Interventions to Improve Endoscopic Screening Adherence of Cancer in High-Risk Populations: A Scoping Review.

Background: Colorectal, and gastric cancers have the second, and fourth mortality rates worldwide, respectively. Endoscopic screening is a crucial diagnostic tool for colorectal, and gastric cancers. Effective interventions can improve adherence to endoscopic screening in high-risk populations, which is important for cancer prevention and mortality reduction. This study aimed to identify interventions that could improve adherence to endoscopic screening for cancer in high-risk populations. Methods: Combination keywords including colorectal cancer, gastric cancer, screening adherence, and interventions were used to search for articles in PubMed, Web of Science, Cochrane Library, and MEDLINE Complete. The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR). Results: A total of 12 articles were included in this review: 9 randomized controlled trials(RCT) and 3 quasi-experimental studies(QEDs). Among the extracted studies, 11 were about colorectal cancer, and 1 was about gastric cancer. Most studies used lecture-based or Information Technology-based health education interventions. Narrative interventions have proven to be novel and effective approaches for promoting adherence to endoscopic screening. Health education interventions included cancer epidemiology, cancer risk factors, warning symptoms, and screening methods. Conclusion: All interventions involved were effective in increasing individual knowledge of cancer-related endoscopic screening, willingness to undergo screening, and screening behaviors. These findings provide a reference for designing endoscopy-related cancer screening interventions.

Knowledge and belief of fecal occult blood screening: A systematic review.

INTRODUCTION: Colorectal cancer (CRC) is associated with a high incidence and mortality rate. Fecal occult blood test (FOBT) is effective in the prevention of CRC. OBJECTIVE: This study aimed to assess knowledge and beliefs regarding FOBT-based screening. METHODS: This study used PubMed, Cochrane Library, MEDLINE Complete, and Web of Science to search for articles. Original full-text studies in English language focusing on knowledge and beliefs of FOBT screening were included. RESULTS: A total of 32 articles were included. This study indicated that the population in most studies had inadequate knowledge and lacked beliefs toward FOBT-based screening. Most of the extracted studies showed that less than half of the participants had heard of FOBT-based screening. Six studies showed that less than 50% of participants had knowledge of FOBT age. Three studies found that less than 40% of participants were aware of the screening interval. Some participants perceived the benefits of FOBT-based screening, while others perceived many barriers to the test. CONCLUSION: Participants' knowledge and belief in FOBT-based screening were insufficient. This review highlights the importance of educational programs to increase knowledge and beliefs regarding FOBT-based screening. It is important to include FOBT-based screening in the health care system to promote the secondary prevention of CRC.

What is the general Chinese public's awareness of and attitudes towards Helicobacter pylori screening and associated health behaviours? A cross-sectional study.

OBJECTIVE: To evaluate the general population's awareness of and attitudes toward Helicobacter pylori (HP) screening and health behaviours. DESIGN: Cross-sectional study. SETTING: Hengyang, Hunan Province, China. PARTICIPANTS: Using stratified cluster random sampling, a pretested structured questionnaire was used to interview members of the general population aged ≥18 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Knowledge of and attitudes toward HP screening and associated health behaviours, sociodemographic factors associated with HP knowledge, and screening behaviours. RESULTS: This study featured 1042 participants. The average knowledge score was 11 (QL=4, QU=20, range 0-29). Approximately 68.9% of the participants said they had heard of HP, but 67.5% had never had an HP test. The most common reasons for not undergoing screening were 'no symptoms' (55.7%) and 'lack of knowledge regarding the benefits of the test' (21.1%). Independent factors related to knowledge included age, education level, occupation, HP infection, frequency of drinking unboiled water (p<0.05). Factors independently associated with screening behaviour included occupation, average monthly income, presence/absence of indigestion, stomach discomfort or pain, and/or stomach disease and knowledge score (p<0.05). Overall, 941 (90.3%) participants never used anti-HP toothpaste, and 442 (40.5%) never used serving spoons or chopsticks. The risk factors for HP infection included eating out and eating in groups (p<0.05). CONCLUSION: In China, the general population has poor knowledge of HP, but most people have a positive attitude towards HP screening. Being asymptomatic and lacking knowledge about testing were the main reasons for reluctance to be screened. These results highlight the urgent need for educational activities to raise awareness, enhance screening rates for HP, and encourage people to adopt a healthy lifestyle.

Personalized Immunotherapy in Colorectal Cancers: Where Do We Stand?

