NEJM â Collection Updates for Colorectal Cancer

REVIEW ARTICLE: Molecular Basis of Colorectal Cancer

Sanford D. Markowitz, M.D., Ph.D., and Monica M. Bertagnolli, M.D. — Thu, 17Â DecÂ 2009 00:00:00 -05:00

Every year in the United States, 160,000 cases of colorectal cancer are diagnosed, and 57,000 patients die of the disease, making it the second leading cause of death from cancer...

CLINICAL PRACTICE: Screening for Colorectal Cancer

David A. Lieberman, M.D. — Thu, 17Â SepÂ 2009 00:00:00 -05:00

A healthy 76-year-old woman presents as a new patient for primary care. She reports having one daily bowel movement and no rectal bleeding. She has no family history of colorectal...

EDITORIAL: The Capsule and Colorectal-Cancer Screening â The Crux of the Matter

Michael Bretthauer, M.D., Ph.D. — Thu, 16Â JulÂ 2009 00:00:00 -05:00

In the United States and other countries, colonoscopy has emerged as the primary screening test for colorectal cancer. Colonoscopy is believed to prevent colorectal cancer because polyps are removed during...

ORIGINAL ARTICLE: Capsule Endoscopy versus Colonoscopy for the Detection of Polyps and Cancer

Thu, 16Â JulÂ 2009 00:00:00 -05:00

Background: An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was designed to explore the colon. This study compared capsule endoscopy with optical colonoscopy...

CORRESPONDENCE: Mutation in Metastatic Colorectal Cancer

Thu, 02Â JulÂ 2009 00:00:00 -05:00

To the Editor: We recently found that progression-free survival was shorter among patients with metastatic colorectal cancer treated with chemotherapy, bevacizumab, and cetuximab (CBC regimen) than among patients who received...

PERSPECTIVE: CMS's Landmark Decision on CT Colonography â Examining the Relevant Data

Thu, 25Â JunÂ 2009 00:00:00 -05:00

In an unprecedented endorsement of evidence-based medicine, the Centers for Medicare and Medicaid Services (CMS) recently decided to deny coverage of computed tomographic (CT) colonography for cancer screening, concluding that...

ORIGINAL ARTICLE: Cetuximab and Chemotherapy as Initial Treatment for Metastatic Colorectal Cancer

Thu, 02Â AprÂ 2009 00:00:00 -05:00

Background: We investigated the efficacy of cetuximab plus irinotecan, fluorouracil, and leucovorin (FOLFIRI) as first-line treatment for metastatic colorectal cancer and sought associations between the mutation status of the KRAS...

EDITORIAL: Targeted Therapy for Advanced Colorectal Cancer â More Is Not Always Better

Robert J. Mayer, M.D. — Thu, 05Â FebÂ 2009 00:00:00 -05:00

During the past few years, the outlook for patients with colorectal cancer has brightened considerably. Fluorouracil, an inhibitor of thymidylate synthase (and therefore DNA synthesis), was until recently the only...

ORIGINAL ARTICLE: Chemotherapy, Bevacizumab, and Cetuximab in Metastatic Colorectal Cancer

Thu, 05Â FebÂ 2009 00:00:00 -05:00

Background: Fluoropyrimidine-based chemotherapy plus the antiâvascular endothelial growth factor (VEGF) antibody bevacizumab is standard first-line treatment for metastatic colorectal cancer. We studied the effect of adding the antiâepidermal growth factor...

ORIGINAL ARTICLE: Effect of Aspirin or Resistant Starch on Colorectal Neoplasia in the Lynch Syndrome

Thu, 11Â DecÂ 2008 00:00:00 -05:00

Background: Observational and epidemiologic data indicate that the use of aspirin reduces the risk of colorectal neoplasia; however, the effects of aspirin in the Lynch syndrome (hereditary nonpolyposis colon cancer)...

EDITORIAL: Targeting EGFR in Colorectal Cancer

Wells A. Messersmith, M.D., and Dennis J. Ahnen, M.D. — Thu, 23Â OctÂ 2008 00:00:00 -05:00

In the United States, cancer is the most common cause of death among people under the age of 85 years, and colorectal cancer is the second most common cause of...

ORIGINAL ARTICLE: Mutations and Benefit from Cetuximab in Advanced Colorectal Cancer

Thu, 23Â OctÂ 2008 00:00:00 -05:00

Background: Treatment with cetuximab, a monoclonal antibody directed against the epidermal growth factor receptor, improves overall and progression-free survival and preserves the quality of life in patients with colorectal cancer...

EDITORIAL: Colorectal Cancer Screening on Stronger Footing

Robert H. Fletcher, M.D., M.Sc. — Thu, 18Â SepÂ 2008 00:00:00 -05:00

Screening for colorectal cancer has lagged behind other cancer screening, but it is now in a dynamic phase. New screening tests are available, and there is stronger evidence of their...

ORIGINAL ARTICLE: Five-Year Risk of Colorectal Neoplasia after Negative Screening Colonoscopy

Thu, 18Â SepÂ 2008 00:00:00 -05:00

Background: The appropriate interval for endoscopic rescreening after a negative colonoscopic examination is uncertain.

Methods: We identified persons with no adenomas on baseline screening colonoscopy who returned at 5 years for...

ORIGINAL ARTICLE: Accuracy of CT Colonography for Detection of Large Adenomas and Cancers

Thu, 18Â SepÂ 2008 00:00:00 -05:00

Background: Computed tomographic (CT) colonography is a noninvasive option in screening for colorectal cancer. However, its accuracy as a screening tool in asymptomatic adults has not been well defined.

Methods: We...

ORIGINAL ARTICLE: Cetuximab for the Treatment of Colorectal Cancer

Thu, 15Â NovÂ 2007 00:00:00 -05:00

Background: Cetuximab, an IgG1 chimeric monoclonal antibody against epidermal growth factor receptor (EGFR), has activity against colorectal cancers that express EGFR.

Methods: From December 2003 to August 2005, 572 patients who...

ORIGINAL ARTICLE: CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia

Thu, 04Â OctÂ 2007 00:00:00 -05:00

Background: Advanced neoplasia represents the primary target for colorectal-cancer screening and prevention. We compared the diagnostic yield from parallel computed tomographic colonography (CTC) and optical colonoscopy (OC) screening programs.

