bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colorectal cancer incidence in Texas border versus non-border counties.
Authors: LaPelusa Michael Brian , Machiorlatti Michael 
Published: January 2022

21 Background: There are 32 counties and 2.8 million people in the Texas border region. The population is 88.4% Hispanic with estimates that 47% lack health insurance - not including non-US citizens, who are more likely to lack health insurance than US citizens. In 2014, 7 of the 20 US counties with the lowest CRC screening rates were in Texas, 6 of which were Texas border counties. It is unknown how the incidence of CRC in Texas border counties has changed over time compared to non-border counties. In this study, we investigate changes in the incidence of CRC in Texas border counties between 2000 and 2017. Methods: Data were obtained from the Texas Department of State Health Service’s Texas Cancer Registry. Cases of patients aged 18 or older between 2000 and 2017 were included in our analysis. Cases were excluded if they contained incomplete information regarding age, sex, year of diagnosis, site of diagnosis or poverty level. Simple descriptive statistics were calculated for all covariates. Chi-square tests of independence were created to examine the association between each categorical variable and border county status. Age-adjusted incidence rates (AAIR) were created for the state overall and by border status. SAS v9.4 was used for all data analysis. Results: In border counties from 2000 to 2017, the overall AAIR decreased from 65.9 (per 100,000) to 56.7. In those 50-64 years old and 65 years and older residing in border counties, the AAIR increased from 63.3 to 78.1 and decreased from 244 to 176.1, respectively. In non-border counties from 2000 to 2017, the overall AAIR decreased from 85.2 (per 100,000) to 57.3. In those 50-64 years old and 65 years and older residing in non-border counties, the AAIR decreased from 94.9 to 78.0 and from 303 to 168.5, respectively. Conclusions: The overall AAIR of CRC was lower in Texas border counties compared to non-border counties, which is likely a consequence of lower screening rates in border counties. The overall AAIR decreased at a slower rate in Texas border counties compared to non-border counties, which may represent lower rates of utilization of CRC screening over time in border counties. The increase in the AAIR among those 50-64 years old in Texas border counties warrants further investigation.
Detection of minimal residual disease (MRD) in colorectal cancer (CRC) patients UICC stage II/III by ultra-deep sequencing of cfDNA from post-surgery plasma.
Authors: McNamara Sylvie , Patel Rajesh D. , Adams Hans-Peter , Qu Xueping , Hinzmann Bernd , Wong Cheryl V , Heilek Gabrielle , Mantke Renè , Heise Michael , Steinmüller Thomas , Pross Matthias , Marusch Frank , Bais Carlos , Palma John F. 
Published: January 2022

26 Background: Detection of primary tumor mutations in cell-free DNA (cfDNA) of post-surgery plasma of patients with R0-resected not-metastasized solid tumors is a strong indicator of recurrence of disease. We explored whether ultra-deep sequencing of cfDNA could improve sensitivity and specificity with respect to time-to-progression. Methods: 84 CRC patients UICC stage II/III were recruited into the prospective, observational study “Molecular Signatures in Colorectal Cancer”. Matched tumor tissue samples, plasma depleted blood cells (PDBC), and cfDNA (drawn 1 to 34 days after R0-resection, median 7 days) were processed with the Roche AVENIO Tumor Tissue and ctDNA Surveillance Kits*. Samples of 79 patients passed all quality controls, in particular cfDNA was sequenced ultra-deep with a median of 180 Mio. instead of 50 Mio. reads/sample. Somatic variants were identified with AVENIO Oncology Analysis software 2.0*. PDBC informed germline variants were removed. If a tissue baseline variant was detected in cfDNA with a significant adjusted p-value, the patient was defined ctDNA+, and ctDNA- otherwise. Results: 8 ctDNA+ patients (28 variants, median AF = 0.15%) were identified of which 4 had a progression of disease at two years. Sensitivity was 44% (95% CI [0.137, 0.788]), specificity was 94% (95% CI [0.86, 0.984]), positive predictive value was 50% (95% CI [0.157, 0.843]), and negative predictive value was 93% (95% CI [0.843, 0.977]). Comparison of time-to-progression of ctDNA+ and ctDNA- patients using the log-rank test resulted in a p-value of 0.0058. Comparison of survival times of ctDNA+ and ctDNA- patients resulted in a p-value of 0.0333. Multivariate analyses of times-to-progression resulted in ctDNA-status (p = 0.0022, hazard ratio (HR) = 7.098) and neoadjuvant therapy (p = 0.0010, HR = 6.618) as significant parameters. Conclusions: Even in this small cohort of CRC UICC stage II/III patients, MRD detection in post-surgery plasma is the strongest predictor of shorter time to progression. Ultra-deep sequencing of cfDNA samples did not influence MRD detection on a patient-level. *for Research Use Only; not for use in diagnostic procedures.
