Search Results (79)

Early screening is essential for improving the prognosis of colorectal cancer (CRC), for which fecal occult blood testing (FOBT) remains one of the most widely adopted noninvasive screening approaches. However, conventional FOBT methods often exhibit insufficient sensitivity and limited reliability when handling complex fecal matrices, largely due to nonspecific fouling and cumbersome sample pretreatment procedures. Herein, we report a surface plasmon resonance biosensor integrating a self-assembled anti-fouling interface with DNA aptamer-mediated molecular recognition for sensitive hemoglobin detection in fecal samples. The engineered sensing surface exhibits high interfacial stability and resistance to nonspecific adsorption, enabling direct analysis of fecal samples without complicated pretreatment. The proposed platform achieved a detection limit of 1 nM and a diagnostic accuracy of 97.6%. This study demonstrates the feasibility of SPR-based hemoglobin detection in complex fecal samples using an antifouling sensing interface and highlights its potential as a promising optical biosensing strategy for noninvasive colorectal cancer screening. Full article

Background/Objectives: Cancer screening is a key strategy for reducing cancer-related morbidity and mortality. This study assessed adherence to breast, cervical, and colorectal cancer screening among Spanish women and identified factors independently associated with participation. Methods: A cross-sectional study was conducted using data from the 2023 Spanish Health Survey. Women eligible for mammography (40–69 years), cervical cytology (25–65 years), and fecal occult blood testing (FOBT; 50–69 years) were included. Weighted prevalence estimates were calculated, and multivariable logistic regression models were fitted separately for each screening test. Results: A total of 7454 women aged 25–69 years were analyzed. Adherence was highest for mammography (71.1%), followed by cervical cytology (64.1%) and FOBT (36.8%). Only 24.4% of women eligible for all three programs were adherent to all screening tests simultaneously. Across all screening programs, adherence was consistently associated with being born in Spain, living with a partner, greater social support, healthcare utilization, private health insurance coverage, and physical activity. Strong social support was independently associated with participation in mammography (OR 1.72; 95% CI 1.35–2.20), cervical cytology (OR 1.58; 95% CI 1.29–1.94), and FOBT uptake. Participation in one screening program was strongly associated with participation in the others, particularly between mammography and cervical cytology (OR 4.37; 95% CI 3.84–4.98). Conclusions: Adherence to cancer screening among Spanish women remains suboptimal, particularly for colorectal cancer. Participation appears to reflect a broader preventive health behavior pattern, with social support emerging as one of the strongest and most consistent determinants across all three screening programs. Full article

Background/Objectives: The stool DNA-based SDC2 methylation (meSDC2) test has emerged as a promising noninvasive tool for the early detection of colorectal cancer (CRC). This study aimed to validate the clinical performance of the meSDC2 test for CRC detection in a multicenter hospital setting. Materials and Methods: This prospective, retrospective, multicenter, single-blind, case–control study was conducted at three tertiary medical centers. The primary endpoints were sensitivity and specificity for CRC detection. Secondary endpoints included test performance by tumor stage and location, and positivity rates in non-CRC lesions. Results: Among 636 participants, 260 (40.9%) had CRC, 173 (27.2%) had colorectal polyps, and 182 (28.6%) had normal colonoscopy findings. The meSDC2 test demonstrated a sensitivity of 87.7% (95% CI: 83.7–91.7%) and a specificity of 86.2% (95% CI: 82.7–89.7%) for CRC detection, with an AUC of 0.869 (95% CI: 0.841–0.895). Specificity among participants with negative colonoscopy findings was 91.8%. Positivity rates were 28.3% (95% CI: 15.3–41.3%) for advanced adenomas and 13.8% (95% CI: 6.6–21.0%) for non-advanced adenomas. Compared with the fecal immunochemical test (FIT), the meSDC2 test showed significantly higher sensitivity, whereas FIT demonstrated higher specificity. Combined testing improved sensitivity to 95.6% and 82.4% specificity. The meSDC2 test also showed significantly greater sensitivity than FIT for early-stage CRC (p = 0.037), while combined testing further improved sensitivity for both early- and late-stage CRC(p = 0.037 and p = 0.006, respectively). Conclusions: The stool-based meSDC2 test demonstrated high sensitivity, specificity, and consistent diagnostic performance across subgroups, supporting its clinical utility as a reliable and noninvasive CRC screening tool. Full article

