Unraveling colorectal cancer prevention:The vitamin D-gut flora-immune system nexus

Colorectal cancer(CRC)is one of the most common cancers diagnosed in the world.Although environmental and genetic factors play a major role in the pathogenesis of CRC,extensive research has suggested that vitamin D may play a pivotal role in the development of CRC.Vitamin D,primarily obtained through sunlight exposure,dietary sources,and supplements,has long been recognized for its essential functions in maintaining health,including immune regulation.This article delves into the intricate relationship between vitamin D,the immune system,gut flora,and the prevention of CRC.It presents a synthesis of epidemiological data,experimental studies,and clinical trials,highlighting the mechanisms by which vitamin D influences immune cell function,cytokine production,and inflammation.By enhancing the immune system’s surveillance and antitumor activity,vitamin D may offer a promising avenue for CRC prevention.Furthermore,this comprehensive review delves into the prospective clinical applications of vitamin D supplementation and delineates the forthcoming avenues of research in this dynamic domain.Additionally,the paper tentatively outlines a spectrum of prophylactic impacts of vitamin D on CRC,emphasizing its significant potential in reducing CRC risk through shedding light on its mechanisms,encompassing antineoplastic mechanisms,influences on the immune system,and modulation of the gut microbiome.

External validation of the Prostate Cancer Prevention Trial and the European Randomized Study of Screening for Prostate Cancer risk calculators in a Chinese cohort

Several prediction models have been developed to estimate the outcomes of prostate biopsies. Most of these tools were designed for use with Western populations and have not been validated across different ethnic groups. Therefore, we evaluated the predictive value of the Prostate Cancer Prevention Trial （PCPT） and the European Randomized Study of Screening for Prostate Cancer （ERSPC） risk calculators in a Chinese cohort. Clinicopathological information was obtained from 495 Chinese men who had undergone extended prostate biopsies between January 2009 and March 2011. The estimated probabilities of prostate cancer and high-grade disease （Gleason 〉6） were calculated using the PCPT and ERSPC risk calculators. Overall measures, discrimination, calibration and clinical usefulness were assessed for the model evaluation. Of these patients, 28.7% were diagnosed with prostate cancer and 19.4% had high-grade disease. Compared to the PCPT model and the prostate-specific antigen （PSA） threshold of 4 ng m1-1, the ERSPC risk calculator exhibited better discriminative ability for predicting positive biopsies and high-grade disease （the area under the curve was 0.831 and 0.852, respectively, P〈O.01 for both）. Decision curve analysis also suggested the favourable clinical utility of the ERSPC calculator in the validation dataset. Both prediction models demonstrated miscalibration： the risk of prostate cancer and high-grade disease was overestimated by approximately 20% for a wide range of predicted probabilities. In conclusion, the ERSPC risk calculator outperformed both the PCPT model and the PSA threshold of 4 ng ml- z in predicting prostate cancer and high-grade disease in Chinese patients. However, the prediction tools derived from Western men significantly overestimated the probability of prostate cancer and high-grade disease compared to the outcomes of biopsies in a Chinese cohort.

Natural products for cancer prevention associated with Nrf2–ARE pathway

Cancer chemoprevention involves the application of natural or synthetic compounds to reduce the risk of cancer development.One of the most effective strategies for preventing human cancers might involve inducing phase II detoxifying enzymes and antioxidant enzymes via natural dietary compounds.The regulatory regions of these inducible genes encode the antioxidant response element(ARE).Nuclear factor-erythroid 2-related factor 2(Nrf2),as a transcription factor,plays a key role in the expression of ARE-mediated genes.Similarly,Nrf2 performs an essential function in the up-regulation of these genes in response to oxidative stress and treatment with dietary phytochemicals.In this article,we discuss the current state of knowledge regarding the Nrf2/ARE pathway as a potential molecular target for cancer chemoprevention and its molecular regulation mechanisms,and highlight Nrf2/ARE inducers derived from natural products,which may be used as chemopreventive agents for cancer patients.©2013 Beijing Academy of Food Sciences.Production and hosting by Elsevier B.V.All rights reserved.