Colorectal cancer conversations on Twitter: A content analysis of global perceptions and outreach efforts.
Authors: Chu Alexander L. , Patel Vishal R. , Blanton Christopher J. , Gereta Sofia , Mackert Michael , Nortje Nico , Pignone Michael 
Published: January 2022

35 Background: Screening is highly effective at reducing colorectal cancer (CRC) mortality. Social media is extensively used to communicate about cancer care, yet little is known about the role of these online platforms in promoting CRC screening and early diagnosis. This study tracked Twitter discussions about CRC and characterized participating users to better understand public communication and perceptions of CRC on social media. Methods: Tweets containing references to CRC were collected from January 2020 to April 2021 using Twitter’s Application Programming Interface. Account metadata was used to predict user demographic information and classify users as either organizations, individuals, or influencers. Influencers represent high-impact users, defined by sizeable follower counts or verified Twitter status. Latent Dirichlet Allocation, a natural language processing model, was used to identify observed topics of discussion in the collected tweets. Results: There were 72,229 unique CRC-related tweets by 31,170 users. Tweets reached a daily maximum after Chadwick Boseman, a well-known American actor, died from CRC. Individuals accounted for the majority of users (62.8%); organizations (35.2%); influencers (2%). Influencers made the most median impressions (35,853 impressions). Tweets contained the following topics: bereavement (27.9%), appeals for early detection (19.4%), research (14.0%), National Colorectal Cancer Awareness Month (NCCAM) (13.7%), screening access (12.5%), and risk factors (12.4%). Tweets referencing bereavement had the most user engagement. Links to clinical trial enrollment information were the least shared type of embedded content (0.3%). Conclusions: Discussions about CRC largely focused on bereavement and early detection. Online coverage of NCCAM, personal experiences, and celebrity deaths related to CRC effectively stimulated goal-oriented tweets about early detection. Our findings suggest that Twitter may be a suitable platform for promoting and communicating future public health recommendations about CRC.
Real-world persistence and adherence with oral trifluridine/tipiracil or regorafenib in patients with colorectal cancer.
Authors: Braiteh Fadi S. , Girman Cynthia J. , Young Jessica C. , Danese Mark D. , Irwin Debra E. , Kazerooni Reza , Salimi Tehseen , Morlock Robert , Epstein Robert S. 
Published: January 2022

49 Background: Trifluridine/tipiracil (FTD/TPI) and regorafenib are among the limited treatment options in later lines of therapy for patients with advanced colorectal cancer (CRC). While these treatments have demonstrated similar efficacy, differences have been observed in tolerability and data on the impact of such differences on real-world outcomes are limited. To better understand the real world use of FTD/TPI and regorafenib in the US, we report data for adherence/persistence among patients with CRC initiating these therapies. Methods: This was a retrospective cohort study among adults with CRC identified from the IBM MarketScan Commercial Claims and Medicare Supplemental Databases, who initiated FTD/TPI or regorafenib (index) from October 2015-September 2019 and had 6 months of continuous enrollment before the index date. Follow-up was until disenrollment or end of study period. Treatment cohorts were propensity score 1:1 matched, adjusting for differences in socio-demographics, comorbidities, and other baseline characteristics. Adherence and persistence outcomes included time to discontinuation (medication gap of >45 days), medication possession ratio (MPR; number of treated days/ duration of treatment), proportion of days covered (PDC; number of treated days/ days in specified time period), and number of prescriptions received. Results: A total of 1477 patients were included: 892 initiating FTD/TPI (60%) and 585 regorafenib (40%). Demographics were similar prior to matching: mean age was 58 and 59 years, and 57% and 59% were male, in the FTD/TPI and regorafenib groups, respectively. Mean Charlson Comorbidity Index score (excluding cancer) was 0.69 for FTD/TPI initiators and 0.62 for regorafenib initiators. For the matched cohorts (n=585 in each), measures of adherence and persistence (Table) showed longer time to discontinuation (2.5 vs. 2.0 months; p<0.01), and a higher MPR (0.90 vs. 0.87; p<0.01), PDC (at 3 months, 0.74 vs. 0.63; p<0.01), and proportion of patients receiving ≥2 prescriptions (76% vs. 63%; p<0.01) with FTD/TPI vs. regorafenib. Conclusions: Results of this real-world study suggest that patients with CRC initiating FTD/TPI have improved adherence and persistence with therapy compared with those initiating regorafenib. Reasons for this difference and potential impacts on health outcomes require further study. [Table: see text]
Long-term survival outcomes following resection of lung metastases (LM) from a colorectal primary.
