Medicine and Health Sciences Commons^™

Exploring The Use Of Bidirectional Text Messaging Reminders To Increase Colorectal Cancer Screening Rates In Patients Prescribed Cologuard®, James Harris

Translational Projects (Open Access)

Meaningfully engaging with patients through technology is becoming increasingly important in healthcare. Mailed letters, phone calls, and even one-way text messaging or some combination of these have all been utilized to communicate with patients regarding preventative healthcare screening measures, with varying degrees of success. While many studies have examined the use of bidirectional text messaging (BTM) to engage patients regarding mammograms, cervical cancer screening, and other issues, very little literature exists on BTM concerning colorectal cancer (CRC).

Therefore, this project sought to examine the impact of BTM between two primary care clinics and their respective patients who were prescribed and …

Social Determinants Of Health And Uptake Of Colorectal Cancer Screening In Canada, Seth F. Kadish

Electronic Thesis and Dissertation Repository

Colorectal cancer (CRC) screening uptake may be associated with social determinants of health and could indicate potential barriers to health service access. The goal of this thesis was to evaluate the association of social determinants with CRC screening in screen-eligible adults. We used Andersen’s Behavioural Model of Health Service Utilization and the PROGRESS-Plus Framework to conceptualize potential social determinants. Our first study was a systematic review of peer-reviewed Canadian studies, and the second was a cross-sectional analysis of data from the Canadian Longitudinal Study on Aging (CLSA). The systematic review found lower uptake was associated with non-White ethno-racial identity, less …

Increasing Colorectal Cancer Screening Rates In The Psychiatric Inpatient Unit, Diane R. Ventura

Master's Projects and Capstones

Increasing Colorectal Cancer Screening Rates in the Psychiatric Inpatient Unit

Abstract

Problem: Colorectal cancer is one of the leading cancer deaths in the United States. The Psychiatric Inpatient Unit has a colorectal cancer screening compliance rate of 40% compared to the statewide average of 80%.

Context: The Psychiatric Inpatient Unit is a 58-bed inpatient intermediate care facility mental health program in Northern California. Upon review of the EMR, most PIU nurses give verbal instructions and patient education on colorectal cancer screenings when due. Still, no printed handout was provided to the patients upon review of the EMR.

Intervention: Review of …

Identification And Quantitation Of Unspecified Impurities Discovered In Novel Oral Irinotecan By Lc-Ms/Ms And Uhplc, Laura B. Miller

Forensic Science Master's Projects

Irinotecan is a cancer medication approved for medical use in the United States in 1996. It is currently administered via intravenous injection. However, intravenous dosing has disadvantages such as requirement of administration by a trained professional in a medical facility, possible severe adverse effects, pain at the injection site, and possible hemolysis if injected too rapidly. Previously oral administration was not feasible because the p-glycoprotein (p-GP) on the cell membrane of stomach cells acts as a defense mechanism against harmful substances by pumping the irinotecan back into the intestinal lumen for excretion. With the discovery of the p-GP inhibitor encequidar …

Exploring Factors Related To Cancer Recurrence In Nebraska, Zenghan Tong

Capstone Experience

Currently, the studies of cancer burden are focused on the incidence, mortality, and survival of cancer. Due to the early detection and advancement of therapies, more patients can live much longer after a cancer diagnosis. Health care providers and patients want to know more about cancer recurrence, which can significantly impact cancer survivors’ quality of life. At this moment, the cancer recurrence studies are clinically based on specific treatments of particular cancers and are usually limited to small and selected populations. This study utilized the population-based cancer registry data between 1996-2015 to examine the cancer recurrence status in Nebraska. The …

The Effects Of Metronomic And Maximum-Tolerated Dose Chemotherapy In Colorectal Cancer Angiogenesis: A Combined Approach Using Endoscopic Diffuse Reflectance Spectroscopy And Mrna Expression, Ariel Isaac Mundo Ortiz

Graduate Theses and Dissertations

Colorectal cancer (CRC) continues to be one of the most incident and deadliest types of cancer worldwide. Chemotherapy has proven effective to reduce tumor burden for CRC patients, but there are several disadvantages associated with the use of mainstay maximtolerated dose (MTD) chemotherapeutic strategies. Metronomic chemotherapy (MET) has been developed as an alternative that addresses the shortcomings of maximum-tolerated dose chemotherapy but so far its effectiveness as a neoadjuvant strategy for CRC has not been explored.