Background: Anemia is an important clinical sign which often points to a serious and possibly treatable medical condition. We aimed to investigate the frequency of anemia long before colorectal cancer (CRC) surgeries among older adults aged ≥ 75 years (group 2), compared to patients aged 50–75 years (group 1). Participants and setting: Consecutive patients operated for CRC in our center who belonged to the health maintenance organization (HMO) at least 36 months before their diagnosis were included. Methods: Laboratory data were extracted from the HMO database. Anemia and severe anemia were defined as Hb < 14 g/dL and <12 g/dL for males and <12 g/dL and <10 g/dL for females, respectively. Low serum iron was defined as below 45 mcg/dL. Results: 647 patients were identified, including 277 (42.8%) ≥75 years (mean age 80.7 ± 4.1 y) and 370 (57.1%), aged 50–75 years (mean 65.8 ± 6.5 y). CRC was more commonly diagnosed following a presentation of iron deficiency anemia in group 2 (20.6% vs. 11.6%, p = 0.002), while positive fecal occult blood test was more frequent among the younger group. Anemia and severe anemia ≥ 1 year before CRC diagnosis were observed in 156 (56.3%) and 56 (20.2%) patients of group 2 compared to 142 (38.4%) and 38 (10.3%) of patients from group 1 (p < 0.001 and p = 0.001, respectively). A low iron level ≥ 1 year before diagnosis was observed in 49 (17.6%) patients in group 2 compared to 35 (9.5%) of group 1 (p = 0.007). Conclusions: More than 50% of older adults aged ≥ 75 years, diagnosed with CRC had evidence of anemia, at least 1 year before cancer diagnosis. Health policymakers should educate physicians about the importance of recognizing abnormal laboratory results, such as anemia, particularly within this often-overlooked group of older patients to increase early detection of CRC. Full article

Background/Objectives: Despite the availability of the National Cancer Screening Program in Korea, participation rates remain suboptimal. The literature demonstrates that cancer screening participation extends beyond individual-level knowledge and attitudes and is largely associated with trust. This study examines the role of trust—across cancer screening tests, health care providers, and health care organizations—as a central determinant of cancer screening participation among Koreans. Methods: A cross-sectional study was conducted with 369 Korean adults aged 40 years and older, recruited through convenience sampling from community centers in a metropolitan city. Data were collected using structured, paper-based questionnaires assessing socio-demographic factors and multilevel trust across specific screening tests, doctors, and health care organizations. Following descriptive statistics, bivariate and multivariate logistic regression analyses were performed to identify significant predictors of cancer screening utilization. Results: Koreans had relatively high trust in doctors and cancer screening tests. On an 11-point numeric rating scale ranging from 0 (not at all) to 10 (completely), the mean scores were 7.47 for the trust in doctors; colonoscopy had the highest trust score (M = 7.71), whereas the fecal occult blood test had the lowest (M = 7.14). Multivariate logistic regression revealed that trust and distrust were associated with the utilization of Pap smear, gastroscopy, upper gastrointestinal series, and colonoscopy in complex and sometimes paradoxical ways, and having a usual source of care was a consistent facilitator of cancer screening. Conclusions: These findings suggest that future research is needed to examine the complex interplay among trust, access to health care, and national policy in shaping cancer screening utilization in the Republic of Korea. Full article