Authors: Ramanujam Sangeetha , Dunn Catherine , Antippa Phillip , Kosmider Suzanne , To Yat Hang , Lee Margaret , Wong Vanessa , Caird Susan , Shapiro Jeremy David , McKendrick Joseph James , Wong Hui-Li , Ma Brigette , Lim Stephanie Hui-Su , Torres Javier , Zimet Allan Solomon , Lee Belinda , Gibbs Peter 
Published: January 2022

50 Background: Liver metastatectomy in oligometastatic colorectal cancer (CRC) can result in long-term disease control1. The benefit of resecting LM is unclear, with good survival outcomes from medical therapy (MT) alone and a recent randomised controlled trial failed to demonstrate an overall survival (OS) benefit2. Methods: We examined TRACC (Treatment of Recurrent and Advanced Colorectal Cancer), a multisite registry for metastatic colorectal cancer (mCRC) patients (pts) from September 2002 – July 2021, focusing on the longer-term outcomes for pts with lung only metastatic disease (LOM). Key clinicopathological, treatment and outcome variables were analysed. Survival outcomes were determined by Kaplan-Meier method. Results: Of 3928 pts, 341 (8.7%) had LOM. The median OS was significantly improved for LOM vs. all mCRC pts (44.5 months vs. 24.8 months, p = <0.0001). Of 341 LOM pts, 142 (42%) had lung resection (LRes),128 (38%) had MT, 71 (20%) best supportive care. Key clinicopathological characteristics are summarised in Table. OS was significantly longer for LRes vs. MT (3yrs-80.1% vs. 41.9%, p = <0.0001, 5 yrs-65.2% vs. 21.1%, p = 0.0001). 10 yr survival for LRes was 50%, with no survivors from MT. The median palliative chemotherapy free interval was 13 months (95% CI 3.1 – 18.7) with recurrence after LRes/death. 20/142 (14%) of the LRes pts had recurrent LRes (median time to repeat resection of 11.4 months, median survival of 66.9 months from repeat LRes). Conclusions: LM from mCRC have an indolent course, with good survival outcomes with MT alone. LRes provides a clinically meaningful palliative chemotherapy free interval and long term survival in selected pts. Significant differences in prognostic factors may have contributed to the observed survival differences between LRes and MT. Reference Dexiang Z, Li R, Ye W, Haifu W, Yunshi Z, Qinghai y, Shenyong Z, Bo X, Li L, Xiangou P, Haohao L, Lehi Y, Tianshu L, Jia f, Xinyu Q, Jianmin X. Outcome of patients with colorectal liver metastasis: analysis of 1,613 consecutive cases. Ann Surg Oncol. 2012 Sep;19(9):2860-8. doi:10.1245/s10434-012-2356-9.Epub 2012 Apr 12. PMID: 22526903. Treasure, T., Farewell, V., Macbeth, F. et al. Pulmonary Metastatectomy versus Continued Active Monitoring in Colorectal Cancer (PulMiCC): a multicentre randomised clinical trial. Trials 20,718 (2019). https://doi.org/10.1186/s13063-019-3837-y [Table: see text]
Analysis of survival trends, clinical, and molecular characteristics of patients with early-onset colorectal cancer (EOCRC).