This dissertation uses a combined optics and molecular biology approach (using diffuse reflectance spectroscopy and mRNA expression) to study the changes in angiogenesis and …

Applying Mci-062, A Novel Pan-Ras Inhibitor, To Treat Kras-Mutant Lung Cancer, Richard Fu

Honors Theses

RAS is a prevalent oncogene that is mutated in 27% of human cancers. Gain-of-function RAS mutations activate multiple downstream pathways, including the RAS-RAF-MEK-ERK and PI3K/AKT/mTOR pathways, which are critical in tumorigenesis and cancer cell proliferation. RAS proteins such as KRAS, a member of the RAS protein family, and their downstream effectors are attractive targets for cancer therapy since their mutations act as frequent drivers in lung, colorectal, and pancreatic cancers. However, RAS proteins have relatively smooth surfaces that lack traditional binding pockets, making inhibitors specific to RAS difficult to create. Recently, a novel small molecule pan-RAS inhibitor named MCI-062 was …

Effects Of Tailored Colorectal Cancer Patient Education On Colorectal Cancer Screening Rates In An Urban Kentucky Clinic, Brittany Pittman Hardcorn

DNP Projects

Background: Colorectal cancer (CRC) is one of the leading causes of death among Americans and Kentuckians. Most colorectal cancers are slow-growing, making regular colorectal cancer screening increasingly important to decrease morbidity and mortality. Although of this importance, there is low screening rates. Thus, the need to explore all colorectal screening options.

Purpose: The purpose of this project was to increase the number of patients screened for colorectal cancer by providing education on colorectal cancer and screening options in a primary care setting.

Methods: The design of the study was a 2 group quasi-experimental practice improvement project using a post-test educational …

Understanding Colorectal Cancer: Increasing Screening Rates Amongst Young- And Middle-Aged Adults By Enhancing Prevention Potential, Sarah Agudelo

Nursing | Senior Theses

As nurses, working towards the best health outcomes for our patients is critical to our care. A large aspect of this care includes being knowledgeable of risk factors and precautions to take to avoid conditions and illnesses. Colorectal cancer remains to be a highly preventable disease, yet it is one of the top five leading causes of cancer deaths in the nation. Preventing colorectal cancer requires the efficient use of screening and education, while also addressing barriers of inconvenience and affordability. This senior thesis delves deeper into colorectal cancer prevention by asking the research question: For young and middle-aged adults, …

Attenuated Bacteria Potentiate The Outcome Of Immunotherapy With Pd-L1 Blockade In A Pre-Clinical Model Of Colorectal Cancer, Besan Haytham Mohammad Al-Saafeen

Theses

After more than a century of investigation, it has become evident that cancer development and progression occur at the expense of a dysfunctional immune system. This realization has ushered cancer immunotherapy as a new modality of treatment. In the last decade, the use of immune checkpoint inhibitors to treat cancer patients resulted in unprecedented and durable clinical benefits. However, the response rate in many cancers remains rather modest, with colorectal cancer being at the lower end of the spectrum. Previous work from our laboratory demonstrated the efficacy of using attenuated bacteria as immunomodulatory anti-cancer agents. The current study investigated the …

Anti-Inflammatory And Chemopreventive Activity Of Lunasin From Tofu Whey For The Management Of Gastrointestinal Diseases, Cindy Andrea Nieto Veloza

Doctoral Dissertations

Gastrointestinal diseases such as inflammatory bowel diseases (IBD) and colorectal cancer (CRC) are pathological conditions associated with chronic inflammation, characterized by intestinal damage, debilitating symptoms, and detrimental health consequences. The increased risk of CRC in IBD patients, and the adverse effects associated with current therapeutic strategies, point out the need for safer alternatives to reduce chronic inflammation in the bowel. Lunasin is a bioactive peptide naturally occurring in soybeans, with chemopreventive and anti-inflammatory properties demonstrated in several extra-intestinal diseases. However, to date, there is no evidence of the biological activity of lunasin on the gastrointestinal tract as a target site. …

The Impact Of An Evidence-Based Multi-Component Intervention On Colorectal Cancer Screening In Primary Care At A Healthcare System, Ahnnya Slaughter

Student Scholarly Projects

Practice Problem: Colorectal cancer is the second leading cause of cancer death in the United States; many of the deaths are preventable with early detection. Adherence rates for colorectal cancer screening with fecal immunochemical test kits (FIT) was below the national benchmark at this facility.