Methods: We...

ORIGINAL ARTICLE: Rofecoxib and Cardiovascular Adverse Events in Adjuvant Treatment of Colorectal Cancer

Thu, 26Â JulÂ 2007 00:00:00 -05:00

Background: Selective cyclooxygenase inhibitors may retard the progression of cancer, but they have enhanced thrombotic potential. We report on cardiovascular adverse events in patients receiving rofecoxib to reduce rates of...

EDITORIAL: Aspirin and Colon Cancer â Targeting Prevention?

Sanford D. Markowitz, M.D., Ph.D. — Thu, 24Â MayÂ 2007 00:00:00 -05:00

The compelling evidence that chronic use of aspirin or certain nonsteroidal antiinflammatory drugs (NSAIDs) can substantially lower the risk of colon cancer has important implications, especially because colon cancer is...

ORIGINAL ARTICLE: Aspirin and the Risk of Colorectal Cancer in Relation to the Expression of COX-2

Thu, 24Â MayÂ 2007 00:00:00 -05:00

Background: Regular use of aspirin reduces the risk of a colorectal neoplasm, but the mechanism by which aspirin affects carcinogenesis in the colon is not well understood.

Methods: We estimated cyclooxygenase-2...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 13-2007 â A 46-Year-Old Woman with Gynecologic and Intestinal Cancers

Thu, 26Â AprÂ 2007 00:00:00 -05:00

A 46-year-old woman came to the Center for Cancer Risk Analysis at the Cancer Center of this hospital because of recent diagnoses of endometrial, ovarian, and colonic cancers.

Fifteen weeks earlier,...

EDITORIAL: Genetics and Epigenetics â Nature's Pen-and-Pencil Set

Roger G. Gosden, Ph.D., D.Sc., and Andrew P. Feinberg, M.D. — Thu, 15Â FebÂ 2007 00:00:00 -05:00

The sequence of the four nucleotides of the genetic code is like an indelible ink that, with rare exceptions, is faithfully transcribed from cell to cell and from generation to...

ORIGINAL ARTICLE: Inheritance of a Cancer-Associated Germ-Line Epimutation

Thu, 15Â FebÂ 2007 00:00:00 -05:00

Persons who have hypermethylation of one allele of MLH1 in somatic cells throughout the body (a germ-line epimutation) have a predisposition for the development of cancer in a pattern typical...

IMAGES IN CLINICAL MEDICINE: Progression of a Pedunculated Polyp

Kuangi Fu, M.D., Ph.D. and Yasushi Sano, M.D., Ph.D. — Thu, 02Â NovÂ 2006 00:00:00 -05:00

A 56-year-old man underwent a colonoscopy after a positive fecal occult-blood test. Colonoscopy revealed two pedunculated polyps, one in the ascending colon and one in the transverse colon. One polyp...

ORIGINAL ARTICLE: Colonoscopy in Colorectal-Cancer Screening for Detection of Advanced Neoplasia

Thu, 02Â NovÂ 2006 00:00:00 -05:00

Background: Recommendations for colorectal-cancer screening are based solely on age and family history of cancer, not sex.

Methods: We performed a cross-sectional analysis of the data from a large colonoscopy-based screening...

PERSPECTIVE: Time-to-Event Analyses for Long-Term Treatments â The APPROVe Trial

Thu, 13Â JulÂ 2006 00:00:00 -05:00

The Adenomatous Polyp Prevention on Vioxx (APPROVe) trial1 compared rofecoxib with placebo in the prevention of recurrent colorectal polyps, but the researchers also collected data on adverse cardiovascular events, including...

EDITORIAL: Decoding Hereditary Colorectal Cancer

C. Richard Boland, M.D. — Thu, 29Â JunÂ 2006 00:00:00 -05:00

This year, colorectal cancer will strike about 150,000 people in the United States and 500,000 worldwide. Much of the morbidity and mortality of the disease could be prevented if we...

ORIGINAL ARTICLE: Identification and Survival of Carriers of Mutations in DNA Mismatch-Repair Genes in Colon Cancer

Thu, 29Â JunÂ 2006 00:00:00 -05:00

Background: The identification of mutations in germ-line DNA mismatch-repair genes at the time of diagnosis of colorectal cancer is important in the management of the disease.

Methods: Without preselection and regardless...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Colon Cancer â Understanding How NSAIDs Work

Hans Clevers, M.D., Ph.D. — Thu, 16Â FebÂ 2006 00:00:00 -05:00

Chronic inflammation of the intestine and colorectal cancer are closely associated. The risk of colorectal cancer among patients with ulcerative colitis is an order of magnitude higher than the risk...

EDITORIAL: Calcium plus Vitamin D Supplementation and Colorectal Cancer in Women

Michele R. Forman, Ph.D., and Bernard Levin, M.D. — Thu, 16Â FebÂ 2006 00:00:00 -05:00

The effect of vitamin and mineral supplementation and diet on the risk of colorectal cancer is an active area of research. In this issue of the Journal, Wactawski-Wende et al.1...

ORIGINAL ARTICLE: Calcium plus Vitamin D Supplementation and the Risk of Colorectal Cancer

Thu, 16Â FebÂ 2006 00:00:00 -05:00

Background: Higher intake of calcium and vitamin D has been associated with a reduced risk of colorectal cancer in epidemiologic studies and polyp recurrence in polyp-prevention trials. However, randomized-trial evidence...

IMAGES IN CLINICAL MEDICINE: Subacute Urinary Retention

Sameer Kassem, M.D. and Gideon Friedman, M.D. — Thu, 09Â FebÂ 2006 00:00:00 -05:00

An 88-year-old man with benign prostate hypertrophy and ischemic heart disease who had undergone an anterior peritoneal resection due to adenocarcinoma of the rectum presented with a three-month history of...

EDITORIAL: Reducing the Risk of Gynecologic Cancer in the Lynch Syndrome

Kenneth Offit, M.D., M.P.H., and Noah D. Kauff, M.D. — Thu, 19Â JanÂ 2006 00:00:00 -05:00

The first description of a kindred with hereditary nonpolyposis colorectal cancer (HNPCC) in 1925 was based on the family history of a woman who later died from endometrial cancer. On...