Objectives: Disruptions in circadian-related behaviors are emerging as potential risk factors for gastrointestinal cancers. This study investigated the independent and joint associations of nightly fasting duration and sleep duration with the risk of colorectal cancer (CRC) among community-dwelling Chinese older adults. Methods: Participants were drawn from the Guangzhou CRC Screening Program, which used a questionnaire-based investigation, two separate fecal occult blood tests (FOBTs) for risk evaluation, and colonoscopy for high-risk individuals. Of the 347,297 people initially screened, 197,507 individuals were finally included after excluding 100,930 cases with missing eating/sleeping data or unknown/benign lesions via colonoscopy. Among the final sample, 351 CRC cases and 1384 precancerous lesions were diagnosed, while 195,772 individuals had negative results. Habitual times for dinner, breakfast, bedtime, and wake-up were used to define nightly fasting duration (dinner-to-breakfast) and nightly sleep duration (bedtime-to-wake). Multivariable logistic regression, subgroup analyses, and sensitivity analyses were performed to evaluate the associations. Results: In the fully adjusted models, each 1-h increment in nightly fasting duration was associated with a 9.5% (95% CI 1.039–1.153) higher risk of CRC, and the direct association was limited to individuals over 60 years (OR = 1.147, 95% CI 1.073–1.226), while each 1-h increment in nightly sleep duration was associated with a 15.2% (95% CI 0.806–0.893) lower risk of CRC. Consistently, earlier dinner, later breakfast and later bedtime were also associated with a higher CRC risk. Conclusions: In Guangzhou older residents, long nightly fasting duration was a risk factor for CRC, especially among individuals over 60 years old; while long nightly sleep duration was protective. These findings suggest that maintaining adequate sleep and optimizing the nightly fasting window may be viable lifestyle strategies for CRC prevention, emphasizing the need for tailored preventive measures for different age groups. Full article

Background/Objectives: Colorectal cancer (CRC) is a major health concern in South Korea, where incidence and mortality rates remain high despite the National Cancer Screening Program. Understanding the factors associated with CRC screening behaviors is essential for developing effective interventions. The purpose of this study was to examine the associations of sociodemographic characteristics, access to health care, knowledge, health beliefs, and cultural beliefs with CRC screening behaviors among Koreans. Methods: A cross-sectional survey was conducted with 648 Koreans aged 50 years and older at average risk for CRC. Participants completed questionnaires assessing sociodemographic characteristics, access to health care, knowledge, health beliefs, cultural beliefs, and CRC screening behaviors. Data were analyzed using descriptive statistics, bivariate logistic regression, and multivariate logistic regression with stepwise procedures. Results: Physician recommendation and perceived barriers were the strongest predictors of fecal occult blood test (FOBT) adherence, while physician recommendation, a usual source of health care, perceived benefits, and perceived barriers significantly predicted colonoscopy use. Perceived barriers reduced the likelihood of adhering to both, FOBT or colonoscopy (OR = 0.431, 95% CI = 0.316–0.588) or colonoscopy (OR = 0.432, 95% CI = 0.313–0.596), respectively, by 57%, whereas higher perceived benefits doubled the odds of colonoscopy participation (OR = 1.871, 95% CI = 1.331–2.631). Knowledge gaps were evident regarding CRC seriousness and the need for screening beginning at age 50 without symptoms. Conclusions: CRC screening participation among Koreans is associated primarily with access to care and health belief components. Encouraging physician recommendation and reducing perceived barriers are essential for improving screening rates. Culturally informed education and consideration of expanding colonoscopy services within the national cancer screening program is needed to further enhance CRC screening adherence. Full article

Background/Objectives: Colorectal cancer is the most frequently diagnosed cancer and second by mortality among all cancers in Croatia. The Organized National Colorectal Cancer Screening Program was introduced by the government in 2007. It targets individuals aged 50–74 years with a biennial screening with a guaiac fecal occult blood test (gFOBT). The aim of this study is to analyze the costs associated with colorectal cancer in Croatia and to compare the cost-effectiveness of three screening strategies: no screening, biennial gFOBT, and biennial fecal immunochemical testing (FIT). Patients and methods: A model was developed to compare the three screening scenarios. The model simulated a cohort of 10,000 patients aged 50 years without colorectal cancer. Health outcomes and associated costs were projected over a five-year time horizon. The model outcomes include the number of newly diagnosed colorectal cancer cases, number of colorectal cancer-related deaths, life-years gained, and costs per life-year gained. Results: The average five-year costs per patient for the treatment of advanced cancer are EUR 39,802, which is substantially higher than the average costs of EUR 16,897 per patient across all stages. The implemented model indicates that both screening options yielded improved health outcomes at lower costs compared with no screening. FIT is considered the preferred screening option due to its higher sensitivity, greater health outcomes, and lower costs relative to gFOBT. Conclusions: The introduction of FIT screening instead of gFOBT could increase screening uptake for colorectal cancer, improve health outcomes, and reduce healthcare expenditures and the economic burden associated with colorectal cancer in Croatia. Full article

