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July 18, 2011, 8:18 AM CT

Genetic mutations that lead to colon cancer

Genetic mutations that lead to colon cancer
Scientists at UT Southwestern Medical Center say there are at least 70 genetic mutations involved in the formation of colon cancer, far more than researchers previously thought.

Based on the study, reported in the July 2011 Cancer Research (Priority Reports), scientists are suggesting a new approach to colon cancer therapys targeting multiple genes and pathways simultaneously. Current cancer therapys target just one or two known cancer-driver genes believing this would be beneficial to patients. While patients may get transient tumor burden reduction, almost universally tumor growth returns.

The UT Southwestern research contradicts prior thinking that only a few mutated genes are important in the development of malignant tumors.

"The ways we've been treating patients up to now is to just go after one target when we should be going after three to four different pathways simultaneously," said Dr. Jerry W. Shay, vice chairman and professor of cell biology at UT Southwestern.

Under the old model, researchers believed there were 151 candidate genes and that mutations in just eight to 15 of them would lead to cancer. There were 700 other genes classified as passenger genes whose mutations were incidental to cancer growth.

"Those numbers are dead wrong," Dr. Shay said. As per UT Southwestern's research, there are 65 candidate genes and at least five passenger genes whose mutations play significant roles in cancer development. Inactivating the function of any of these tumor-suppressing genes led to a key step in cancer development called anchorage-independent growth, meaning cells piled up on top of each other rather than aligning neatly.........

Posted by: Sue      Read more         Source


July 5, 2011, 8:38 PM CT

Folate intake may reduce colorectal cancer risk

Folate intake may reduce colorectal cancer risk
A newly released study finds high folate intake is linked to a reduced risk of colorectal cancer, a finding consistent with the findings of most prior epidemiologic studies. The study is reassuring, as prior recent evidence has suggested that consumption of very high levels of folate through supplements and from folate-fortified diet may increase risk of some cancers. Nonetheless, the potential importance of folate in colorectal cancer prevention remains in question because at least one other study found folate supplementation had no effect on recurrence of colorectal adenomas, precursors to colorectal cancer.

The study appears in Gastroenterology, and is the first to look at the association of folate with colorectal cancer risk with follow-up entirely after the required fortification of the U.S. diet with folate. It also is the first to distinguish between the forms of folate found naturally in forms and folic acid, the form used for fortification and in supplements.

A research team led by Victoria Stevens, Ph.D., strategic director of laboratory services at the American Cancer Society, investigated the association between folate intake and colorectal cancer among 99,523 participants in the Cancer Prevention Study II Nutrition Cohort. A total of 1,023 participants were diagnosed with colorectal cancer between 1999 and 2007, a period entirely after folate fortification began. Neither higher nor lower risk was observed during the first two years of follow-up (1999 to 2001), but during 2002 to 2007, high folate intake was linked to a reduced risk of colorectal cancer.........

Posted by: Sue      Read more         Source


June 21, 2011, 11:45 PM CT

Marriage improves odds of surviving colon cancer

Marriage improves odds of surviving colon cancer
A newly released study shows that being married boosts survival odds for both men and women with colon cancer at every stage of the disease.

Married patients had a 14 percent lower risk of death as per scientists at Penn State's College of Medicine and Brigham Young University. That estimate is based on analysis of 127,753 patient records.

Similar to studies of other types of cancers, the scientists did find that married people were diagnosed at earlier stages of colon cancer and sought more aggressive therapy. The scientists took those and other factors into account before calculating the benefit of marriage on survival odds.

"Controlling for the stage that the cancer was detected is key," said Sven Wilson, a study coauthor and professor at Brigham Young University. "Without that, it's hard to know whether the analysis is just picking up a diagnosis effect".

Colon cancer is the fourth most common type of cancer in the United States for both men and women. Curiously, the marriage benefit seen in the newly released study was nearly identical for both men and women.

So what's driving the different survival rates? Marriage is a self-selected group, and Wilson is careful to note that the selection process makes it difficult to sort out the root cause. One intuitive idea is that spouses serve as an important informal caregiver during a critical time, and that extra support may translate into better disease management and, hence, better outcomes.........

