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Colon cancer screening in high-risk population

ABSTRACT: Intervention 1: Intervention includes below: •Tailored massages via phone counseling •Interactive and in-person counseling about screening barriers •Individualized motivational interview •Consequent Follow-up reminder calls. Intervention 2: One parallel control group of usual care will be designed in this study. That is, counselees (index patients or FDRs) in control group will receive a simple doctor recommendation that screening is necessary should be done in FDRs, and that they better to inform their FDRs, as happened in routine care, the main source of recommendation is doctor’s recommendation. Usually index patients during their treatment are informed by doctors about the risk of developing cancer in their relatives and the significance of screening or early detection among their relatives.;Early detection;Early detection;Intervention includes below: •Tailored massages via phone counseling •Interactive and in-person counseling about screening barriers •Individualized motivational interview •Consequent Follow-up reminder calls;One parallel control group of usual care will be designed in this study. That is, counselees (index patients or FDRs) in control group will receive a simple doctor recommendation that screening is necessary should be done in FDRs, and that they better to inform their FDRs, as happened in routine care, the main source of recommendation is doctor’s recommendation. Usually index patients during their treatment are informed by doctors about the risk of developing cancer in their relatives and the significance of screening or early detection among their relatives. Primary outcome(s): Screening Colonoscopy. Timepoint: 0, 6months follow-up. Method of measurement: Colonoscopy report verification. Study Design: Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Screening.

DISEASE(S): C18, C19,Malignant Neoplasm Of Colon, Malignant Neoplasm Of Rectosigmoid Junction, Malignant Neoplasm Of Rectum,Colorectal Cancer

PROVIDER: 2486459 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Background: Extra-articular manifestations of rheumatoid arthritis (RA), potentially due to systemic inflammation, include cardiovascular disease and sarcopenic obesity. Adiponectin, an adipose-derived cytokine, has been implicated in inflammatory processes in RA, but little is known regarding its association with inflammation in a pre-clinical period. Therefore, we investigated whether adiponectin was associated with inflammatory markers in individuals at risk for RA, and whether RA-related autoimmunity modifies these associations. Methods: We analyzed samples from 144 first-degree relatives (FDRs) of RA probands, of whom 23 were positive for anti-cyclic citrullinated peptide antibody and/or ≥ 2 rheumatoid factor isotypes (IgM, IgG or IgA). We called this phenotype the ‘high risk autoantibody profile (HRP)’ as it has been shown in prior work to be >96% specific for future RA. We measured adiponectin, cytokines/chemokines, and high-sensitivity C-reactive protein (hsCRP). Using linear mixed effects models, we evaluated interaction between HRP positivity and adiponectin on inflammatory markers, adjusting for age, sex, ethnicity, body mass index, pack-years smoking, and use of cholesterol-lowering medications. Results: In everyone, adiponectin concentration was inversely associated with hsCRP and IL-1b in adjusted models, where a 1% higher adiponectin was associated with a 26% lower hsCRP (p=0.04) and a 26% lower IL-1b (p=0.04). Significant interactions between HRP and adiponectin for associations with GM-CSF, IL-6, and IL-9 were detected in fully adjusted models (p=0.0006, p=0.006, p=0.01, respectively). In HRP positive FDRs but not HRP negative FDRs, a 1% higher adiponectin was associated with 97% higher GM-CSF, 73% higher IL-6, and 54% higher IL-9 concentrations. Conclusions: Adiponectin associates with inflammatory markers, and these associations differ in individuals with a high-risk autoantibody profile compared with those without. The interaction between adiponectin and autoimmunity may occur systemically, rather than at the joint, which may provide insight into the systemic effects of RA-related autoantibodies and inflammation in the absence of clinically apparent RA.

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Colon cancer screening in high-risk population

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