Objectives: This study aims to evaluate teachers’ lifestyle habits and to investigate their knowledge and behaviors related to cancer screening. Methods: This cross-sectional survey was performed among teachers randomly selected from schools located in the Campania region, Italy. Results: Only 17% of the teachers were current smokers, while 72.1% consumed alcohol. Female teachers, those who were married/cohabitant, and those who discussed with students about alcohol consumption were more likely to have never smoked or drunk alcohol. Female and older teachers, those with a university or a master/PhD degree, and those who had a moderate/high level of physical activity (PA) were more likely to sufficiently consume fruits and vegetables. Only 20.9% of teachers had a moderate/high level of PA. Those who had at least one child, who taught humanistic and support disciplines, and who needed additional information on healthy lifestyle habits were less likely to have a moderate/high level of PA. Among participants, 42.3% had ever undergone mammography for screening and 37.5% a Pap test and a fecal occult blood test. Conclusions: This survey describes a worrying prevalence of unhealthy behaviors and low adherence to screening programs among Italian teachers, suggesting the need for education and screening campaigns to improve preventive strategies in this population. Full article

Colonoscopy remains the gold standard for colorectal cancer (CRC) screening, but its invasiveness, cost, and limited availability in resource-constrained settings pose major barriers. Stool-based methylated DNA biomarkers, such as vimentin, offer sensitive, non-invasive alternatives. Given the high burden of HIV and helminth co-infections in sub-Saharan Africa and their potential contribution to cancer susceptibility, this study investigated whether stool-derived vimentin methylation could detect early oncogenic changes in these high-risk groups. In this retrospective cross-sectional study, archived stool samples from 62 South African adults were stratified into five groups: uninfected controls, HIV-infected only, helminth-infected only, HIV-helminth co-infected, and CRC-confirmed patients. DNA was extracted, bisulfite-converted, and analyzed for vimentin methylation using a high-resolution melt assay. Fecal occult blood testing (FOBT) was also performed. Vimentin methylation differed significantly across groups (p < 0.0001). CRC cases showed 90% methylation, confirming its role as a CRC biomarker. Interestingly, vimentin methylation frequencies were also observed in HIV-only (92.9%, p < 0.0001 vs. controls), helminth-only (93.3%, p < 0.0001), and HIV-helminth co-infected (77.9%, p < 0.0001) individuals without diagnosed cancer, compared to 10% in controls. Methylation levels in infected groups were not significantly different from CRC patients (all p > 0.05), suggesting infection-induced epigenetic changes of comparable magnitude to malignancy. To support these results, DNMT1–RG108 molecular docking (PDB 4WXX, Maestro 2025-3) demonstrated stable binding (GlideScore −6.285 kcal/mol; ΔG_bind −49.61 kcal/mol) via hydrogen bonding with Glu1266 and Asn1578 and π–π stacking with Phe1145, providing a mechanistic explanation for infection-driven vimentin methylation. No significant differences were found between infected groups. FOBT was positive in 83.3% of CRC cases, with only sporadic positives in infected groups. These findings provide novel evidence that chronic HIV and helminth infections are associated with vimentin promoter methylation at levels indistinguishable from CRC. This supports the hypothesis that persistent infection-driven inflammation promotes early epigenetic reprogramming toward oncogenesis. In high-burden African settings, stool-based methylation assays could serve as early diagnostic tools to identify at-risk individuals long before clinical disease manifests, enabling targeted surveillance and prevention. Full article