Posted by: Sue      Read more         Source


April 4, 2011, 7:02 AM CT

Utilization of virtual colonoscopy triples

Utilization of virtual colonoscopy triples
Medicare coverage and nationwide utilization of computed tomographic colonography (CTC), usually referred to as virtual colonoscopy, has tripled in recent years, as per a research studyin the recent issue of the Journal of the American College of Radiology (www.jacr.org). CTC employs virtual reality technology to produce a three-dimensional visualization that permits a thorough and minimally invasive assessment of the entire colon and rectum. CT colonography is an alternative to conventional optical colonoscopy for colorectal cancer screening and diagnosis.

Colorectal cancer is the second leading cause of cancer deaths in the U.S. Yet, only 50 percent of the eligible population participates in colorectal cancer screening programs. Since most colon cancers develop from polyps, and screening to find and remove these polyps can prevent colon cancer, an opportunity exists to save lives with early detection. CTC, which is an American Cancer Society recommended screening exam, can attract more people to be screened and save more lives through early detection of disease.

"Several well-designed multicenter trials now corroborate the results of an earlier landmark trial demonstrating equivalent performance of conventional optical colonoscopy and CTC in screening for cancer and premalignant polyps. The rapid expansion of the use of diagnostic CTC, even in the absence of Medicare coverage for screening CTC, speaks volumes to the need of an alternative exam for those who choose not to undergo colonoscopy. As more insurers provide coverage for CTC, access to CTC is likely to expand," said Richard Duszak Jr., MD, main author of the study.........

Posted by: Sue      Read more         Source


March 26, 2011, 10:21 PM CT

A new colon cancer marker

A new colon cancer marker
Vasilis Vasiliou, PhD
A research team at the University of Colorado Cancer Center has identified an enzyme that could be used to diagnose colon cancer earlier. It is possible that this enzyme also could be a key to stopping the cancer.

Colon cancer is the third most common cancer in Americans, with a one in 20 chance of developing it, as per the American Cancer Society. This enzyme biomarker could help physicians identify more colon cancers and do so at earlier stages when the cancer is more successfully treated.

The research was led by Vasilis Vasiliou, PhD, professor of molecular toxicology at the University of Colorado School of Pharmacy, and reported in the Jan. 7 online issue of Biochemical and Biophysical Research Communications. Vasiliou's laboratory specializes in understanding the role of enzymes called aldehyde dehydrogenases in drug metabolism, metabolic diseases, cancer and normal and cancer stem cells.

Vasiliou's team studied colon cancers from 40 patients and found a form of this enzyme known as ALDH1B1 present in every colon cancer cell in 39 out of the 40 cases. The enzyme, which is normally found only in stem cells, was detected at extraordinarily high levels.

"Other potential colon cancer biomarkers have been identified in the past, but none thus far are present in such a high percent of the cancer cells and virtually none are overexpressed like this one," says David Orlicky, PhD, associate professor of pathology at the CU medical school and a member of the research team.........

Posted by: Sue      Read more         Source


January 10, 2011, 6:17 AM CT

Colorectal cancer screening disparities

Colorectal cancer screening disparities
Individuals from certain areas of the United States are more likely to get screened for colorectal cancer than those from other areas, especially when comparing non-whites living in different parts of the country. That is the conclusion of a newly released study published early online in Cancer, a peer-evaluated journal of the American Cancer Society. Additional research is needed to better understand how colorectal cancer screening disparities develop in some regions and not in others.

Racial and ethnic disparities in colorectal screening exist among the Medicare population, but scientists do not know whether these disparities differ across geographic regions. To find out, Thomas Semrad, MD, of the University of California Davis led a team that examined colorectal cancer screening among Medicare enrollees within eight U.S. states. Individuals were considered up-to-date on screening if they had fecal occult blood testing in the previous year or sigmoidoscopy or colonoscopy in the previous five years.

There was little geographic variation in up-to-date status among whites, who were consistently more likely to be up-to-date on screening than other races (except in Hawaii). White versus non-white up-to-date status varied significantly across regions for blacks and Asian/Pacific Islanders but not Hispanics. While white versus black differences in up-to-date status were greatest in Atlanta, rural Georgia, and the San Francisco Bay Area (range: 10 percent to 16 percent differences), there were no significant white versus black differences in Connecticut, Seattle, or Iowa. Whereas Asian/Pacific Islanders had significantly lower up-to-date prevalence than whites in Michigan, San Francisco, Los Angeles, and San Jose (range: 4 percent to 15 percent differences), Asian/Pacific Islanders in Hawaii had higher up-to-date status than whites (52 percent versus 38 percent). White versus Hispanic differences were substantial but homogeneous across regions (range: 8 percent to 16 percent differences).........