ORIGINAL ARTICLE: Prophylactic Surgery to Reduce the Risk of Gynecologic Cancers in the Lynch Syndrome

Thu, 19Â JanÂ 2006 00:00:00 -05:00

Background: Women with the Lynch syndrome (hereditary nonpolyposis colorectal cancer) have a 40 to 60 percent lifetime risk of endometrial cancer and a 10 to 12 percent lifetime risk of...

ORIGINAL ARTICLE: Effector Memory T Cells, Early Metastasis, and Survival in Colorectal Cancer

Thu, 22Â DecÂ 2005 00:00:00 -05:00

Background: The role of tumor-infiltrating immune cells in the early metastatic invasion of colorectal cancer is unknown.

Methods: We studied pathological signs of early metastatic invasion (venous emboli and lymphatic and...

IMAGES IN CLINICAL MEDICINE: Cetuximab-Associated Acneiform Eruption

Jeremy E. Moss, M.D., Ph.D. and Barbara Burtness, M.D. — Thu, 10Â NovÂ 2005 00:00:00 -05:00

A 48-year-old man who has metastatic colon cancer was treated with intravenous fluorouracil, leucovorin, oxaliplatin, and cetuximab, which is a monoclonal antibody to the epidermal growth factor receptor (EGFR). He...

IMAGES IN CLINICAL MEDICINE: Actinomyces Hepatic Abscess with Cutaneous Fistula

Mustafa Saad, M.D. and Jonathan Moorman, M.D., Ph.D. — Thu, 03Â NovÂ 2005 00:00:00 -05:00

A 64-year-old man with a history of colonic resection for adenocarcinoma six years earlier presented with weakness and abdominal discomfort of six months' duration. Computed tomography of the abdomen with...

IMAGES IN CLINICAL MEDICINE: Relapsed Colon Cancer

Guido Carillio, M.D. and Raffaele Longo, M.D. — Thu, 22Â SepÂ 2005 00:00:00 -05:00

A 67-year-old man presented with an asymptomatic swelling in the lateral surface of the left thigh three years after resection of a carcinoma of the left colon and synchronous liver...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 23-2005 â A 57-Year-Old Man with a Mass in the Liver

Thu, 28Â JulÂ 2005 00:00:00 -05:00

A 57-year-old man was admitted to the hospital because of a mass in the liver.

The patient had been well until approximately two years before admission, when a diagnosis of chronic...

EDITORIAL: Adjuvant Therapy for Colon Cancer â The Pace Quickens

Carmen Allegra, M.D., and Daniel J. Sargent, Ph.D. — Thu, 30Â JunÂ 2005 00:00:00 -05:00

Every year in the United States, approximately 30,000 people receive the diagnosis of lymph-nodeâpositive colon cancer (stage III); worldwide, the number approaches 200,000. The primary therapy for this condition is...

IMAGES IN CLINICAL MEDICINE: The Virtual Apple Core of a Colonic Carcinoma

Eric M. Rubin, M.D. and Vassilios D. Raptopoulos, M.D. — Thu, 30Â JunÂ 2005 00:00:00 -05:00

A 67-year-old woman presented with a three-month history of abdominal pain, weight loss, and rectal bleeding. She had never been screened for colon cancer. Laboratory evaluation revealed a hematocrit of...

ORIGINAL ARTICLE: Capecitabine as Adjuvant Treatment for Stage III Colon Cancer

Thu, 30Â JunÂ 2005 00:00:00 -05:00

Background: Intravenous bolus fluorouracil plus leucovorin is the standard adjuvant treatment for colon cancer. The oral fluoropyrimidine capecitabine is an established alternative to bolus fluorouracil plus leucovorin as first-line treatment...

EDITORIAL: Statins and Cancer â Beyond the âOne Drug, One Diseaseâ Model

Ernest Hawk, M.D., M.P.H., and Jaye L. Viner, M.D., M.P.H. — Thu, 26Â MayÂ 2005 00:00:00 -05:00

Colorectal cancer is a major health concern, with more than 1 million cases and half a million cancer-related deaths estimated worldwide in 2002.1 These statistics are sobering, considering that the...

ORIGINAL ARTICLE: Statins and the Risk of Colorectal Cancer

Thu, 26Â MayÂ 2005 00:00:00 -05:00

Background: Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and effective lipid-lowering agents. Statins inhibit the growth of colon-cancer cell lines, and secondary analyses of some, but not all, clinical...

ORIGINAL ARTICLE: Colonoscopic Screening of Average-Risk Women for Colorectal Neoplasia

Thu, 19Â MayÂ 2005 00:00:00 -05:00

Background: Veterans Affairs (VA) Cooperative Study 380 showed that some advanced colorectal neoplasias (i.e., adenomas at least 1 cm in diameter, villous adenomas, adenomas with high-grade dysplasia, or cancer) in...

EDITORIAL: New Treatment Options for Colorectal Cancer

Charles Erlichman, M.D., and Daniel J. Sargent, Ph.D. — Thu, 22Â JulÂ 2004 00:00:00 -05:00

Epidermal growth factor receptor (EGFR) is a member of the HER family of tyrosine kinase cell-surface receptors that are dysregulated in many types of tumor; its expression has been associated...

ORIGINAL ARTICLE: Cetuximab Monotherapy and Cetuximab plus Irinotecan in Irinotecan-Refractory Metastatic Colorectal Cancer

Thu, 22Â JulÂ 2004 00:00:00 -05:00

Background: The epidermal growth factor receptor (EGFR), which participates in signaling pathways that are deregulated in cancer cells, commonly appears on colorectal-cancer cells. Cetuximab is a monoclonal antibody that specifically...

PERSPECTIVE: The Price Tag on Progress â Chemotherapy for Colorectal Cancer

Deborah Schrag, M.D., M.P.H. — Thu, 22Â JulÂ 2004 00:00:00 -05:00

From the 1960s until the mid-1990s, fluorouracil was the primary chemotherapeutic agent available for the treatment of colorectal cancer. During the past decade, the Food and Drug Administration (FDA) has...

