Modifiable risk factors for colon cancer.
Although many mechanisms remain unclear, an outsized body of evidence indicates that several dietary and lifestyle factors are likely to possess a serious influence on the danger of carcinoma . Physical inactivity, excess weight , and a central deposition of adiposity are consistent risk factors. Overconsumption of energy is probably going to be one among the main contributors to the high rates of carcinoma in Western countries. Beyond their influence on energy balance, the independent role of specific macronutrients remain controversial. Red meat, processed meats, and maybe refined carbohydrates contribute to risk. Recent evidence indicate that chronic hyperinsulinemia may increase risk of carcinoma . As insulin resistance and subsequent hyperinsulinemia is induced by excess energy intake and a few aspects of the Western diet (e.g., saturated fats and refined carbohydrates), insulin could also be attention of things influencing carcinoma risk. [1]
Insulin and colon cancer
Some factors associated with Westernization or industrialization increase risk of carcinoma . it’s believed widely that this increase in risk is said to the direct effects of dietary fat and fiber within the colonic lumen. However, the fat and fiber hypotheses, a minimum of as originally formulated, don’t explain adequately many emerging findings from recent epidemiologic studies. an alternate hypothesis, that hyperinsulinemia promotes colon carcinogenesis, is presented here. Insulin is a crucial protein of colonic epithelial cells and may be a mitogen of tumor cell growth in vitro. Epidemiologic evidence supporting the insulin/colon-cancer hypothesis is essentially indirect and supported the similarity of things which produce elevated insulin levels with those associated with carcinoma risk. [2]
Inflammation and Colon Cancer
The connection between inflammation and tumorigenesis is well-established and within the last decade has received an excellent deal of supporting evidence from genetic, pharmacological, and epidemiological data. Inflammatory bowel disease is a crucial risk factor for the event of carcinoma . Inflammation is additionally likely to be involved other sorts of sporadic also as heritable carcinoma . The molecular mechanisms by which inflammation promotes cancer development are still being uncovered and will differ between colitis-associated and other sorts of colorectal cancer. Recent work has elucidated the role of distinct immune cells, cytokines, and other immune mediators in virtually all steps of colon tumorigenesis, including initiation, promotion, progression, and metastasis. These mechanisms, also as new approaches to prevention and therapy, are discussed during this review. [3]
Tumor sidedness influences prognostic impact of lymph node metastasis in colon cancer patients undergoing curative surgery
This study aimed to guage prognostic impacts of the amount of lymph nodes (LNs) examined and LN ratio on cancer-specific mortality after surgery in patients with right-sided carcinoma (RCC) or left-sided carcinoma (LCC) using the Surveillance, Epidemiology, and End Results database. Number of LNs examined and LN ratio were treated as categorical and/or continuous. Competing risks proportional hazards regressions adjusted by propensity score were performed. All included patients had stage I, II, or III disease, and 45.1% of them had RCC. RCC and LCC patients with high level of LNs examined had better prognosis after segmental resection or hemicolectomy. RCC and LCC patients with higher LN ratio had worse prognosis no matter surgery. Survival advantage of having high level of LNs examined was observed in RCC patients with stage I, II, or III disease, but only in LCC patients with stage II disease. [4]
An Unusual Cause of Upper Gastrointestinal Bleeding in Clinical Practice; A Case Report of Locally Invasive Colon Cancer with Superimposed Actinomycosis
Background: carcinoma commonly presents with lower gastrointestinal bleeding in symptomatic patients. Upper gastrointestinal bleeding as a symbol of carcinoma is unusual. This case highlights the diagnostic and management challenges of carcinoma masquerading as peptic ulcer with a bleeding complication.
Case Presentation: We report the case of a 45-year-old man who presented with passage of melaena stools with associated epigastric pain. Endoscopy revealed peptic ulcer within the greater curvature. Histopathology identified a diffuse adenocarcinoma with superimposed actinomycosis. Intra-operatively the patient was found to possess a carcinoma of the colon diffusely infiltrating and ulcerating the stomach in its greater curvature. Patient died from bilateral pulmonary thromboembolism 10 weeks after the surgery. [5]
Reference
[1] Giovannucci, E., 2002. Modifiable risk factors for colon cancer. Gastroenterology Clinics of North America, 31(4), (Web Link)
[2] Giovannucci, E., 1995. Insulin and colon cancer. Cancer Causes & Control, 6(2), (Web Link)
[3] Terzić, J., Grivennikov, S., Karin, E. and Karin, M., 2010. Inflammation and colon cancer. Gastroenterology, 138(6), (Web Link)
[4] Tumor sidedness influences prognostic impact of lymph node metastasis in colon cancer patients undergoing curative surgery
Hsin-Wu Lai, James Cheng-Chung Wei, Hung-Chang Hung & Chun-Che Lin
Scientific Reports volume 9, (Web Link)
[5] Awuku, Y. A., Nartey, Y. A., Lovi, J. I., Nortey, M., Morna, T. M. and Akakpo, P. K. (2017) “An Unusual Cause of Upper Gastrointestinal Bleeding in Clinical Practice; A Case Report of Locally Invasive Colon Cancer with Superimposed Actinomycosis”, Journal of Advances in Medicine and Medical Research, 20(12), (Web Link)