Posted by: Sue      Read more         Source


September 9, 2010, 6:40 AM CT

Body weight colon cancer mortality link

Body weight colon cancer mortality link
Postmenopausal women diagnosed with colon cancer appears to be at increased risk of death if they fail to maintain a healthy body weight before cancer diagnosis, as per a research studyreported in the recent issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

The scientists observed that women considered "underweight" or "obese," or who had increased abdominal obesity previous to cancer diagnosis seemed to face a greater risk of mortality.

"Maintaining a healthy body weight is beneficial for postmenopausal women. This may also be beneficial for those diagnosed with colon cancer during the later part of life. It looks like abdominal obesity appears to be a useful indicator of higher colon cancer mortality," said Anna E. Prizment, Ph.D., M.P.H., a postdoctoral fellow in the division of epidemiology and community health at the University of Minnesota, Masonic Cancer Center. "It is too early to say whether a decrease in weight characteristics after diagnosis will also decrease mortality risk; at that point it appears to be too late. Therefore, it's best to maintain a normal, healthy body weight throughout life".

Prizment and his colleagues extracted data from the Iowa Women's Health Study, which included 1,096 women diagnosed with colon cancer who were observed over a maximum 20-year period. During that time, 493 died, of which 289 died from colon cancer.........

Posted by: Sue      Read more         Source


February 5, 2010, 7:52 AM CT

Barriers to screening for colorectal cancer

Barriers to screening for colorectal cancer
Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Despite evidence and guidelines supporting the value of screening for this disease, rates of screening for colorectal cancer are consistently lower than those for other types of cancer, particularly breast and cervical. Although the screening rates in the target population of adults over age 50, have increased from 20-30 percent in 1997 to nearly 55 percent in 2008 the rates are still too low. An NIH state-of-the-science panel was convened this week to identify ways to further increase the use and quality of colorectal cancer screening in the United States.

"We recognize that some may find colorectal cancer screening tests to be unpleasant and time-consuming. However, we also know that recommended screening strategies reduce colorectal cancer deaths," said Dr. Donald Steinwachs, panel chair, and professor and director of the Health Services Research and Development Center at the Johns Hopkins University. "We need to find ways to encourage more people to get these important tests".

The panel found that the most important factors associated with being screened are having insurance coverage and access to a regular health care provider. Their recommendations highlighted the need to remove out-of-pocket costs for screening tests.........

Posted by: Sue      Read more         Source


January 26, 2010, 8:46 AM CT

Virtual colonoscopy is effective

Virtual colonoscopy is effective
Computed tomographic colonography (CTC), also known as virtual colonoscopy, remains effective in screening older patients for colorectal cancer (CRC), produces low referral for colonoscopy rates similar to other screening exams now covered by Medicare, and does not result in unreasonable levels of additional testing resulting from extracolonic findings, as per a research studyreported in the recent issue of Radiology.

CT colonography employs virtual reality technology to produce a three-dimensional visualization that permits a thorough and minimally invasive assessment of the entire colon and rectum. Prior CTC trials have demonstrated excellent performance in average risk individuals. However, concerns remained that such results may not be applicable to older Medicare beneficiaries. Scientists at the University of Wisconsin School of Medicine and Public Health analyzed various CTC performance and program outcome measures for screening individuals aged 65-79.

"These results confirm that CTC is a safe and effective colorectal cancer screening tool for the older individual. There is no significant difference in the way CTC performs in older patients as opposed to younger patients," said David H. Kim, MD, associate professor of radiology, University of Wisconsin School of Medicine and Public Health, and principal investigator of the study.........

Posted by: Sue      Read more         Source


December 2, 2009, 8:21 AM CT

CT imaging taken post avastin

CT imaging taken post avastin
Using routine computed tomography (CT) imaging to analyze form and structural changes to colorectal liver metastasis after bevacizumab and chemotherapy may predict overall survival, as per research from The University of Texas M. D. Anderson Cancer Center.