PICOT: The PICOT question that guided this project was: Among veterans 50 – 75 years old requiring average risk colorectal cancer screening (CRCS) seen in primary care at a veterans affairs healthcare system facility (P), how does the use of a multi-component intervention (I), compared to the usual care (C), affect the number of …

Increasing Colorectal Cancer Screening Rates Through Education, Kayla Metz

Doctor of Nursing Practice Projects

Colorectal cancer is the second leading cause of cancer deaths in the United States. Adenomatous polyps cause 90% of colorectal cancer. These polyps can be identified before they become cancerous through numerous colorectal cancer screenings. There are many ways to help cover the cost of screenings or to make them no cost to patients, but the number of individuals who have ever been screened or who are current with screening recommendations remains low. This DNP project aims to provide education to providers and individuals regarding the various type of colorectal cancer screening options. A reduction in fears and improved knowledge …

Rare Variant Association Studies In Crohn’S Disease And Colorectal Cancer: Methods And Applications, Jiun-Sheng Chen

Dissertations & Theses (Open Access)

Genetic factors account for a substantial portion of Crohn’s disease and colorectal cancer (CRC) risk. Patients with Crohn’s disease, a condition that causes chronic inflammation of the gastrointestinal tract, are at increased risk of colorectal cancer morbidity and mortality. Genome-wide association studies using single marker approaches have identified loci responsible for these diseases, but disease susceptibility from rare variants is incompletely understood. This dissertation includes three chapters, two association studies for Crohn’s disease and CRC, and a statistical method to improve the power of statistical tests.

For Crohn’s disease, we performed targeted sequencing of 101 genes in 205 children with …

Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …

Improving Colorectal Cancer Screening And Testing In A Primary Care Clinic, Leslie Michelle Dubois

Doctor of Nursing Practice

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer-related deaths worldwide (World Health Organization, 2019a). In the United States, CRC was the fourth most common cancer in 2016 (Centers for Disease Control and Prevention, 2019a). The American Cancer Society (2020a) estimated that there will be 147,950 estimated new cases and 53,200 estimated deaths of CRC in the U.S. in 2020. The purpose of the project was to improve CRC screening completion rates and follow up referrals from 27.5% to 35% for adult patients, 50-75 years of age, within a family medicine clinic …

Modulation Of Pi3k-Akt Pathway In Colorectal Cancer, Maliha Nusrat

Dissertations & Theses (Open Access)

The phosphatidylinositol-3-kinase (PI3K) signaling pathway is activated in 20-40% colorectal cancers (CRC) through PTEN loss (PTEN^loss) and PIK3CA mutations (PIK3CA^mut). Allosteric AKT inhibition with MK2206 monotherapy has been ineffective in CRC patients. We investigated the impact of MK2206 on pharmacodynamic (PD) markers and signaling pathways using reverse phase protein array (RPPA) on (1) paired tumor biopsies from a clinical trial of MK2206 in PI3K-altered metastatic CRC, (2) PTEN^lossCRC patient derived xenografts (PDX) treated with MK2206 or carrier, and (3) MK2206-treated cell lines. PD inhibition was deep in cell lines, less but significant in …

Evidence-Based Colorectal Cancer Screening Staff Education, Chantal Navalah

Walden Dissertations and Doctoral Studies

Colorectal Cancer (CRC) is the leading cause of cancer-related death, although it is considered preventable with adequate routine screening. Despite the decline in prevalence and mortality of CRC in the United States, the African American population persist in having the highest rates of death and shortest survival for CRC. This doctoral project focused on the gastrointestinal (G.I.) staff knowledge gap about the importance of CRC screening to achieve better patient outcomes. The purpose of this project was to address the knowledge gap among the G.I staff as it relates to CRC screening. The health belief model served as a guide …

The Impact Of Dietary Intake On Mortality Risk In Colorectal Cancer Survivors, Ellen Chow