ORIGINAL ARTICLE: Tumor Microsatellite-Instability Status as a Predictor of Benefit from Fluorouracil-Based Adjuvant Chemotherapy for Colon Cancer

Thu, 17Â JulÂ 2003 00:00:00 -05:00

Background: Colon cancers with high-frequency microsatellite instability have clinical and pathological features that distinguish them from microsatellite-stable tumors. We investigated the usefulness of microsatellite-instability status as a predictor of the...

PERSPECTIVE: Microsatellite Instability

Albert de la Chapelle, M.D., Ph.D. — Thu, 17Â JulÂ 2003 00:00:00 -05:00

Microsatellites are stretches of DNA in which a short motif (usually one to five nucleotides long) is repeated several times. A typical mononucleotide-repeat microsatellite might be, for instance, a stretch...

REVIEW ARTICLE: Hereditary Colorectal Cancer

Henry T. Lynch, M.D., and Albert de la Chapelle, M.D., Ph.D. — Thu, 06Â MarÂ 2003 00:00:00 -05:00

The annual incidence of colorectal cancer in the United States is approximately 148,300 (affecting 72,600 males and 75,700 females), with 56,600 deaths (in 27,800 males and 28,800 females).1 The lifetime...

ORIGINAL ARTICLE: A Randomized Trial of Aspirin to Prevent Colorectal Adenomas

Thu, 06Â MarÂ 2003 00:00:00 -05:00

Background: Laboratory and epidemiologic data suggest that aspirin has an antineoplastic effect in the large bowel.

Methods: We performed a randomized, double-blind trial of aspirin as a chemopreventive agent against colorectal...

ORIGINAL ARTICLE: A Randomized Trial of Aspirin to Prevent Colorectal Adenomas in Patients with Previous Colorectal Cancer

Thu, 06Â MarÂ 2003 00:00:00 -05:00

Background: Experimental studies in animals and observational studies in humans suggest that regular aspirin use may decrease the risk of colorectal adenomas, the precursors to most colorectal cancers.

Methods: We conducted...

PERSPECTIVE: Aspirin and the Prevention of Colorectal Cancer

Thomas F. Imperiale, M.D. — Thu, 06Â MarÂ 2003 00:00:00 -05:00

Awareness of the substantial morbidity and mortality attributable to colorectal cancer has focused attention on early detection and prevention through screening and on other strategies such as chemoprevention. Among several...

EDITORIAL: Multiple Colorectal Adenomas â Is Their Number Up?

Giancarlo Marra, M.D., Ph.D., and Josef Jiricny, Ph.D. — Thu, 27Â FebÂ 2003 00:00:00 -05:00

In this issue of the Journal, Sieber et al.1 report that up to 30 percent of cases of multiple colorectal adenomas (15 to 100 adenomas) might be linked to biallelic...

ORIGINAL ARTICLE: Multiple Colorectal Adenomas, Classic Adenomatous Polyposis, and Germ-Line Mutations in

Thu, 27Â FebÂ 2003 00:00:00 -05:00

Background: Germ-line mutations in the base-excisionârepair gene MYH have been associated with recessive inheritance of multiple colorectal adenomas. Tumors from affected persons displayed excess somatic transversions of a guanineâcytosine pair...

ORIGINAL ARTICLE: Results of Screening Colonoscopy among Persons 40 to 49 Years of Age

Thu, 06Â JunÂ 2002 00:00:00 -05:00

Background: The prevalence of colorectal lesions in persons 40 to 49 years of age, as identified on colonoscopy, has not been determined.

Methods: 02060626.xml We reviewed the procedure and pathology reports...

EDITORIAL: Cyclooxygenase Inhibition in Cancer â A Blind Alley or a New Therapeutic Reality?

Thu, 04Â AprÂ 2002 00:00:00 -05:00

In their prevention trial, published in this issue of the Journal, Giardiello et al. showed that the nonsteroidal antiinflammatory drug (NSAID) sulindac did not inhibit the development of colorectal adenomatous...

ORIGINAL ARTICLE: Primary Chemoprevention of Familial Adenomatous Polyposis with Sulindac

Thu, 04Â AprÂ 2002 00:00:00 -05:00

Background: Familial adenomatous polyposis is caused by a germ-line mutation in the adenomatous polyposis coli gene and is characterized by the development of hundreds of colorectal adenomas and, eventually, colorectal...

ORIGINAL ARTICLE: Detection of Mutations in Fecal DNA from Patients with Colorectal Tumors

Thu, 31Â JanÂ 2002 00:00:00 -05:00

Background: Noninvasive methods for detecting colorectal tumors have the potential to reduce morbidity and mortality from this disease. The mutations in the adenomatous polyposis coli (APC) gene that initiate colorectal...

PERSPECTIVE: A Needle in a Haystack of Genes

Thu, 31Â JanÂ 2002 00:00:00 -05:00

The holy grail of cancer screening is a sensitive, specific, and noninvasive test for the detection of malignant cells. Cytologic analysis of urine or sputum has not lived up to...

CLINICAL PRACTICE: Screening for Colorectal Cancer

David F. Ransohoff, M.D., and Robert S. Sandler, M.D., M.P.H. — Thu, 03Â JanÂ 2002 00:00:00 -05:00

A healthy 50-year-old woman at average risk for colorectal cancer (i.e., age is her only risk factor) is scheduled to undergo a periodic examination. Which screening test for colorectal cancer...

ORIGINAL ARTICLE: A Pooled Analysis of Adjuvant Chemotherapy for Resected Colon Cancer in Elderly Patients

Thu, 11Â OctÂ 2001 00:00:00 -05:00

Background: Adjuvant chemotherapy is standard treatment for patients with resected colon cancer who are at high risk for recurrence, but the efficacy and toxicity of such treatment in patients more...

EDITORIAL: Refining Multimodal Therapy for Rectal Cancer

Thu, 30Â AugÂ 2001 00:00:00 -05:00

For a short time, the treatment of rectal cancer seemed clear and definitive. The 1990 National Institutes of Health consensus statement concluded, âCombined postoperative chemotherapy and radiation therapy improves local...