The findings appear in the Dec. 2 issue of JAMA

When combined with chemotherapy, the angiogenesis inhibitor bevacizumab, also known as Avastin, is linked to both improved survival in those with metastatic colorectal cancer and higher rates of pathologic response in patients undergoing surgical resection of colorectal liver metastases. The monoclonal antibody was approved for use in the front line setting of metastatic colorectal cancer in 2004.

However, the treatment presents a unique set of challenges, explains Jean-Nicolas Vauthey, M.D., professor in M. D. Anderson's Department of Surgical Oncology.

"We've known for years that tumor shrinkage is not necessarily a strong indicator of survival in this patient population, and this has been an area of much controversy and study within the cancer community," explained Vauthey, the study's corresponding author. "Some of these tumors are so aggressive and may immediately start to grow when a patient goes off bevacizumab-containing chemotherapy".........

Posted by: Sue      Read more         Source


August 6, 2009, 11:35 PM CT

Starving the colon cancer cells

Starving the colon cancer cells
Researchers at the Johns Hopkins Kimmel Cancer Center have discovered how two cancer-promoting genes enhance a tumor's capacity to grow and survive under conditions where normal cells die. The knowledge, they say, may offer new therapys that starve cancer cells of a key nutrient - sugar. However, the researchers caution that research does not suggest that altering dietary sugar will make any difference in the growth and development of cancer.

"Cancer cells adapt to living within the inner layers of a tumor, a place where circulating nutrients are relatively scarce," says Nickolas Papadopoulos, Ph.D., associate professor at the Johns Hopkins Kimmel Cancer Center. "We wanted to know what makes these cancer cells survive under such conditions".

Working with colorectal cancer cell lines that carry two of the most common cancer genes - KRAS and BRAF - they went on a hunt for genes that were controlled by KRAS and BRAF and allowed cancer cells to be more fit for survival. Nearly half of all patients with colon cancer carry KRAS mutations in their tumors and another five percent of these patients have alterations in BRAF. The findings are published online in the August 6 issue of Science Express.

Their hunt quickly narrowed to one gene, GLUT1, which was consistently turned on at high levels in cells laden with KRAS and BRAF mutations. Proteins made by GLUT1 are located on the cell surface and transport glucose into cells' interiors. With increased expression of the GLUT1 gene, cells make more GLUT1 transporters and ingest more glucose.........

Posted by: Sue      Read more         Source


August 5, 2009, 9:59 PM CT

Significant Benefits of F-FDG PET in Evaluating Colorectal Liver Metastases

Significant Benefits of F-FDG PET in Evaluating Colorectal Liver Metastases
The Access to Medical Imaging Coalition (AMIC) announced recently that a study published in this month's Journal of Nuclear Medicine demonstrated the tremendous benefits of advanced imaging in the assessment of colorectal liver metastases. Dr. Theo Ruers lead a team of scientists in evaluating the benefits of F-fluorodeoxyglucose (FDG) positron emission tomography (PET) when combined with computed tomography (CT), and its ability to diagnose and stage hepatic growths far more effectively than standard CT alone. The study was presented at the Society of Nuclear Medicine annual meeting in 2008 and received the Siemens Award for Excellence in Practice-Based Research.

"Liver metastases are among the most dangerous threats to patients who have been treated for colorectal cancer, and it is absolutely imperative that at-risk patients have access to the highest quality diagnostic procedures in order to detect and properly stage these malignant growths if they develop," said Tim Trysla, executive director, AMIC. "Effective staging of these growths can lead to improved clinical outcomes, and in a number of cases can prevent unnecessary or ineffective surgeries. AMIC applauds the work of Dr. Ruers and his team, whose research proves the addition of F-FDG PET to standard diagnostic protocols to be extremely useful in accurately identifying the population of individuals most likely to benefit from hepatic surgery and, in turn, drastically reducing the number of wasteful procedures".........

Posted by: Sue      Read more         Source


June 1, 2009, 5:18 AM CT

Surgery for late-stage colon cancer

Surgery for late-stage colon cancer
A newly released study shows that a great majority of patients who present with advanced colorectal cancer that has spread to other organs (stage IV) don't require immediate surgery to remove the primary tumor in the colon. Scientists from Memorial Sloan-Kettering Cancer Center (MSKCC) presented their data today at the American Society of Clinical Oncology Annual Meeting.