Walden Dissertations and Doctoral Studies

The colorectal cancer (CRC) survivor population is increasing in the United States. The lack of effective dietary recommendations in recurrence prevention undermines the health-related quality of life of survivors. Grounded in the socioecological model, dietary behavior is a personal-level risk factor that individuals may control. This study investigated the CRC-specific mortality risk as predicted by diet quality, dietary fiber intake, and dietary fat intake in hope of contributing to future dietary recommendations. A secondary analysis using data from 1,166 CRC survivors in the Multiethnic Cohort Study was analyzed via Cox proportional hazard regression models to estimate mortality risk. Results from …

The Difference In Barriers To Colorectal Cancer Screening Between Men And Women In The 45-55-Year Age Group, Maren Christina Davis

All Graduate Theses, Dissertations, and Other Capstone Projects

Statement of the Problem: Adults, 50 years or older, should have a screening colonoscopy every ten years and fecal immunochemical test (FIT) every year. However, close to 22 million adults between the ages of 50-75 in the U.S. have never been screened for colorectal cancer, which delays treatment and can be fatal if the cancer is not found in time.

Procedure: This study used a descriptive, cross-sectional, survey-based design and a convenience sample of men and women between 45 and 55 years old to assess colorectal screening practices, barriers to screening, and knowledge levels about colorectal cancer screening.

Findings: A …

Epidemiology Of Colorectal Cancer Comorbidities And Stage At Diagnosis, Survival, And Second Primary Malignancies In Kentucky, 2003-2016, Nikita Leigh Vundi

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Colorectal cancer (CRC) is the third most common type of cancer and the third most common cause of cancer death among men and women in the United States.^1-3 The American Cancer Society estimates that there will be 147,950 new cases of CRC and 53,200 CRC related deaths in the U.S. for the year 2020.3 Kentucky CRC incidence for 2012-2016 was the highest in the nation, and the mortality rate for years 2013-2017 was ranked 5th in the nation.^4-6 Risk factors for CRC include lifestyle factors, genetics, and disease status (comorbidities and treatment).2, 7 Diabetes has been …

Uptake Of Colorectal Cancer Screening Tests By Ontario Physicians., Owen Litwin

Electronic Thesis and Dissertation Repository

This population-based study used administrative healthcare data to examine the uptake of tests recommended for colorectal cancer screening by eligible Ontario physicians and non-physicians, and to examine if testing of primary care physicians is associated with greater testing in their patients. Physicians (n=11,434) were matched 1:4 to non-physicians (n=45,736) on age, sex, and geographic location as of April 21, 2016. Uptake of colorectal tests was similar in physicians (67.9%, 95% CI, 67.0–68.7%) and non-physicians (66.6%, 95% CI, 66.2–67.1%). Physicians were more likely than non-physicians to undergo colonoscopy and less likely to undergo fecal occult blood testing. Uptake of colorectal tests …

Macrophages And Associated Inflammation Differentially Impact Obesity, Colorectal Cancer And Obesity-Enhanced Colorectal Cancer, Jackie Bader

Theses and Dissertations

Colorectal Cancer (CRC) is the third-most common malignancy for men or women, with chronic inflammation considered as a primary risk factor. Obesity is also considered a chronic inflammatory disease and is associated with increased CRC incidence. Further, obesity and CRC occur in men and women differently with the highest incidence of either disease found in men, suggesting that female sex hormones may play a protective role in inflammatory diseases. Macrophages can promote inflammation and are a driving force in obesity-associated metabolic dysfunction. Conversely, macrophages also contribute to pro-tumoral responses including, proliferation, angiogenesis and tissue remodeling. This heterogeneity of macrophage behavior …

Determinants Of Disparities In The Colorectal Cancer Burden, Karen Elizabeth Callahan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Colorectal cancer (CRC) is the third leading cause of cancer incidence and mortality in the United States, with an estimated 140,000 new cases and 51,000 deaths expected in 2018. Like most cancers, the burden of CRC is unequally distributed among population groups. The current dissertation included two studies filling gaps in knowledge about CRC disparities. Study 1 characterized the relationship between educational attainment and CRC mortality by race/ethnicity. Six years of CRC mortality data (2012-2017) from the diverse state of California, with 30,180 deaths were analyzed. Sex-specific mortality rate ratios (MRR) stratified by race/ethnicity as well as by educational level …

The Effect Of A Provider-Based Educational Program On Knowledge, Attitudes, Self-Efficacy, And Order Rates Of Cologuard® In A Primary Care Clinic, Cassilly B. Besten

DNP Projects

BACKGROUND: Colorectal cancer is one of the most common and deadly cancers, particularly in persons greater than 50 years of age. Most colorectal malignancies are slow-growing, making regular screening increasingly important to decrease morbidity, mortality, and cost of treatment. Cologuard® serves as an effective and non-invasive colorectal cancer screening modality for average-risk adults.

