ACP advice for evaluating blood in the urine as a sign of cancer

January 25, 2016

1. ACP issues advice for evaluating blood in the urine as a sign of cancer
Blood in the urine is a common finding in adults during primary care visits
Free content: http://www.annals.org/article.aspx?doi=10.7326/M15-1496

In a paper published in Annals of Internal Medicine, the American College of Physicians (ACP) issued advice for the evaluation of blood in the urine, or hematuria, as a sign of urinary tract cancer and to help physicians make decisions about referral of patients for urological assessment.

While there is little controversy regarding the indication for urologic evaluation for patients with gross hematuria, ACP explains in the paper, the evaluation of patients with the much more common finding of microscopic hematuria is complicated by a lack of clarity regarding indications for referral and optimal components of the evaluation. ACP offers physicians the following advice: Media Contact: For embargoed PDFs of the full paper and press release, please contact Cara Graeff. To interview someone from ACP, please contact Steve Majewski at smajewski@acponline.org or 215-351-2514.


2. Fecal immunochemical test effective for annual colon cancer screening
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-0983
URL goes live when embargo lifts

According to a study published in Annals of Internal Medicine, the fecal immunochemical test (FIT) is highly sensitive for detecting colorectal cancer, and adherence to annual follow-up screening among initial participants is high, making the non-invasive test feasible and effective for annual colorectal cancer screening programs.

Colorectal cancer is the second leading cause of cancer death in the United States. Evidence shows that highly sensitive guaiac-based fecal occult blood tests (FOBT), which are recommended for annual screening of average risk patients between the ages of 50 and 75, can reduce morbidity and mortality from colorectal cancer. But community screening programs can only be successful if people participate. FIT screening is another noninvasive option that can be delivered by mail and does not require any dietary or medication restrictions, making it easy for people to comply. FIT also has higher detection rates for CRC and advanced adenomas than FOBT, but little is known about how well FIT works over several rounds of annual screening.

Researchers collected data on a large cohort of patients from Kaiser Permanente Northern and Southern California over four rounds of annual screening with FIT. Sensitivity was highest during the first round of testing (84.5 percent) and became lower but stable over subsequent years (73.4 to 78.0 percent). Over 4 years of repeated testing, patients continued to use the test and it continued to identify colorectal cancer, suggesting that he FIT is acceptable and effective for community colorectal cancer screening programs.

Note: For an embargoed PDF, please contact Cara Graeff. To interview the lead author, please contact Janet Byron at Janet.L.Byron@kp.org or 510-891-3115.


3. More may be better when sharing genetic testing results with patients
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-0187
Editorial: http://www.annals.org/article.aspx?doi=10.7326/M15-2993
URLs go live when embargo lifts

Being told they were at also at risk for coronary artery disease did not increase depression or anxiety among patients undergoing a genetic test for Alzheimer disease. Providing information about how to reduce risk for coronary artery disease also helped patients improve health behaviors. The results are published in Annals of Internal Medicine.

Genetic testing is being increasingly used to identify risks for certain diseases. These tests often identify incidental or secondary findings that are important but unrelated to the original purpose of testing. This topic is controversial because revealing secondary risks to patients may increase psychological risks.

Pleiotropy is the association between genetic variants and multiple disease traits. The apolipoprotein E (APOE) gene is associated with increased risk for both Alzheimer disease and coronary artery disease. Researchers sought to determine the behavioral effects of revealing modest associations between the APOE genotype and coronary artery disease risk during APOE-based genetic risk assessments for Alzheimer disease. More than 250 participants were randomly assigned to receive risk information on either Alzheimer disease only or Alzheimer disease and coronary artery disease. The research examined measures of anxiety and depression over a year following provision of genomic risk information.

The researchers found that patients who were informed of increased risk for both Alzheimer disease and coronary artery disease had a decrease in distress and an increase in healthy behaviors compared with those who received information about Alzheimer disease risk alone. These finding suggest that receiving information about increased long-term risk for a debilitating disease for which no specific clinical action can be undertaken to decrease risk (Alzheimer's) was more distressing than when this bad news was coupled with information about risk for a second debilitating disease for which clinical action can decrease risk (coronary artery disease).

Note: For an embargoed PDF, please contact Cara Graeff. To interview the lead author, please contact Haley Bridger at hbridger@partners.org or 617-525-6383.
-end-
Also in this issue:

The Future Ecology of Care
Jacob West, MPP, and Ateev Mehrotra, MD, MPH
Ideas and Opinions
http://www.annals.org/article.aspx?doi=10.7326/M15-1978

Two Ways of Knowing: Big Data and Evidence-Based Medicine
Ida Sim, MD, PhD
Ideas and Opinions
http://www.annals.org/article.aspx?doi=10.7326/M15-2970

American College of Physicians

Related Colorectal Cancer Articles from Brightsurf:

Colorectal cancer treatment: the winning combinations
Chemotherapy has distressing side effects for patients and increases the risk of developing resistance to the treatment.

A new model to predict survival in colorectal cancer
This signature could be useful in clinical practice, especially for colorectal cancer diagnosis and therapy.

Roadmap to reducing colorectal cancer deaths
The American Gastroenterological Association has outlined a strategy to increase the number of people screened via tests that are more convenient, accurate and less expensive and tailored to people's individual cancer risks.

Study provides new insight on colorectal cancer growth
A new study by researchers at the University of Kentucky identifies a novel function of the enzyme spermine synthase to facilitate colorectal cancer growth.

Researchers ID target for colorectal cancer immunotherapy
Researchers at the Indiana University Melvin and Bren Simon Comprehensive Cancer Center have identified a target for colorectal cancer immunotherapy.

Colorectal cancer partner-in-crime identified
A protein that helps colorectal cancer cells spread to other parts of the body could be an effective treatment target.

Cancer cell reversion may offer a new approach to colorectal cancer treatment
A novel approach to reverse the progression of healthy cells to malignant ones may offer a more effective way to eradicate colorectal cancer cells with far fewer side effects, according to a KAIST research team based in South Korea.

A novel pathway to target colorectal cancer
Survival rates for patients with late-stage colorectal cancer are dismal, and new therapeutic strategies are needed to improve outcomes.

Colorectal cancer rates in Canada
The incidence of colorectal cancer among younger adults increased in recent years in this analysis of data from Canadian national cancer registries that included about 688,000 new colorectal cancers diagnosed over more than 40 years.

Cancer drugs promote stem cell properties of colorectal cancer
Scientists from the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) and the Mannheim University Medical Center have now discovered that a certain group of cancer drugs (MEK Inhibitors) activates the cancer-promoting Wnt signalling pathway in colorectal cancer cells.

Read More: Colorectal Cancer News and Colorectal Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.