"For this population with metastatic disease that cannot be cured by surgery, undergoing colon surgery is not always necessary," said Philip Paty, a surgical oncologist at MSKCC and one of the study's main authors. "If the colon tumor is not causing obstruction, perforation, or bleeding we've found these patients are best treated with chemotherapy. By moving straight to chemotherapy, patients can avoid the risk of surgical complications and can start therapy for all sites of disease without delay".

For this retrospective study, a multidisciplinary team looked at 233 metastatic colorectal cancer cases treated at MSKCC from 2000 to 2006. Their analysis showed that 217 of the 233 patients, or 93 percent, did not have complications that mandatory resection of the primary tumor. Only 16 patients mandatory colon surgery for symptom management.

Previously, in the conventional approach to treating stage IV disease, patients underwent colon surgery immediately following their diagnosis and would typically start chemotherapy therapys three to six weeks later. The rationale for immediate colon resection was to prevent future symptoms and complications from the primary tumor. It was assumed that the majority of colorectal cancers would have little response to chemotherapy.........

Posted by: Sue      Read more         Source


June 1, 2009, 5:00 AM CT

Obesity predicts inadequate bowel prep at colonoscopy

Obesity predicts inadequate bowel prep at colonoscopy
Obesity is an independent predictor of inadequate bowel preparation at colonoscopy, and the presence of additional risk factors further increases the likelihood of a poorly cleansed colon, as per a newly released study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

Obesity has become an epidemic in the present era, both in the U.S. and in other developed nations. Abnormal elevation of body mass index (BMI) is linked to several gastrointestinal diagnoses, including diverticular disease, gastroesophageal reflux disease, colon polyps and colon cancer.

Since the majority of colon cancers arise from adenomatous (benign) colon polyps, proper screening becomes crucial while performing colonoscopy on obese patients. An inadequately cleansed colon can jeopardize the effectiveness of screening or surveillance colonoscopy, exposing these patients at higher risk for colorectal tumors to the dangers of missed lesions and higher cost of repeat colonoscopy.

"The implications of our findings are profound. Since over a quarter of all patients had an inadequate examination, identification of a patient profile with a high risk for poor colon preparation will be helpful in capturing those who would benefit from an initial individualized designer preparation regimen," said Brian Borg, MD, of Washington University in St. Louis, MO and main author of the study. "Our results suggest that the obese patient should at least be subject to more precise instructions and possibly a more rigorous bowel preparation regimen. In addition, as the number of risk factors for an inadequate bowel preparation increase, the need for early repeat colonoscopy escalates".........

Posted by: JoAnn      Read more         Source


April 13, 2009, 12:47 AM CT

How high-fiber diet protects you from colon cancer?

How high-fiber diet protects you from colon cancer?
Though a high-fiber diet has long been considered good for you and beneficial in staving off colon cancer, Medical College of Georgia scientists have discovered a reason why: roughage activates a receptor with cancer-killing potential.

Scientists report in the recent issue of Cancer Research that the GPR109A receptor is activated by butyrate, a metabolite produced by fiber-eating bacteria in the colon. The receptor puts a double-whammy on cancer by sending signals that trigger cell death, or apoptosis, and shutting down a protein that causes inflammation, a precursor to cancer.

"We know the receptor is silenced in cancer but it's not like the gene goes away," says Dr. Vadivel Ganapathy, corresponding author and chair of the Department of Biochemistry and Molecular Biology in the MCG School of Medicine.

Cancer shuts down the receptor by chemically modifying its gene through a process called DNA methylation. It's a typical MO for cancer to turn genes off to suit its purpose which is why DNA methylation inhibitors already are under study for a variety of cancers.

But cancer patients likely also need something to ensure the receptor gets activated by butyrate, such as eating more roughage or, more likely, getting mega doses of butyrate or a compound with similar properties, Dr. Ganapathy says.........

Posted by: Sue      Read more         Source


February 18, 2009, 6:15 AM CT

Predicting recurrence in colorectal cancer

Predicting recurrence in colorectal cancer

(PHILADELPHIA) Findings reported in the Journal of the American Medical Association by scientists at Thomas Jefferson University show that the presence of a biomarker in regional lymph nodes is an independent predictor of disease recurrence in patients with colorectal cancer.

