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Take a look at a selection of our recent media coverage:

Overall uptake of CT colonography screening low but higher among ethnic minorities

6th May 2022

The nationwide use of CT colonography is low but appears to be higher among individuals from an ethnic background compared with their White counterparts, according to the results of a cross-sectional survey by researchers in the US.

Globally, cancer of the colon and rectum (colorectal cancer) was diagnosed in 1.93 million people in 2020 and responsible for 916,000 deaths. Moreover, screening colonoscopy has been shown to be associated with a substantial decreased mortality risk. CT colonography (CTC) is a minimally invasive test that uses CT scans to check the colon and rectum. In a 2008 study, the authors concluded that CTC screening identified 90% of subjects with adenomas or cancers measuring 10 mm or more in diameter and that the results augmented published data on the role of CTC in screening patients with an average risk of colorectal cancer. However, to date, there is limited information on the sociodemographic factors that might influence uptake of CTC.

For the present investigation, the researchers turned to the National Health Interview Survey (NHIS), which is a nationally representative cross-sectional survey and used data collected in 2019. Included participants were aged 50 to 75 years of age and with no recorded history of colorectal cancer. In the NHIS survey, individuals were asked about whether or not they ever had a CTC and if they responded positively, when the scan had been performed. The researchers collected additional information on age, gender, ethnicity and employment status. They employed multiple variable logistic regression to evaluate predictors of CTC use.

Predictors of CTC utilisation

A total of 13,709 individuals with a mean age of 61.4 years (52.7% female) were included in the analysis, of whom, 70.3% were White, 10.4% Black and 12.1% Hispanic.

In total, only 1.4% of participants reported having previously undergone CTC and, of these, 39.9% had the procedure within the last 12 months.

When analysing the association between CTC use and ethnicity, Hispanic individuals were more than twice as likely to undergo CTC compared with White participants (OR = 2.67, 95% CI 1.66 – 4.29, p < 0.001). There was also a similarly higher use among Black individuals (OR = 2.47, 95% CI 1.60 – 3.82, p < 0.001) than White participants.

Among the other sociodemographic factors examined, only participants who reported that they worked in the last week were significantly less likely to have a CTC (OR = 0.61, 95% CI 0.40 – 0.94, p = 0.024).

One limitation recognised by the authors was how the study data were collected in 2019 prior to the COVID-19 pandemic and therefore they were unable to assess any potential impact on CTC uptake. They concluded that strategies improving access to CTC services could mitigate the observed racial disparities.

Citation
O’Connor B et al. Predictors of CT Colonography Use: Results From the 2019 National Health Interview Cross-Sectional Survey J Am Coll Radiol 2022

Study provides insight into how aerobic exercise might reduce colon cancer cell proliferation

13th April 2022

Aerobic exercise induces interleukin-6 and suppresses a marker of DNA damage, offering insight as to how it could reduce the risk of colon cancer

Aerobic exercise increases expression of interleukin-6 (IL-6) and suppresses the level of γ-H2AX, a marker for DNA damage, in a colon cancer cell line, providing a possible explanation as to how exercise reduces the risk of colon cancer. This was the conclusion of a study by a team from the School of Biomedical, Nutritional and Sport Sciences, Newcastle University, Newcastle upon Tyne, UK.

In 2020, globally, colon cancer was responsible for over 1.9 million cases and 0.9 million deaths. Moreover, there is evidence that physical activity reduces cancer risk and in 2018, the American physical activity guidelines advisory committee concluded that there is now strong evidence that physical activity lowers the risk of seven types of cancer (namely colon, breast, kidney, endometrium, bladder, and stomach cancer, and oesophageal adenocarcinoma) although this evidence is derived from epidemiological studies. Aerobic exercise is a form of physical activity and an accumulating body of evidence suggests that the incubation of cancer cells with post-exercise serum can have powerful effects on key hallmarks of cancer cell behaviour in vitro. In fact, a 2020 systematic review concluded that the transient serological responses to acute exercises reduce cancer cell growth, although many questions remain regarding the underlying mechanistic pathways and potential effect modifiers. Nevertheless, while the evidence suggests a beneficial effect on cancer risk, in order to achieve a better understanding of how aerobic exercise affects the biological processes involved in cancer, requires comparison with a control group.

For the present study, the UK team recruited men with lifestyle risk factors for colon cancer e.g., older than 50 years of age, with a body mass index (BMI) > than 25 or a waist circumference > 94 cm and who did not engage in > 30 minutes of moderate physical activity at least 3 days/week over the previous 3 months. The same participants served as their own control and undertook aerobic activity (6 x 5 minutes of cycling) and a control intervention (60 minutes of a quiet rested sitting), which was separated by a period of 2 to 7 days. The team used LoVo cells, which served as a model of colon cancer and the primary outcome of the study was the mean difference in LoVo cell proliferation between exercise and control conditions. A total of 7 cytokines were quantified including interleukins (IL-) 6, 8 and 10 as well as markers of DNA damage such as γ-H2AX, were assessed.

Aerobic exercise and LoVo cell response

A total of 16 men with a mean age of 60 years and mean BMI of 29.9 were included in the study.

After stimulation of the LoVo cells with post-exercise serum, there was a decrease in cell proliferation compared to pre-exercise serum (-4.2%, 95% CI -6.8 to -1.5%, p = 0.006). In contrast, during the control period, there was a post-control increase in cell proliferation compared to pre-control serum (5.4%, 95% CI 2.2 to 8.6%, p = 0.003). After adjustment for pre-values, the authors calculated that exercise-conditioned serum reduced cell proliferation compared to control by 5.7% (95% CI -8.8 to -2.6%, p = 0.002).

Turning to changes in biological markers, the researchers found that exercise reduced levels of γ-H2AX by 24% (p = 0.029) which reflected a decrease in DNA damage. In addition, the acute bout of aerobic exercise only significantly increased expression of one marker, IL-6, by 24.6% (p = 0.002).

The authors concluded the increased IL-6 expression may help explain the observed benefits of aerobic exercise in epidemiological studies and could account for why exercise helps to reduce colon cancer risk.

Citation
Orange ST et al. Acute aerobic exercise‐conditioned serum reduces colon cancer cell proliferation in vitro through interleukin‐6‐induced regulation of DNA damage Int J Cancer 2022