ORIGINAL ARTICLE: Preoperative Radiotherapy Combined with Total Mesorectal Excision for Resectable Rectal Cancer

Thu, 30Â AugÂ 2001 00:00:00 -05:00

Background: Short-term preoperative radiotherapy and total mesorectal excision have each been shown to improve local control of disease in patients with resectable rectal cancer. We conducted a multicenter, randomized trial...

EDITORIAL: Screening for Colon Cancer â Can We Afford Colonoscopy?

Thu, 23Â AugÂ 2001 00:00:00 -05:00

Over the past 20 years, much has been learned about screening for colon cancer from biologic, epidemiologic, and clinical studies.1 Colorectal cancer is a leading cause of death in the...

ORIGINAL ARTICLE: One-Time Screening for Colorectal Cancer with Combined Fecal Occult-Blood Testing and Examination of the Distal Colon

Thu, 23Â AugÂ 2001 00:00:00 -05:00

Background: Fecal occult-blood testing and sigmoidoscopy have been recommended for screening for colorectal cancer, but the sensitivity of such combined testing for detecting neoplasia is uncertain. At 13 Veterans Affairs...

ORIGINAL ARTICLE: Molecular Predictors of Survival after Adjuvant Chemotherapy for Colon Cancer

Thu, 19Â AprÂ 2001 00:00:00 -05:00

Background: Adjuvant chemotherapy improves survival among patients with stage III colon cancer, but no reliable molecular predictors of outcome have been identified.

Methods: We evaluated loss of chromosomal material (also called...

EDITORIAL: The Best Screening Test for Colorectal Cancer â A Personal Choice

Thu, 30Â NovÂ 2000 00:00:00 -05:00

It is well established that screening for colorectal cancer with the fecal occult-blood test significantly lowers the rate of death from the disease.1 The report by Mandel et al.2 in...

IMAGES IN CLINICAL MEDICINE: Gas Gangrene Associated with Occult Cancer

David J. Schneider, M.D. and J. Spence Reid, M.D. — Thu, 30Â NovÂ 2000 00:00:00 -05:00

Figure 1. A 78-year-old man with cardiac disease presented with pain in his left elbow of several hours' duration in the absence of trauma. Examination of the elbow disclosed no...

ORIGINAL ARTICLE: The Effect of Fecal Occult-Blood Screening on the Incidence of Colorectal Cancer

Thu, 30Â NovÂ 2000 00:00:00 -05:00

Background: Both annual testing for fecal occult blood and biennial testing significantly reduce mortality from colorectal cancer. However, the effect of screening on the incidence of colorectal cancer remains uncertain,...

EDITORIAL: Moving beyond Fluorouracil for Colorectal Cancer

Thu, 28Â SepÂ 2000 00:00:00 -05:00

For more than 40 years, fluorouracil has been the mainstay of treatment for advanced colorectal cancer, the second leading cause of cancer-related death in the United States. The drug is...

ORIGINAL ARTICLE: Irinotecan plus Fluorouracil and Leucovorin for Metastatic Colorectal Cancer

Thu, 28Â SepÂ 2000 00:00:00 -05:00

Background: The combination of fluorouracil and leucovorin has until recently been standard therapy for metastatic colorectal cancer. Irinotecan prolongs survival in patients with colorectal cancer that is refractory to treatment...

EDITORIAL: Going the Distance â The Case for True Colorectal-Cancer Screening

Thu, 20Â JulÂ 2000 00:00:00 -05:00

Available screening methods should make it possible to prevent most deaths from colorectal cancer. Almost all colorectal cancers arise from adenomatous polyps that develop over a period of years. During...

ORIGINAL ARTICLE: Risk of Advanced Proximal Neoplasms in Asymptomatic Adults According to the Distal Colorectal Findings

Thu, 20Â JulÂ 2000 00:00:00 -05:00

Background: and Methods: The clinical significance of a distal colorectal polyp is uncertain. We determined the risk of advanced proximal neoplasia, defined as a polyp with villous features, a polyp...

ORIGINAL ARTICLE: Use of Colonoscopy to Screen Asymptomatic Adults for Colorectal Cancer

Thu, 20Â JulÂ 2000 00:00:00 -05:00

Background: and Methods: The role of colonoscopy in screening for colorectal cancer is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence and location of...

REVIEW ARTICLE: Chemoprevention of Colorectal Cancer

Pasi A. JÃ¤nne, M.D., Ph.D., and Robert J. Mayer, M.D. — Thu, 29Â JunÂ 2000 00:00:00 -05:00

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. It is estimated that this cancer will develop in 130,000 people in the United States in...

ORIGINAL ARTICLE: The Effect of Celecoxib, a Cyclooxygenase-2 Inhibitor, in Familial Adenomatous Polyposis

Thu, 29Â JunÂ 2000 00:00:00 -05:00

Background: Patients with familial adenomatous polyposis have a nearly 100 percent risk of colorectal cancer. In this disease, the chemopreventive effects of nonsteroidal antiinflammatory drugs may be related to their...

EDITORIAL: The End of Barium Enemas?

Thu, 15Â JunÂ 2000 00:00:00 -05:00

For many years, barium enema was the only way to obtain a complete structural examination of the colon, short of surgery. Development of the double-contrast barium enema improved the ability...

ORIGINAL ARTICLE: A Comparison of Colonoscopy and Double-Contrast Barium Enema for Surveillance after Polypectomy

Thu, 15Â JunÂ 2000 00:00:00 -05:00

Background: After patients have undergone colonoscopic polypectomy, it is uncertain whether colonoscopic examination or a barium enema is the better method of surveillance.

Methods: As part of the National Polyp Study,...

EDITORIAL: Diet, Colorectal Adenomas, and Colorectal Cancer

Thu, 20Â AprÂ 2000 00:00:00 -05:00

Because colorectal cancers usually arise from adenomatous polyps, it is believed that preventing the growth of adenomas in the colon and rectum or removing any that appear will prevent colorectal...

ORIGINAL ARTICLE: Lack of Effect of a High-Fiber Cereal Supplement on the Recurrence of Colorectal Adenomas

Thu, 20Â AprÂ 2000 00:00:00 -05:00

Background: The risks of colorectal cancer and adenoma, the precursor lesion, are believed to be influenced by dietary factors. Epidemiologic evidence that cereal fiber protects against colorectal cancer is equivocal....