Colorectal cancer (CRC) is the second leading cause of cancer death in the world. Immunotherapy using monoclonal antibodies, immune-checkpoint inhibitors, adoptive cell therapy, and cancer vaccines has raised great hopes for treating poor prognosis metastatic CRCs that are resistant to the conventional therapies. However, high inter-tumor and intra-tumor heterogeneity hinder the success of immunotherapy in CRC. Patients with a similar tumor phenotype respond differently to the same immunotherapy regimen. Mutation-based classification, molecular subtyping, and immunoscoring of CRCs facilitated the multi-aspect grouping of CRC patients and improved immunotherapy. Personalized immunotherapy using tumor-specific neoantigens provides the opportunity to consider each patient as an independent group deserving of individualized immunotherapy. In the recent decade, the development of sequencing and multi-omics techniques has helped us classify patients more precisely. The expansion of such advanced techniques along with the neoantigen-based immunotherapy could herald a new era in treating heterogeneous tumors such as CRC. In this review article, we provided the latest findings in immunotherapy of CRC. We elaborated on the heterogeneity of CRC patients as a bottleneck of CRC immunotherapy and reviewed the latest advances in personalized immunotherapy to overcome CRC heterogeneity.

Preclinical tumor organoid models in personalized cancer therapy: Not everyone fits the mold.

In contrast to conventional cancer treatment, in personalized cancer medicine each patient receives a specific treatment. The response to therapy, clinical outcomes, and tumor behavior such as metastases, tumor progression, carcinogenesis can be significantly affected by the heterogeneous tumor microenvironment (TME) and interpersonal differences. Therefore, using native tumor microenvironment mimicking models is necessary to improving personalized cancer therapy. Both in vitro 2D cell culture and in vivo animal models poorly recapitulate the heterogeneous tumor (immune) microenvironments of native tumors. The development of 3D culture models, native tumor microenvironment mimicking models, made it possible to evaluate the chemoresistance of tumor tissue and the functionality of drugs in the presence of cell-extracellular matrix and cell-cell interactions in a 3D construction. Various personalized tumor models have been designed to preserving the native tumor microenvironment, including patient-derived tumor xenografts and organoid culture strategies. In this review, we will discuss the patient-derived organoids as a native tumor microenvironment mimicking model in personalized cancer therapy. In addition, we will also review the potential and the limitations of organoid culture systems for predicting patient outcomes and preclinical drug screening. Finally, we will discuss immunotherapy drug screening in tumor organoids by using microfluidic technology.

A Systematic Review of the Potential Chemoprotective Effects of Resveratrol on Doxorubicin-Induced Cardiotoxicity: Focus on the Antioxidant, Antiapoptotic, and Anti-Inflammatory Activities.

PURPOSE: Although doxorubicin chemotherapeutic drug is commonly used to treat various solid and hematological tumors, its clinical use is restricted because of its adverse effects on the normal cells/tissues, especially cardiotoxicity. The use of resveratrol may mitigate the doxorubicin-induced cardiotoxic effects. For this aim, we systematically reviewed the potential chemoprotective effects of resveratrol against the doxorubicin-induced cardiotoxicity. METHODS: In the current study, a systematic search was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline for the identification of all relevant studies on "the role of resveratrol on doxorubicin-induced cardiotoxicity" in the electronic databases of Web of Science, PubMed, and Scopus up to March 2021 using search terms in their titles and abstracts. Two hundred and eighteen articles were screened in accordance with a predefined set of inclusion and exclusion criteria. Finally, 33 eligible articles were included in this systematic review. RESULTS: The in vitro and in vivo findings demonstrated a decreased cell survival, increased mortality, decreased heart weight, and increased ascites in the doxorubicin-treated groups compared to the control groups. The combined treatment of resveratrol and doxorubicin showed an opposite pattern than the doxorubicin-treated groups alone. Furthermore, this chemotherapeutic agent induced the biochemical and histopathological changes on the cardiac cells/tissue; however, the results (for most of the cases) revealed that these alterations induced by doxorubicin were reversed near to normal levels (control groups) by resveratrol coadministration. CONCLUSION: The results of this systematic review stated that coadministration of resveratrol alleviates the doxorubicin-induced cardiotoxicity. Resveratrol exerts these chemoprotective effects through several main mechanisms of antioxidant, antiapoptosis, and anti-inflammatory.

Awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China: a cross-sectional study.