Objectives: This study assessed socioeconomic inequalities in cancer screening at the district level in Peru, focusing on bilateral mammography, fecal occult blood test (FOBT), and prostate-specific antigen (PSA) test. Methods: An ecological study was conducted using 2021–2023 data from the Health Information System (HIS) of MINSA. Screening rates were calculated per 1000 eligible individuals. Socioeconomic disparities were assessed using concentration indices (CIs) and gap analysis, with the Human Development Index (HDI) as the stratification variable. Results: Screening rates were higher in districts with greater HDI. The mean district-level rates were 15.41 (SD: 72.66) for mammography, 97.27 (SD: 107.34) for FOBT, and 104.87 (SD: 101.92) for PSA per 1000 eligible individuals. Positive concentration indices indicated a pro-rich inequality: CI for mammography (0.1745, p = 0.045), FOBT (0.0633, p < 0.001), and PSA (0.0290, p = 0.028). The largest gaps were observed in Amazonian and Andean regions, where screening coverage remained markedly low. Spatial distribution revealed that certain districts, particularly in Loreto, Ucayali, and Amazonas, had screening gaps exceeding 97%. Conclusions: Significant disparities in cancer screening exist across Peruvian districts, disproportionately affecting lower-HDI districts areas. Targeted interventions, including education, telemedicine, and improved infrastructure, are necessary to enhance equitable access to early detection services and reduce the burden of disease. Full article

Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide, with patient outcomes highly dependent on early and accurate diagnosis. However, existing diagnostic methods, such as colonoscopy, fecal occult blood testing, and imaging, are often invasive, costly, or lack sufficient sensitivity and specificity, particularly in early-stage disease. In this context, aptamers, which are synthetic single-stranded oligonucleotides capable of binding to specific targets with high affinity, have emerged as a powerful alternative to antibodies for biosensing applications. This review provides a comprehensive overview of aptamer-based strategies for CRC detection, spanning from biomarker discovery to clinical translation. We first examine established and emerging CRC biomarkers, including those approved by regulatory agencies, described in patents, and shared across multiple cancer types. We then discuss recent advances in aptamer selection and design, with a focus on SELEX variants and in silico optimization approaches tailored to CRC-relevant targets. The integration of aptamers into cutting-edge sensing platforms, such as electrochemical, optical, and nanomaterial-enhanced aptasensors, is highlighted, with emphasis on recent innovations that enhance sensitivity, portability, and multiplexing capabilities. Furthermore, we explore the convergence of aptasensing with microfluidics, and wearable technologies to enable intelligent, miniaturized diagnostic systems. Finally, we consider the clinical and regulatory pathways for point-of-care implementation, as well as current challenges and opportunities for advancing the field. By outlining the technological and translational trajectory of aptamer-based CRC diagnostics, this review aims to provide a roadmap for future research and interdisciplinary collaboration in precision oncology. Full article

Background/Objectives: Data on cancer screening programs as well as on the willingness to adhere to these programs in women living in prison (WLP) are lacking. This study investigated the adherence and willingness to undergo cancer screening programs among WLP. Methods: This cross-sectional study was conducted from October 2023 to March 2024. Results: Overall, 159 WLP were eligible for at least one screening test and 56.8%, 57.6%, and 27.6% had undergone a mammography, PAP-test, and fecal occult blood test (FOBT) in screening programs, respectively. Having undergone a PAP-test for screening purposes was significantly more likely for those in the overweight category, who were experiencing their first detention and were involved in working activities in prison. Moreover, 72.5%, 56.7%, and 72.9% expressed their willingness to undergo mammography, PAP-test, and FOBT for screening purposes if offered in prison, respectively. Willingness to undergo a PAP-test for screening in prison was significantly higher in those in their first experience of detention, who were underweight/healthy weight, who reported correct fruit, vegetable, and protein consumption, and who had expressed willingness to receive vaccinations in prison if offered. Furthermore, older WLP and those with a length of detention of 2–5 years were significantly less willing to undergo a PAP-test. Conclusions: The findings of this study have demonstrated that adherence to recommended cancer screening tests is definitely poor in WLP, but have ascertained a strong willingness to participate in cancer screening programs if offered in prison. This is an opportunity that cannot be missed, suggesting that it is imperative to recommend policies aimed at the elimination of barriers for the provision of cancer screening tests as standard preventive care for WLP. Full article