ORIGINAL ARTICLE: Lack of Effect of a Low-Fat, High-Fiber Diet on the Recurrence of Colorectal Adenomas

Thu, 20Â AprÂ 2000 00:00:00 -05:00

Background: We tested the hypothesis that dietary intervention can inhibit the development of recurrent colorectal adenomas, which are precursors of most large-bowel cancers.

Methods: We randomly assigned 2079 men and women...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A Nuclear Receptor to Prevent Colon Cancer

Thu, 02Â MarÂ 2000 00:00:00 -05:00

It is not often that two seemingly separate lines of investigation converge to yield both a new insight into the pathogenesis of a disease and possibilities for clinical applications. Such...

ORIGINAL ARTICLE: Tumor Microsatellite Instability and Clinical Outcome in Young Patients with Colorectal Cancer

Thu, 13Â JanÂ 2000 00:00:00 -05:00

Background: Colorectal cancer can arise through two distinct mutational pathways: microsatellite instability or chromosomal instability. We tested the hypothesis that colorectal cancers arising from the microsatellite-instability pathway have distinctive clinical...

EDITORIAL: Genetic Prognostic Markers for Colorectal Cancer

Thu, 13Â JanÂ 2000 00:00:00 -05:00

Genetic testing is increasingly being used in the management of cancer. Cytogenetic and molecular genetic assays now play a part in the diagnosis and monitoring of a variety of leukemias,...

ORIGINAL ARTICLE: Hepatic Arterial Infusion of Chemotherapy after Resection of Hepatic Metastases from Colorectal Cancer

Thu, 30Â DecÂ 1999 00:00:00 -05:00

Background: Two years after undergoing resection of liver metastases from colorectal cancer, about 65 percent of patients are alive and 25 percent are free of detectable disease. We tried to...

EDITORIAL: Virtual Colonoscopy â Promising, but Not Ready for Widespread Use

Thu, 11Â NovÂ 1999 00:00:00 -05:00

Three-dimensional computed tomographic (CT) colography, or âvirtual colonoscopy,â is a promising new imaging method. The technique combines the use of rapid helical CT with computer software capable of rendering images...

ORIGINAL ARTICLE: A Comparison of Virtual and Conventional Colonoscopy for the Detection of Colorectal Polyps

Thu, 11Â NovÂ 1999 00:00:00 -05:00

Background: Virtual colonoscopy is a new method of imaging the colon in which thin-section, helical computed tomography (CT) is used to generate high-resolution, two-dimensional axial images. Three-dimensional images of the...

EDITORIAL: Fiber and Colorectal Cancer â Where to Now?

Thu, 21Â JanÂ 1999 00:00:00 -05:00

The idea that unrefined foods have an important influence on health goes back at least to Hippocrates. Writing in 1585, Stubs asked pointedly: âDoe we not see the poore man...

ORIGINAL ARTICLE: Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women

Thu, 21Â JanÂ 1999 00:00:00 -05:00

Background: A high intake of dietary fiber has been thought to reduce the risk of colorectal cancer and adenoma.

Methods: We conducted a prospective study of 88,757 women, who were 34...

ORIGINAL ARTICLE: Calcium Supplements for the Prevention of Colorectal Adenomas

Thu, 14Â JanÂ 1999 00:00:00 -05:00

Background: and Methods: Laboratory, clinical, and epidemiologic evidence suggests that calcium may help prevent colorectal adenomas. We conducted a randomized, double-blind trial of the effect of supplementation with calcium carbonate...

ORIGINAL ARTICLE: Aberrant Crypt Foci of the Colon as Precursors of Adenoma and Cancer

Thu, 29Â OctÂ 1998 00:00:00 -05:00

Background: Aberrant crypt foci of the colon are possible precursors of adenoma and cancer, but these lesions have been studied mainly in surgical specimens from patients who already had colon...

ORIGINAL ARTICLE: Clinical Findings with Implications for Genetic Testing in Families with Clustering of Colorectal Cancer

Thu, 20Â AugÂ 1998 00:00:00 -05:00

Background: Germ-line mutations in DNA mismatch-repair genes (MSH2, MLH1, PMS1, PMS2, and MSH6 ) cause susceptibility to hereditary nonpolyposis colorectal cancer. We assessed the prevalence of MSH2 and MLH1 mutations...

EDITORIAL: Improved Tumor Staging in Colorectal Cancer

Thu, 23Â JulÂ 1998 00:00:00 -05:00

Successful treatment is available for many neoplasms, but patients with cancer often die despite therapy because of a disseminated tumor that was not detected at the time of diagnosis. Surgery...

ORIGINAL ARTICLE: Micrometastases and Survival in Stage II Colorectal Cancer

Thu, 23Â JulÂ 1998 00:00:00 -05:00

Background: Standard treatment of colorectal cancer includes adjuvant chemotherapy for patients with stage III disease (defined by the presence of lymph-node metastases), but not for patients with stage II tumors...

EDITORIAL: Identifying Hereditary Nonpolyposis Colorectal Cancer

Thu, 21Â MayÂ 1998 00:00:00 -05:00

The recent discovery of the genetic basis of certain familial aggregations of colorectal cancer validated 90 years of clinical observation suggesting that such aggregations are hereditary.1 It also promised the...

ORIGINAL ARTICLE: Incidence of Hereditary Nonpolyposis Colorectal Cancer and the Feasibility of Molecular Screening for the Disease

Thu, 21Â MayÂ 1998 00:00:00 -05:00

Background: Genetic disorders that predispose people to colorectal cancer include the polyposis syndromes and hereditary nonpolyposis colorectal cancer. In contrast to the polyposis syndromes, hereditary nonpolyposis colorectal cancer lacks distinctive...

ORIGINAL ARTICLE: Improved Survival with Preoperative Radiotherapy in Resectable Rectal Cancer

Swedish Rectal Cancer Trial — Thu, 03Â AprÂ 1997 00:00:00 -05:00

Background: Adjuvant radiotherapy for rectal cancer has been extensively studied, but no trial has unequivocally demonstrated improved overall survival with radiotherapy, despite a reduction in the rate of local recurrence.