Authors: Soto Javier , Gutiérrez Alonso Natalia , Bringas Beranek Marianela , Catoya Villa Juan Luis , Gutierrez Ortiz de la Tabla Ana , López Jiménez Carlos , Alva Bianchi Manuel , Jiménez Rodríguez Roberto , Martín Lozano Rocío , Arregui Valles Marta , Aparicio Salcedo Inmaculada , Ortega Morán Laura , Torres Pérez-Solero Gabriela , Muñoz Martín Andrés J. , Calvo Ferrándiz Aitana , Blanco Codesido Montserrat , Martínez Delfrade Íñigo , Juliao Caamaño David Salomon , Martin Miguel , Garcia-Alfonso Pilar 
Published: January 2022

59 Background: Over the last decades the incidence of EOCRC (age 50 or less) has dramatically increased, and so has the scientific interest in this field, given that clinical and molecular characteristics in these patients are not well understood, and may be critical to identify prognostic factors. Methods: We conducted a retrospective analysis of 554 patients with metastatic colorectal cancer (mCRC), analyzing the PFS and OS of 68 (12.25%) patients with EOCRC, as well as their clinical and molecular characteristics. We used a log-rank test to compare PFS and OS, and the estimate of hazard ratio (HR) between the studied groups was calculated by means of Cox proportional hazard model. We also used the exact test of Fisher to identify significant association between categoric variants, while Mann-Whitney test was applied to identify significant differences between numeric values. Results: We performed a survival analysis: those patients with EOCRC had significantly higher median PFS in first line of treatment (16.2 vs. 11.3 months, p = 0.042) and significantly higher median OS (121.5 vs. 58.1 months, p = 0.011). Several characteristics were significantly more frequent in patients with EOCRC (n=68): BMI < 18.5 (n = 16, OR = 1.9, p = 0.046), primary tumor site at transverse colon (n = 9, OR = 2.61, p = 0.03) and ECOG 0 (n = 32, OR = 2.21, p = 0.003). Having peritoneal metastases almost reached statistical signification (n = 17, OR = 1.82, p = 0.055). Some other characteristics were less frequent: BMI 25-30 (n = 13, OR = 0.51, p = 0.046), primary tumor site at sigmoid colon (n = 14, OR = 0.49, p = 0.038) and former-smoker status (n = 7, OR = 0.44, p = 0.048). Moreover, mean values of LDH at diagnosis were significantly higher in EOCRC patients (359 U/L vs. 280 U/L, p = 0.015). EOCRC patients received a significantly higher number of lines of chemotherapy (2.94 vs. 2.38, p = 0.027) and underwent more surgeries (2,42 vs. 1.24, p < 0,001) than patients with > 50 years. Significant differences in tumor mutational status (BRAF, KRAS, NRAS, MSI, PI3K and HER2), sex, primary tumor resection or number of metastatic sites between groups were not found. Conclusions: This retrospective analysis showed that EOCRC patients had significant higher rates of PFS in first-line treatment and OS. Moreover, EOCRC patients had more frequently BMI < 18.5, primary tumor located at transverse colon and ECOG 0.
Patterns of colorectal cancer (CRC) screening rates among the average risk U.S. population.
Authors: Fisher Deborah A , Engel-Nitz Nicole , Miller-Wilson Lesley-Ann , Le Lisa , Limburg Paul J. 