The Changes in the Awareness of Cervical Cancer Prevention and the Acceptability of HPV Vaccines among Women after Their Introduction in China

Cervical cancer is a form of malignant tumor that seriously threatens women’s health. In China,according to the cancer statistics, 98,900 new cervical cancer cases and 30,500 deaths due to cervical cancer were estimated to have occurred in2015, and the incidence and mortality rates still exhibited an upward trend[1].

Chinese Anti-Cancer Association as a non-governmental organization undertakes systematic cancer prevention work in China

Cancer has become the first leading cause of death in the world, particularly in low- and middle-income countries. Facing the increasing trend of cancer incidence and mortality, China issued and implemented ＂three-early（early prevention, early diagnosis and early treatment）＂ national cancer prevention plan. As the main body and dependence of social governance, non-governmental organizations（NGOs） take over the role of government in the field of cancer prevention and treatment. American Cancer Society（ACS） made a research on cancer NGOs and civil society in cancer control and found that cancer NGOs in developing countries mobilize civil society to work together and advocate governments in their countries to develop policies to address the growing cancer burden. Union for International Cancer Control（UICC）, Cancer Council Australia（CCA）, and Malaysian cancer NGOs are the representatives of cancer NGOs in promoting cancer control. Selecting Chinese Anti-Cancer Association（CACA） as an example in China, this article is to investigate how NGOs undertake systematic cancer prevention work in China. By conducting real case study, we found that, as a NGO, CACA plays a significant role in intensifying the leading role of government in cancer control, optimizing cancer outcomes, decreasing cancer incidence and mortality rates and improving public health.

Cervical Cancer Prevention Challenges and Barriers to Cervical Cancer Screening and HPV Vaccinations in Ukraine and Eastern Europe

Objectives: To identify the obstacles and issues that hinder effective cancer prevention efforts in Ukraine. The study aims to provide a comprehensive assessment of the barriers to cancer prevention, including both infrastructure and behavioral factors, and identify potential solutions to address these challenges. Study Design: Comprehensive literature review. Methods: The following databases were searched: National Center for Biotechnology Information (NCBI) and PubMed (U.S. National Library of Medicine at the National Institutes of Health). The keywords used in the search included “Cervical Cancer”, “Human Papillomavirus Vaccination (HPV)”, “Ukraine”, “Eastern Europe”, “Healthcare Infrastructure in Disasters”, “Cervical Cancer Prevention”, “Pap Smear”, and “HPV Testing”. Results: A total of 3500 articles were screened. A total of 65 articles met the inclusion criteria. Limited public awareness and limited access to vaccination and screening, combined with inadequate treatment facilities lead to higher rates of cervical cancer. The COVID pandemic, war with Russia, and the Chernobyl disaster are significant factors for the low level of vaccination in Ukraine. Conclusion: The prevention and treatment of cervical cancer in Ukraine face significant challenges due to the inadequate HPV vaccination rates and screening by cytology. Efforts to improve funding and increase education of both the population and health care providers are necessary to increase interventions such as HPV vaccination, cervical cytology, and HPV testing to reduce cervical cancer rates in Ukraine.

Central Role of Innate B-Cell Immunity in Cancer Prevention

There are some forgotten items. There is a specific way to eradicate cancer cells at the very early stage of their appearance. Natural humoral immunity with CD5+ B-cell produced pentameric IgM to cancer associated glycans normally to eliminate arising cancer cells. This branch of innate immunity is decreasing with age and that is a basis for selective immunodeficieny which may be corrected. This area of research was well studied and proved by the team of Prof. Vollmers (Germany), but then forgotten for about 15 years.