Methods:...

EDITORIAL: Adjuvant Therapy for Rectal Cancer â A Good First Step

Thu, 03Â AprÂ 1997 00:00:00 -05:00

The usual initial treatment for patients who present with clinically resectable rectal cancer is surgery. Adjuvant therapy for this disease has improved considerably in the past decade, and most clinical...

ORIGINAL ARTICLE: Importance of Adenomas 5 mm or Less in Diameter That Are Detected by Sigmoidoscopy

Thomas E. Read, M.D., Julie D. Read, R.N., and Lynn F. Butterly, M.D. — Thu, 02Â JanÂ 1997 00:00:00 -05:00

Background: The need for colonoscopy in patients with adenomas 5 mm or less in diameter that are detected by sigmoidoscopy is controversial.

Methods: We prospectively determined the prevalence of proximal colonic...

ORIGINAL ARTICLE: The DCC Protein and Prognosis in Colorectal Cancer

Thu, 05Â DecÂ 1996 00:00:00 -05:00

Background: Allelic loss of chromosome 18q predicts a poor outcome in patients with stage II colorectal cancer. Although the specific gene inactivated by this allelic loss has not been elucidated,...

EDITORIAL: Improving the Fecal Occult-Blood Test

Thu, 18Â JanÂ 1996 00:00:00 -05:00

Each year 60,000 people in the United States die of colorectal cancer. Current approaches to screening can reduce that number by perhaps one third. One clinical trial in the United...

ORIGINAL ARTICLE: A Comparison of Fecal Occult-Blood Tests for Colorectal-Cancer Screening

Thu, 18Â JanÂ 1996 00:00:00 -05:00

Background: Hemoccult II, a widely used guaiac test for fecal occult blood, has a low sensitivity for detecting colorectal neoplasms in asymptomatic patients at average risk. In such patients, the...

ORIGINAL ARTICLE: Risk of Colorectal Cancer in the Families of Patients with Adenomatous Polyps

Thu, 11Â JanÂ 1996 00:00:00 -05:00

Background: The adenomaâadenocarcinoma sequence in colorectal cancer suggests an increased risk of colorectal cancer in the families of patients with adenomatous polyps.

Methods: A random sample of participants in the National...

NEJM â Collection Updates for Colorectal Cancer

REVIEW ARTICLE: Molecular Basis of Colorectal Cancer

CLINICAL PRACTICE: Screening for Colorectal Cancer

EDITORIAL: The Capsule and Colorectal-Cancer Screening â The Crux of the Matter

ORIGINAL ARTICLE: Capsule Endoscopy versus Colonoscopy for the Detection of Polyps and Cancer

CORRESPONDENCE: Mutation in Metastatic Colorectal Cancer

PERSPECTIVE: CMS's Landmark Decision on CT Colonography â Examining the Relevant Data

ORIGINAL ARTICLE: Cetuximab and Chemotherapy as Initial Treatment for Metastatic Colorectal Cancer

EDITORIAL: Targeted Therapy for Advanced Colorectal Cancer â More Is Not Always Better

ORIGINAL ARTICLE: Chemotherapy, Bevacizumab, and Cetuximab in Metastatic Colorectal Cancer

ORIGINAL ARTICLE: Effect of Aspirin or Resistant Starch on Colorectal Neoplasia in the Lynch Syndrome

EDITORIAL: Targeting EGFR in Colorectal Cancer

ORIGINAL ARTICLE: Mutations and Benefit from Cetuximab in Advanced Colorectal Cancer

EDITORIAL: Colorectal Cancer Screening on Stronger Footing

ORIGINAL ARTICLE: Five-Year Risk of Colorectal Neoplasia after Negative Screening Colonoscopy

ORIGINAL ARTICLE: Accuracy of CT Colonography for Detection of Large Adenomas and Cancers

ORIGINAL ARTICLE: Cetuximab for the Treatment of Colorectal Cancer

ORIGINAL ARTICLE: CT Colonography versus Colonoscopy for the Detection of Advanced Neoplasia

ORIGINAL ARTICLE: Rofecoxib and Cardiovascular Adverse Events in Adjuvant Treatment of Colorectal Cancer

EDITORIAL: Aspirin and Colon Cancer â Targeting Prevention?

ORIGINAL ARTICLE: Aspirin and the Risk of Colorectal Cancer in Relation to the Expression of COX-2

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 13-2007 â A 46-Year-Old Woman with Gynecologic and Intestinal Cancers

EDITORIAL: Genetics and Epigenetics â Nature's Pen-and-Pencil Set

ORIGINAL ARTICLE: Inheritance of a Cancer-Associated Germ-Line Epimutation

IMAGES IN CLINICAL MEDICINE: Progression of a Pedunculated Polyp

ORIGINAL ARTICLE: Colonoscopy in Colorectal-Cancer Screening for Detection of Advanced Neoplasia

PERSPECTIVE: Time-to-Event Analyses for Long-Term Treatments â The APPROVe Trial

EDITORIAL: Decoding Hereditary Colorectal Cancer

ORIGINAL ARTICLE: Identification and Survival of Carriers of Mutations in DNA Mismatch-Repair Genes in Colon Cancer

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Colon Cancer â Understanding How NSAIDs Work

EDITORIAL: Calcium plus Vitamin D Supplementation and Colorectal Cancer in Women

ORIGINAL ARTICLE: Calcium plus Vitamin D Supplementation and the Risk of Colorectal Cancer

IMAGES IN CLINICAL MEDICINE: Subacute Urinary Retention

EDITORIAL: Reducing the Risk of Gynecologic Cancer in the Lynch Syndrome

ORIGINAL ARTICLE: Prophylactic Surgery to Reduce the Risk of Gynecologic Cancers in the Lynch Syndrome

ORIGINAL ARTICLE: Effector Memory T Cells, Early Metastasis, and Survival in Colorectal Cancer

IMAGES IN CLINICAL MEDICINE: Cetuximab-Associated Acneiform Eruption

IMAGES IN CLINICAL MEDICINE: Actinomyces Hepatic Abscess with Cutaneous Fistula

IMAGES IN CLINICAL MEDICINE: Relapsed Colon Cancer

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 23-2005 â A 57-Year-Old Man with a Mass in the Liver