PURPOSE: The purpose of this study was to evaluate the impact of a provider-based educational intervention on the knowledge, attitudes, self-efficacy, and ordering rates of Cologuard® among primary care providers.

METHODS: This study was a single-center, pre/post implementation study of the effectiveness of a provider-based educational intervention …

Identifying Quantitative Enhancement-Based Imaging Biomarkers In Patients With Colorectal Cancer Liver Metastases Undergoing Loco-Regional Tumor Therapy, Mansur Abdul Ghani

Yale Medicine Thesis Digital Library

The purpose of this study was to test and compare the ability of radiologic measurements of lesion diameter, volume, and enhancement on baseline magnetic resonance (MR) images to be predictors of overall survival (OS) and markers of treatment response in patients with liver-dominant colorectal cancer metastases undergoing loco-regional tumor therapies.

This retrospective study included 88 patients with colorectal cancer (CRC) liver metastases, treated with transarterial chemoembolization (TACE) or Y90 transarterial radioembolization (TARE) between 2001 and 2014. All patients received contrast-enhanced MRI prior to therapy. Semi-automated whole liver and tumor segmentations of three dominant lesions were performed on baseline MRI to …

Identifying And Targeting Cancer Stem Cells In Colorectal Cancer, Amber Harnett

Electronic Thesis and Dissertation Repository

The cancer stem cell hypothesis posits that cancer stem cells (CSCs) are the driving force behind tumour progression and metastasis, making them ideal therapeutic targets. Previous research identified Leucine-rich repeat-containing G-protein-coupled receptor 5 (Lgr5) as a marker of CSCs in colorectal cancer (CRC). However, it is not known whether more than one CSC population exists in CRC. Identifying and targeting CSCs in CRC is important for effective treatment of cancer patients. Here, I show that Keratin-19 (K19) labels intestinal CSCs in mouse tumours that recapitulate the early stages of CRC. Moreover, selective ablation of Lgr5 has no effect on tumour …

The Meaning Of A Family History Of Colorectal Cancer In Black Families In The United States, Cassandra Loggins

Dissertations

The purpose of this study is to understand the meaning of a family history of colorectal cancer (CRC) for first-degree relatives of Blacks diagnosed with CRC. Even though CRC is more preventable than other cancers because of effective screening tests for prevention and early detection, Blacks experience a disproportionate burden of CRC compared to other groups. Interventions to increase CRC screening among Blacks have not produced a significant reduction in CRC disparity. Underutilization of CRC screening and low perceived risk of CRC are major factors contributing to CRC disparity. The informing methodological approach employed in this study was hermeneutic phenomenology, …

Genomic And Transcriptomic Landscape Of Colorectal Premalignancy, Kyle Chang

Dissertations & Theses (Open Access)

Colorectal cancer (CRC) is the third most commonly diagnosed cancer among men and women in the United States, with 3 to 5 percent of the cases diagnosed in the background of a hereditary form of the disease. Biologically, CRC is divided into two groups: microsatellite instable (MSI) and chromosomally unstable (CIN). Genomic and transcriptomic characterization of CRC has emerged from large-scale studies in recent years due to the advancement of next-generation sequencing technologies. These studies have identified key genes and pathways altered in CRC and provided insights to the discovery of therapeutic targets. Despite the wealth of knowledge acquired in …

Factors Affecting Colorectal Cancer Screening Among African-Born Immigrants In The United States, Chidoziri Chibundu

Walden Dissertations and Doctoral Studies

Despite the evidence that colorectal cancer screening is effective in reducing the incidence of and mortality from colorectal cancer, racial and ethnic disparities in colorectal cancer screening persist in the United States. African-born immigrants in the United States have lower colorectal cancer screening rates than native-born Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine how family income, health insurance status, language of interview, length of stay in the United States, perceived health status, level of education, and having a usual place for medical care affect colorectal cancer screening among African-born immigrants in the United States. The …