Detection of the biomarker, guanylyl cyclase 2C (GUCY2C), indicates the presence of occult metastases in lymph nodes that may not have been identified by current cancer staging methods, as per Scott Waldman, M.D., Ph.D., chairman of the Department of Pharmacology and Experimental Therapeutics at Jefferson Medical College of Thomas Jefferson University.

As per Dr. Waldman, who is also the Samuel M.V. Hamilton Professor of Clinical Pharmacology in the Department of Medicine at Jefferson Medical College, colorectal cancer that has metastasized, or spread, to the regional lymph nodes carries a worse prognosis and a higher risk for recurrence. However, these metastases are often missed, and the cancer is understaged.

"One of the unmet needs in colorectal cancer is an accurate staging method to determine how far the disease has spread," said Dr. Waldman, who is also director of the Gastrointestinal Malignancies Program at the Kimmel Cancer Center at Jefferson. "The current standard method, histopathology, is imperfect since it only involves looking at a very small sample of the regional lymph nodes under a microscope. There is no way to know whether occult metastases are present in the rest of the tissue".........

Posted by: Sue      Read more         Source


February 12, 2009, 6:14 AM CT

Regular exercise to prevent colon cancer

Regular exercise to prevent colon cancer
An ambitious newly released study has added considerable weight to the claim that exercise can lower the risk for colon cancer. Scientists at Washington University School of Medicine in St. Louis and Harvard University combined and analyzed several decades worth of data from past studies on how exercise affects colon cancer risk. They observed that people who exercised the most were 24 percent less likely to develop the disease than those who exercised the least.

"What's really compelling is that we see the association between exercise and lower colon cancer risk regardless of how physical activity was measured in the studies," says lead study author Kathleen Y. Wolin, Sc.D., a cancer prevention and control expert with the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University. "That indicates that this is a robust association and gives all the more evidence that physical activity is truly protective against colon cancer".

Colorectal cancer is the third most common type of cancer. Each year more than 100,000 people in the United States are diagnosed with colon cancer and about 40,000 are diagnosed with rectal cancer. The study suggests that if the American population became significantly more physically active, up to 24 percent, or more than 24,000, fewer cases of colon cancer would occur each year.........

Posted by: Sue      Read more         Source


February 12, 2009, 5:18 AM CT

New drug to prevent colon cancer in making

New drug to prevent colon cancer in making
Scientists at the Mayo Clinic campus in Florida have observed that a drug now being tested to treat a range of human cancers significantly inhibited colon cancer development in mice. Because the agent appears to have minimal side effects, it may represent an effective chemopreventive therapy in people at high risk for colon cancer, the researchers say.

Their study, reported in the Feb. 15 issue of Cancer Research, observed that use of the agent, enzastaurin, significantly reduced development of malignant colon tumors in treated animals. Furthermore, the tumors that did develop in the mice were of a lower grade, which meant they were less advanced and aggressive than the tumors seen in animals not given the drug. "There is need for an agent that has a proven ability to reduce colon cancer risk, and this study suggests that enzastaurin could be uniquely effective," says the study's senior investigator, Nicole Murray, Ph.D., of the Department of Cancer Biology.

Individuals at high risk for colon cancer often develop numerous premalignant colon polyps, which must be periodically removed during a colonoscopy, Dr. Murray says.

The laboratories of Dr. Murray, and her collaborator and co-author, Alan Fields, Ph.D., chair of the Department of Cancer Biology, focus on characterizing the genes involved in different stages of colon carcinogenesis. They have zeroed in on the protein kinase C (PKC) family of enzymes as major players in cancer development and progression, but it has taken them years to understand the different roles of each type of PKC molecule or "isozyme."........

Posted by: Sue      Read more         Source

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Colorectal cancer
Colorectal cancer is a malignant tumor that arises from the inner wall of the large intestine or rectum. Colorectal cancer is the third commonest cancer diagnosed in the United States. Each year over 100,000 people are diagnosed with colorectal cancer in the United States. Most, of these cancers develop from growths in the colon called polyps. Removal of these polyps can prevent colon cancer.

Medicineworld.org: Colon cancer blog

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