for the Colon Cancer Foundation (CCF), “It’s not just about raising money. We are letting our community know about colon cancer, and that it’s not just an old man’s disease. In fact, many young people don’t know that they’re at risk themselves, and this is something that we are trying to change through fundraising events. Through these events, we’re trying to teach the community that CRC still exists, and people need to be aware of it.” 

The CCF gets creative when coming up with ways to bring CRC awareness to communities all across the U.S. The Rollin’ Colon, a pink, 20-foot long inflatable tunnel, is used as a fun and educational visual that provides important health information to those who experience it. While “walking through the colon”, people are able to learn about the signs and symptoms of CRC; they will see giant polyps, ulcerative colitis, Crohn’s disease, and the different stages of CRC. Organizations are able to request The Rollin’ Colon, which will then be shipped to them to have at their own events and/or fundraisers.

CCF also hosts the Colon Cancer Challenge, an annual event in March (perfectly lining up with Colorectal Cancer Awareness Month). This challenge gives individuals the opportunity to run/walk a 5K or walk a mile. The funds raised through this challenge are used to support CRC prevention through various measures: supporting advocacy efforts, public awareness, research, and screening.

Whether it be on an individual or company-wide level, anyone has the opportunity to start their own fundraiser to support CCF. Regardless of whether or not one has a personal connection to the colorectal community, fundraising endeavors are vital to keeping the mission alive; they are also fun, collaborative events that bring communities and people together. These fundraisers that are held for CCF as well as the donations that individuals make (regardless of how large or small they may be), have an immense impacts on the CRC community. Not only do they support the patients and their families, but they give CCF the opportunity to continue to spread preventative awareness through educational endeavors, such as sending out The Rollin’ Colon to other events.

According to Ms. St.-Germain, “Fundraising is the backbone of our foundation. Without fundraising we wouldn’t be here.”

Donate to CCF today! 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

By Deepthi Nishi Velamuri


Colorectal cancer (CRC) is a significant health concern, particularly for those with a family history of the disease. Unfortunately, many existing screening programs overlook this high-risk group. However, a recent study conducted at the University of California Los Angeles (UCLA) has introduced an innovative intervention aimed at improving CRC screening rates in individuals with a family history of CRC. 

The study was presented at Digestive Disease Week 2023.

A Game-Changing Intervention

The researchers at UCLA conducted a study within their large academic health center that already had a screening program for average-risk individuals. They aimed to engage individuals with a family history of CRC who were resistant to screening and determine the effectiveness of the intervention in increasing colonoscopies ordered, scheduled, and completed.

Study participants were divided into two groups:

  1. Group 1 received reminders to schedule a colonoscopy. The attending doctors also received a reminder.
  2. Group 2 received reminders along with educational materials on CRC risk and the colonoscopy procedure, as did their doctors.

Promising Results and Implications

The study included 150 patients, evenly divided between the two groups. The primary outcome showed that both groups had similar rates of completed colonoscopies. However, both groups experienced a significant increase in the number of colonoscopies ordered, scheduled, and completed.

The multicomponent intervention successfully engaged high-risk individuals who had been hesitant about CRC screening. The combination of reminders for doctors and patients proved effective in increasing screening rates. Surprisingly, the additional educational materials did not significantly impact outcomes, suggesting that they may not be necessary in future interventions.

The study’s findings offer hope for improving CRC prevention and control in high-risk individuals with a family history of the disease. By refining and expanding this intervention, we can raise screening rates, detect CRC at an early stage, and potentially save lives.

Take Action

Regular screening is crucial for early detection of CRC. If you have a family history of CRC or are overdue for screening, consult your healthcare provider to discuss the best screening options for you. Together, we can fight CRC and make a meaningful impact on public health.

The Colon Cancer Foundation remains committed to supporting advancements in CRC prevention, early detection, and treatment. Join us in our mission to raise awareness and promote lifesaving screenings. 

Reference-
Impact of a Multicomponent Health System Intervention to Increase Colorectal Cancer Screening Participation in Patients with a Family History of Colorectal Cancer. Jain S, Galoosian A, Badiee J, Meshkat S, Popoola F; Presented at Digestive Disease Week 2023.

 

 Deepthi Nishi Velamuri is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

In a recent blog post, Parker Lynch discussed the accuracy of blood-based colon screenings that are becoming increasingly popular in colorectal cancer (CRC) prevention efforts. The non-invasive nature of these tests has the potential to improve CRC screening rates in the general population, which is becoming increasingly necessary with the rise in early-onset CRC rates. 

While these tests have high specificity and sensitivity, their newer status on the market raises questions about whether they will be covered by insurance plans for most Americans. 

At the recent American Society of Clinical Oncology meeting, researchers presented their findings on a new multi-cancer detection test that utilizes only a blood sample for cancer screening. This test is groundbreaking in its ability to quickly and accurately provide positive test results for a broad spectrum of cancers. It will be essential to cancer prevention movements in the colorectal sphere and across the board. 

While these new tests are groundbreaking for prevention efforts, ensuring that the population has equitable access to these tests will establish their validity as a public health tool. The much heralded Galleri multi-cancer detection test has a list price on the company website of $949 and states that most insurance plans do not cover it. Considering that a significant portion of Americans (40%) cannot afford to cover a $400 emergency bill, the Galleri test’s pricing and lack of coverage will create access barriers to the general American public. 

Blood-based biomarker tests specifically for detecting CRC will be more easily accessible to the public, but still can be challenging to obtain. The Centers for Medicare & Medicaid Services, for example, will cover a blood-based biomarker test every three years, for an individual who is between 45 and 85 years old, asymptomatic, and at an average risk for developing CRC. This leaves out the early-onset population (<45 years), many of whom are diagnosed at an advanced stage and may benefit from a blood-based testing approach.

To advance health equity in CRC prevention and care, these innovative new tests must become more accessible through pricing and insurance coverage. When all individuals can access high-quality cancer prevention, regardless of income or socioeconomic status, we can protect the most vulnerable members of our population. 

 

Emma Edwards is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.