Background: Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn’s disease (CD), is characterized by chronic intestinal inflammation with fluctuating clinical severity. Although fecal calprotectin (FC) and fecal occult blood (FOBT) are established noninvasive biomarkers of intestinal inflammation, their interplay with nutritional status and disease activity has not been fully elucidated. This study aimed to explore the relationship between FC, FOBT, and disease activity in IBD, and to assess the potential mediating role of nutritional status as measured by the prognostic nutritional index (PNI). Methods: This retrospective study includes 128 adult patients with confirmed IBD (50 UC and 78 CD) examined at a tertiary care center between December 2023 and August 2025. Disease activity was assessed using the Mayo score for UC and the Harvey–Bradshaw Index for CD. FC levels were quantitatively measured using an enzyme-linked immunosorbent assay (ELISA), and fecal occult blood testing was performed with an automated latex agglutination-based system. Multivariable linear regression models were conducted to identify independent predictors of disease activity. Results: UC patients had significantly higher FC levels (278.0 vs. 133.5 µg/g, p < 0.001), FOBT positivity rates (76.7% vs. 43.6%, p = 0.002), and lower PNI (49.2 ± 4.2 vs. 51.5 ± 4.6, p = 0.048) compared to CD patients. In both UC and CD, disease activity scores were positively correlated with FC, FOBT positivity, CRP, and duration of illness, and negatively correlated with PNI (p < 0.05). In multivariable regression, PNI lost predictive value when FC and FOBT were included; FC and FOBT remained strong independent predictors of disease activity. Conclusions: FC and fecal occult blood are independently associated with higher disease activity in IBD, and may mediate the observed relationship between poor nutritional status and inflammation severity. The loss of significance of PNI in adjusted models suggests that intestinal inflammation and bleeding may act as intermediaries linking malnutrition to disease activity. Full article

Background/Objectives: Colorectal cancer (CRC) is the leading cancer-related death in Puerto Rico (PR). Yet CRC screening (CRCS) rates remain low. We developed ¡Salud!, por la Vida, an educational intervention aiming to increase CRCS among age-eligible adults living in PR. Methods: We conducted a cluster randomized controlled trial among adults 50–75 years old at Federally Qualified Health Clinics in PR. Participants could not have a history of CRC nor be currently adherent to CRCS guidelines for a fecal occult blood test (FOBT) or fecal immunochemical test (FIT) (within last year) or colonoscopy (within last 5–10 years). Out of 445 randomized participants, 355 completed the study procedures (Control: 277; Intervention: 78) and were included in the main analysis. Participants in the intervention arm completed baseline and follow-up questionnaires alongside the educational intervention (at baseline) and two reminder calls (before follow-up) within a four-month period. Control arm participants only completed baseline and follow-up questionnaires within the same period. All participants were followed up to assess CRCS completion. Results: Post-trial screening rates were significantly higher in the intervention group: FOBT/FIT (55% vs. 39%, p = 0.02), colonoscopy (10% vs. 3%, p = 0.02), and any CRCS (60% vs. 41%, p < 0.01). Compared to controls, those in the intervention group showed a 48% higher probability of undergoing any CRCS (RR = 1.48, 95%CI: 1.17, 1.86), were 1.4 times more likely to complete a FOBT/FIT (RR = 1.40, 95%CI: 1.09, 1.80), and were over 3 times more likely to undergo a colonoscopy (RR = 3.16, 95%CI: 1.26, 7.91). Conclusions: The findings underscore the efficacy of the intervention in increasing CRCS uptake, potentially preventing late-stage detection and reducing CRC mortality in PR. Full article