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Advances in the detection of colorectal cancer
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Mozdiak, Ella (2018) Advances in the detection of colorectal cancer. MD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3431052~S15
Abstract
Colorectal cancer (CRC) is a significant cause of mortality. In the UK, 1 in 14 men and 1 in 19 women will develop CRC in their lifetime. Overall, five-year survival is 60% and this compares poorly to many countries in Western Europe. Survival is directly linked to stage at presentation. The majority present at Dukes stage B or above. Better methods of detecting CRC at an earlier stage are needed to improve survival figures.
Published evidence on the two-week wait pathway (TWW) for detecting CRC was evaluated using a systematic review. This showed low CRC detection and no difference in stage at presentation in the TWW group compared with the non-TWW pathways of referral. These results indicate the emphasis on TWW targets is not justified and should prompt consideration of better methods of risk stratification for those with suspected CRC.
Biomarkers have the potential to improve the positive predictive value of referral criteria in the symptomatic population and also increase the sensitivity of the faecal occult blood test when used as an adjunct in the bowel screening population. Two potential urinary biomarker groups in the detection of CRC were explored: one based on volatile organic compounds (VOCs) and one on peptide markers. Analysis demonstrated that CRC could be correctly classified from control using a VOC or peptide biomarker-based test with a high degree of accuracy in pilot work. Further protein analysis using immunohistochemistry explored the role of Meprin alpha in the pathology of CRC with possible implications in aggressive disease.
There is a need for better ways of detecting CRC and biomarkers hold huge potential. But there must be a culture change from the current fragmented approach to elucidating diagnostics in CRC. Collaborations between research groups and data-sharing is essential to validate pilot studies and share knowledge on methodology and results.
Item Type: | Thesis (MD) | ||||
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Subjects: | R Medicine > RC Internal medicine | ||||
Library of Congress Subject Headings (LCSH): | Colon (Anatomy) -- Cancer -- Detection, Colon (Anatomy) -- Cancer -- Great Britain, Cancer -- Diagnosis, Rectum -- Cancer -- Research | ||||
Official Date: | August 2018 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | MD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Arasaradnam, Ramesh P.; Pallen, Mark; Klein, Judith | ||||
Sponsors: | Medical and Life Sciences Research Fund; The Midlands Gastroenterological Society | ||||
Format of File: | |||||
Extent: | 287 leaves: illustrations, charts | ||||
Language: | eng |
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