OBJECTIVE: To assess the awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China. DESIGN: A cross-sectional study was employed. SETTING: This study was conducted in nine hospitals in Hunan province, China. PARTICIPANTS: Individuals with a high-risk for colorectal cancer were interviewed using a pretested structured questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES: Knowledge, attitude towards colorectal cancer screening, sociodemographic factors associated with screening knowledge and behaviour and barriers of colorectal cancer screening. RESULTS: This study included 684 participants. The mean knowledge score was 11.86/24 (SD 4.84). But over 70% of them held a positive attitude towards screening. Only 13.3% had undergone colorectal cancer screening. Independent factors related to knowledge were education level of college or above, working as a white collar, higher income, having health insurance, having seen a doctor in the past year and with a high perceived risk (p<0.05). Factors independently associated with screening behaviour included personal history of colorectal disease, having seen a doctor in the past year, previous discussion of colorectal cancer screening, high perceived risk and better knowledge (p<0.05). Main reasons for not undergoing screening were no symptoms or discomfort (71.1%), never having thought of the disease or screening (67.4%) and no doctor advised me (29.8%). CONCLUSION: In China, the majority of high-risk people had deficient knowledge and had never undergone colorectal cancer screening. But most of them held a positive attitude towards the benefits of colorectal cancer screening. This has promising implications to design targeted educational campaigns and establish screening programmes to improve colorectal cancer awareness and screening participation. Healthcare professionals should advise high-risk individuals to participate in screening and inform them about cancer risk.

Sunitinib mesylate inhibits proliferation of human colonic stromal fibroblasts in vitro and in vivo.

OBJECTIVE: Cancer stromal fibroblasts are important members of the cancer microenvironment. In this study, we determined the effect of sunitinib, a small molecule tyrosine kinase inhibitor, on the primary human colonic fibroblasts. METHODS: Cell cycle analysis and cell proliferation assays were performed to evaluate the inhibitory effect of sunitinib in vitro. Western-blot analysis was performed to evaluate variations in the levels of phosphorylated platelet-derived growth factor receptor ß (PDGFR-ß), Akt, and ERK proteins. Co-injection of SW620 cells and colonic fibroblasts in nude mice was employed to test anti-growth efficacy in vivo. RESULTS: Sunitinib was found to effectively inhibit the growth of primary colonic fibroblasts. Low-dose sunitinib blocked the PDGF-BB-induced cell proliferation and PDGFR-ß signaling. Co-injection of SW620 cells and colonic fibroblasts in nude mice generated greater tumor volumes than single injection of SW620 cells. Sunitinib treatment inhibited the SW620 cell+colonic fibroblast tumor growth more effectively than treatment of 5-fluorouracil. CONCLUSIONS: Sunitinib mesylate inhibited the proliferation of primary human colonic fibroblasts through target-inhibited PDGFR signaling in vitro and in vivo.

[Ecological distributions of airborne fungi in outdoor environments in Beijing, China].

An investigation on fungal types, concentrations, and their dynamic variation in outdoor environments was carried out in three different functional areas around one year in Beijing. Results show that the fungal concentrations varied widely and the average was (1164.8 +/- 73.2) CFU x m(-3), ranging from 23.6CFU x m(-3) to 13 959.5 CFU x m(-3). The most common culturable airborne fungi in all seasons and all functional areas were Cladosporium , nonsporulating fungi, Alternaria, Penicillium and Aspergillus. The most dominant fungus was Cladosporium, which contributed to more than 1/3 of the total. The fungal levels in culture and education region (CER) and garden green region (GGR) were highest in the fall and summer, and lowest in the winter and spring, while the seasonal variation in main traffic line (MTL) was not significant. The fungal concentrations in CER and GGR were significantly higher than in MTL (p <0.05). No statistically significant difference exists between CER and GGR.

[Granularity distribution of airborne microbes in summer in Beijing].

A study on granularity distribution of airborne microbes was conducted in details in summer, and the fluctuation regular was analyzed in Beijing. Results show that the distribution characteristics which are not changed with the different functional regions and periods are very different among airborne bacteria, fungi and actinomycete. Airborne bacteria appear skew distribution, the particles larger than 2.0 microm account for 80.0% of the total while smaller than 1.0 microm contribute 9.0% approximately. Airborne fungi are recorded with normal logarithm distribution, the particles between 1.0 microm and 6.0 microm account for 70.0% while smaller than 1.0 microm contribute 5.0% approximately. The distribution of airborne actinomycete are completely opposite to fungi, the particles larger than 8.2 microm and smaller than 1.0 microm account for 60.0% while between 3.0 microm and 6.0 microm contribute 10.0% approximately. Moreover, the granularity distribution of dominant fungi is consistent in different functional regions. But Cladosporium, Penicillium and Aspergillus are most collected in F3, F4 and F5 grades (1.0-6.0 microm) while Alternaria and nonsporing most in former four grades (>2.0 microm) of FA-I sampler, contributing 85.0%, 85.0%, 85.0%, 90.0% and 75.0% of the total respectively. The granularity of former presents normal logarithm distribution and latter skew distribution. In the past ten years, it is no change on the trend of microbial granularity distribution in Beijing, but the peak value declines from 3.0-6.0 microm to 2.0-3.0 microm.