The role of vitamin D in cancer prevention

Vitamin D,also known as cholecalciferol,is the precursor to the active steroid hormone 1,25-dihydroxyvitamin D3(calcitriol; 1,25(OH)2D3).The main physiological role for 1,25(OH)2D3 is to regulate calcium and inorganic phosphate homeostasis for bone health.More recently,vitamin D has been investigated for its effects in the prevention and treatment of a variety of diseases such as cancer,autoimmune disorders,and cardiovascular disease.Preclinical data strongly support a role for vitamin D in the prevention of cancer through its anti-proliferative,pro-apoptotic,and anti-angiogenic effects on cells.Epidemiologic and clinical studies have shown mixed data on the correlation between serum vitamin D levels and cancer risk.This report seeks to outline results from the most recent preclinical and clinical studies investigating the potential role of vitamin D in cancer prevention.

Chiral polypeptide nanoparticles as nanoadjuvants of nanovaccines for efficient cancer prevention and therapy

The chirality of bioactive molecules is closely related to their functions.D-amino acids commonly distributed in the bacterial cell walls trigger a robust anti-infective immune response.Inspired by that,two kinds of chiral polypeptides,poly(L-phenylalanine)-block-poly(L-lysine)(PL-K)and poly(Lphenylalanine)-block-poly(D-lysine)(PD-K),were synthesized and used as nanoadjuvants of nanovaccines for cancer prevention and therapy.The amphiphilic polypeptides self-assembled into nanoparticles with a diameter of about 30 nm during ultrasonic-assisted dissolution in phosphate-buffered saline.The nanovaccines PL-K-OVA and PD-K-OVA were easily prepared by mixing solutions of PL-K or PD-K and the model antigen chicken ovalbumin(OVA),respectively,with loading efficiencies of almost 100%.Compared to PL-K-OVA,PD-K-OVA more robustly induced dendritic cell maturation,antigen cross-presentation,and adaptive immune response.More importantly,it effectively prevented and treated the OVA-expressed B16-OVA melanoma model.PD-K-OVA achieved a tumor inhibition rate of 94.9%and even 97.0%by combining with anti-PD-1 antibody.Therefore,the chiral polypeptide nanoparticles represent simple,efficient,and extensively applicable nanoadjuvants for various nanovaccines.

Keap1-Nrf2 pathway: A promising target towards lung cancer prevention and therapeutics

Objectives: Drugs for targeted therapy have become a new strategy of adjuvant therapy for treatment of lung cancer.The Keapl (kelch-like ECH-associated protein 1)-Nrf2 (nuclear factor erythroid 2-related factor 2) pathway is recognized to be critical in regulating genes related to the cellular protective response and protecting cells from oxidative damages and toxic insult.Methods: Pubmed, Embase, OVID, and the Cochrane Library databases were searched from the beginning of each database without any limitations to the date of publication.Search terms were 'Nrf2' or 'Keap1' and 'Lung cancer'.Results: The upregulation of Nrf2 had been closely related to tumor protection and drug resistance.The aberrant state of Keap 1 or Nrf2 that were frequently found in lung cancer conferred a poor prognosis.Nrf2 could prevent cells from undergoing oncogenesis as a tumor suppressor, while it could also promote cancer progression and resistance to chemotherapeutic drugs as an oncogene,depending on the different stages of tumor progression.Target Nrf2 signaling by specific chemicals showed it could prevent tumor growth or combat chemoresistance.Conclusions: Increasing evidence has demonstrated the dual roles of the Keap1-Nrf2 pathway in tumor initiation and progression.In this paper, we provide a comprehensive overview of the potency of the Keap 1-Nrf2 pathway as an antitumor target, and the current status of Nrf2 activators or inhibitors for therapeutic approaches.Further studies are required to clarify the role of Nrf2 in lung cancer at different tumor stages, in order to maximize the efficacy of Keap1-Nrf2 targeting agents.Copyright 2015, Chinese Medical Association Production.Production and hosting by Elsevier B.V.on behalf of KeAi Communications Co., Ltd.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

A systematic review of phytochemicals from Chinese herbal medicines for non-coding RNAs-mediated cancer prevention and treatment:From molecular mechanisms to potential clinical applications