Published: January 2022

65 Background: There is consensus that the proportion of the average-risk US population up-to-date with CRC screening (58-65%) is insufficient. However, estimates of average risk CRC screening rates are inconsistent and impacted by inclusion of higher-risk individuals, and differing study designs. Accurate measurement of population screening rates is key to addressing gaps in care and assessing the impact of newer CRC screening tests. Methods: The study included individuals aged 50-75 years in a large de-identified claims database, with continuous enrollment during year of analysis, and a variable length baseline enrollment of 1-10 years. Average-risk designation excluded higher risk diagnoses (CRC familial syndromes, colorectal polyp or history of colorectal polyp, history of/current CRC, family history of gastrointestinal cancer, and inflammatory bowel disease). Up-to-date status was assessed within guideline-based time periods: colonoscopy (10 years); FIT or FOBT (annually); mt-sDNA (3 years); flexible sigmoidoscopy/CT colonography (5 years). Analyses assessed the proportion estimated as up-to-date and examined the sensitivity to: a) patient population (average-risk only vs. including higher-risk); b) study design (yearly cross-sectional vs. cohort of 50-year-old patients; c) methods (percent in patients with 10 years of enrollment vs. Kaplan Meier (KM) of censored variable pre-screening period). Results: The cross-sectional analysis average-risk population included 5.3 million individuals. Estimates of the proportion of those up-to-date with screening guidelines for average-risk patients varied by study design, population, and estimation method. KM estimates among the average-risk population (50-75) showed 49-50% were up-to-date in each calendar year. Including higher-risk patients in the KM analysis resulted in 70% up-to-date among the mixed average+higher-risk population. Using a cohort study design (average-risk patients aged 60 with 10 years of baseline data), 65% were up-to-date by age 60. Conclusions: In the base case analysis only half of average risk individuals were up-to-date with CRC screening, a rate lower than typically cited. Sensitivity analyses resulted in substantially different estimates and demonstrate the importance of clearly communicating the methodology used to define the study population. Higher rates quoted in the lay press and medical publications may be based on mixed populations of average+higher-risk individuals or on study designs that do not represent the full population at risk.
Pathogenic variants among Mexican patients with colorectal cancer referred for genetic cancer risk assessment.
Authors: Rodriguez Olivares Jose Luis , Chavarri Guerra Yanin , Arteaga Jazmin , De la Mora Molina Hector , Soto Perez De Celis Enrique , Candanedo Gonzalez Fernando , Rivero García Pamela , Castillo Danielle , Weitzel Jeffrey N. 
Published: January 2022

69 Background: Lynch syndrome (LS) is the most frequent hereditary cancer syndrome among patients with colorectal cancer. Screening tests such as immunohistochemistry (IHC) for mismatch repair (MMR) proteins and PREMM5 model help to identify patients at risk of germline pathogenic variants (PVs). However, there has been a disparity in that evaluation of these screening tools and their correlation with pathogenic variants (PVs) has been limited in Hispanic populations. Methods: Patients with colorectal cancer referred for genetic cancer risk assessment were enrolled in the Clinical Cancer Genomics Community Research Network (CCGCRN) registry from October 2017 to February 2021 at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Genetic testing was performed by full sequencing of the MMR genes ( MLH1, PMS2, MSH2, MSH6 and EPCAM) and other cancer-associated genes ( APC, BRCA1, BRCA2, TP53, NF1, ATM, CHEK2, PALB2, BRIP1) and multiplex ligation dependent probe amplification to detect copy number variants (CNV) was performed for selected genes. Demographic, clinical characteristics and IHC results were obtained from clinical records. MMR PV probability was calculated using PREMM5. Results: Sixty-nine patients with colorectal cancer were included; mean age at diagnosis was 50 (26-82) years and 39/69 (56%) were women. A MMR gene PV was identified in 23/69 patients (33%); most frequently in MLH1 n = 14, followed by MSH2 n = 2, MSH6 n = 2 and PMS2 n = 1. Four recurrent PVs in MLH1 and MSH2 represented 22% of PVs. CNVs were identified in 4/23 (17.4%) patients with LS. PVs in other genes were identified in 8.6% of the cases: 2 ATM, 1 APC, 1 PALB2, 1 BRIP1 and 1 BRCA1. IHC results were available in 52/69 cases (75.4%) and MMR protein deficiency was found in 16/17 (94%) carriers and in 14/31 (45%) non-carriers (sensitivity 94.1% and specificity 54.8%). The area under the ROC curve for PREMM5 score was 0.94 (95% CI 0.88-0.99) with a mean score 31.6 (2.4-50) in patients with LS and 4.1 (0.9-50) in non-carriers. The diagnosis of a second primary colon cancer was more frequent among LS (30% vs 2.5%; p < 0.01). Conclusions: We found a high frequency of MMR gene PVs among patients referred for GCRA with personal history of colon cancer, and only a small proportion with PVs in other genes. Our results showed a good performance of PREMM5 model and a high sensitivity of MMR IHQ in a Mexican population, indicating that these are tools that can be used to prioritize patient selection for germline testing.