EDITORIAL: Adjuvant Therapy for Colon Cancer â The Pace Quickens

IMAGES IN CLINICAL MEDICINE: The Virtual Apple Core of a Colonic Carcinoma

ORIGINAL ARTICLE: Capecitabine as Adjuvant Treatment for Stage III Colon Cancer

EDITORIAL: Statins and Cancer â Beyond the âOne Drug, One Diseaseâ Model

ORIGINAL ARTICLE: Statins and the Risk of Colorectal Cancer

ORIGINAL ARTICLE: Colonoscopic Screening of Average-Risk Women for Colorectal Neoplasia

EDITORIAL: New Treatment Options for Colorectal Cancer

ORIGINAL ARTICLE: Cetuximab Monotherapy and Cetuximab plus Irinotecan in Irinotecan-Refractory Metastatic Colorectal Cancer

PERSPECTIVE: The Price Tag on Progress â Chemotherapy for Colorectal Cancer

ORIGINAL ARTICLE: Tumor Microsatellite-Instability Status as a Predictor of Benefit from Fluorouracil-Based Adjuvant Chemotherapy for Colon Cancer

PERSPECTIVE: Microsatellite Instability

REVIEW ARTICLE: Hereditary Colorectal Cancer

ORIGINAL ARTICLE: A Randomized Trial of Aspirin to Prevent Colorectal Adenomas

ORIGINAL ARTICLE: A Randomized Trial of Aspirin to Prevent Colorectal Adenomas in Patients with Previous Colorectal Cancer

PERSPECTIVE: Aspirin and the Prevention of Colorectal Cancer

EDITORIAL: Multiple Colorectal Adenomas â Is Their Number Up?

ORIGINAL ARTICLE: Multiple Colorectal Adenomas, Classic Adenomatous Polyposis, and Germ-Line Mutations in

ORIGINAL ARTICLE: Results of Screening Colonoscopy among Persons 40 to 49 Years of Age

EDITORIAL: Cyclooxygenase Inhibition in Cancer â A Blind Alley or a New Therapeutic Reality?

ORIGINAL ARTICLE: Primary Chemoprevention of Familial Adenomatous Polyposis with Sulindac

ORIGINAL ARTICLE: Detection of Mutations in Fecal DNA from Patients with Colorectal Tumors

PERSPECTIVE: A Needle in a Haystack of Genes

CLINICAL PRACTICE: Screening for Colorectal Cancer

ORIGINAL ARTICLE: A Pooled Analysis of Adjuvant Chemotherapy for Resected Colon Cancer in Elderly Patients

EDITORIAL: Refining Multimodal Therapy for Rectal Cancer

ORIGINAL ARTICLE: Preoperative Radiotherapy Combined with Total Mesorectal Excision for Resectable Rectal Cancer

EDITORIAL: Screening for Colon Cancer â Can We Afford Colonoscopy?

ORIGINAL ARTICLE: One-Time Screening for Colorectal Cancer with Combined Fecal Occult-Blood Testing and Examination of the Distal Colon

ORIGINAL ARTICLE: Molecular Predictors of Survival after Adjuvant Chemotherapy for Colon Cancer

EDITORIAL: The Best Screening Test for Colorectal Cancer â A Personal Choice

IMAGES IN CLINICAL MEDICINE: Gas Gangrene Associated with Occult Cancer

ORIGINAL ARTICLE: The Effect of Fecal Occult-Blood Screening on the Incidence of Colorectal Cancer

EDITORIAL: Moving beyond Fluorouracil for Colorectal Cancer

ORIGINAL ARTICLE: Irinotecan plus Fluorouracil and Leucovorin for Metastatic Colorectal Cancer

EDITORIAL: Going the Distance â The Case for True Colorectal-Cancer Screening

ORIGINAL ARTICLE: Risk of Advanced Proximal Neoplasms in Asymptomatic Adults According to the Distal Colorectal Findings

ORIGINAL ARTICLE: Use of Colonoscopy to Screen Asymptomatic Adults for Colorectal Cancer

REVIEW ARTICLE: Chemoprevention of Colorectal Cancer

ORIGINAL ARTICLE: The Effect of Celecoxib, a Cyclooxygenase-2 Inhibitor, in Familial Adenomatous Polyposis

EDITORIAL: The End of Barium Enemas?

NEJM â Collection Updates for Colorectal Cancer

EDITORIAL: The Capsule and Colorectal-Cancer Screening â The Crux of the Matter

PERSPECTIVE: CMS's Landmark Decision on CT Colonography â Examining the Relevant Data

EDITORIAL: Targeted Therapy for Advanced Colorectal Cancer â More Is Not Always Better

EDITORIAL: Aspirin and Colon Cancer â Targeting Prevention?

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 13-2007 â A 46-Year-Old Woman with Gynecologic and Intestinal Cancers

EDITORIAL: Genetics and Epigenetics â Nature's Pen-and-Pencil Set

PERSPECTIVE: Time-to-Event Analyses for Long-Term Treatments â The APPROVe Trial

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Colon Cancer â Understanding How NSAIDs Work

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 23-2005 â A 57-Year-Old Man with a Mass in the Liver

EDITORIAL: Adjuvant Therapy for Colon Cancer â The Pace Quickens

EDITORIAL: Statins and Cancer â Beyond the âOne Drug, One Diseaseâ Model

PERSPECTIVE: The Price Tag on Progress â Chemotherapy for Colorectal Cancer

EDITORIAL: Multiple Colorectal Adenomas â Is Their Number Up?

EDITORIAL: Cyclooxygenase Inhibition in Cancer â A Blind Alley or a New Therapeutic Reality?

EDITORIAL: Screening for Colon Cancer â Can We Afford Colonoscopy?

EDITORIAL: The Best Screening Test for Colorectal Cancer â A Personal Choice

EDITORIAL: Going the Distance â The Case for True Colorectal-Cancer Screening

EDITORIAL: Virtual Colonoscopy â Promising, but Not Ready for Widespread Use

EDITORIAL: Fiber and Colorectal Cancer â Where to Now?

EDITORIAL: Adjuvant Therapy for Rectal Cancer â A Good First Step