Worldwide,cancer is a growing epidemic that results in large social and economic burdens.Despite advances in current diagnosis and treatment,most of the prognosis in cancer patients remains poor.It is urgent to find alternative therapies with effective cancer prevention and treatment.Chinese herbal medicines(CHMs)have been increasingly used worldwide for cancer prevention and treatment due to their privileged properties.CHMs are useful in the suppression of various types of cancers through different mechanisms of action.Non-coding RNAs(ncRNAs),including microRNAs,long non-coding RNAs and circular RNAs,are closely involved in the cancer progression and development.Regulation of ncRNAs in tumor cells may be a useful pharmacological strategy for the cancer prevention and treatment.Substantial evidence exists that various phytochemicals from CHMs exert potent anticarcinogenic effects by regulating ncRNAs-related targets and signaling pathways.Herein,the purpose of this paper is to conclude the current understanding of phytochemicals from CHMs in ncRNAs-mediated cancer suppression and the molecular mechanisms.This review will help to provide beneficial clues related to the clinical use of CHMs in the cancer prevention and treatment and further promote new drug discovery against cancer.

Cancer: Education and Primary Prevention Starts in Childhood and Adolescence

At least one third of all newly diagnosed cancers could be prevented if lifestyle factors were changed. The University Cancer Center Dresden initiated two programs aiming at cancer awareness and intentions to engage in health-promoting behavior among children and adolescents. Study 1 examined sun protection knowledge of 80 preschool children in a non-randomized design and Study 2 inspected 235 7th grade students’ knowledge of cancer and its behavioral risk-factors as well as intentions on health-promoting behavior using a randomized pre-post design on group-level. Study 1 showed significant improvement of sun protection knowledge in preschool children (p 0.05). Study 2 was effective in increasing knowledge about risk factors for cancer (p 0.001) and in increasing intentions to engage in health-promoting behavior (p 0.001). Communicating health-related behavior in preschools as well as school-based programs targeting multiple cancer-related risk factors are promising tools for primary prevention of cancer.

Investigation and analysis of the status of cancer health popularization in China,2023

BACKGROUND Cancer presents a significant public health challenge in China,necessitating broad collaboration across society.The Chinese government has articulated a goal to increase the overall five-year survival rate for cancer by 15%by 2030.Achieving this objective requires not only advances in medical technology,but also an im-provement in the dissemination of knowledge pertaining to cancer prevention and treatment.AIM To provide a comprehensive understanding of the status of cancer prevention and level of popularization in China in 2023.METHODS From January 2023 to May 2023,online questionnaires were distributed to 3000 participants,including medical personnel,patients with cancer,their families,and the general public.There were 2711 valid responses,covering the entire nation.RESULTS A total of 1020 medical personnel and 1691 patients with cancer,their family members,and the general public participated in the survey.Among medical personnel,93.2%had popularized cancer health.Commonly addressed topics included cancer prevention(85.9%)and cancer screening(77.8%).Primary challenges included time constraints(73.9%),insufficient personnel and material support(66.7%),and uncertainty as to where to begin(49.3%).Among patients with cancer,their family members,and the general public,93.4%reported reading or watching cancer science popularization materials and 56.9%expressed a desire for deeper understanding.The most sought-after topics in cancer science popularization included cancer screening(80.2%)and cancer prevention(75.8%).The greatest challenge encountered in accessing cancer health popularization was an abundance of misinformation(67.5%).CONCLUSION Most clinical doctors,patients,family,and the general public wish to participate in cancer education.However,improvement in the quality of content in cancer prevention and treatment education is required.

Associations between blood glucose and early- and late-onset colorectal cancer: evidence from two prospective cohorts and Mendelian randomization analyses

Background: The incidence of early-onset colorectal cancer (EOCRC), which exhibits differential clinical, patho- logical, and molecular features compared to late-onset CRC (LOCRC), is rising globally. The potential differential effects of blood glucose on EOCRC compared to LOCRC have not been investigated. Methods: This study analyzed 374,568 participants from the UK Biobank cohort and 172,809 participants from the Kailuan cohort. The linear associations between blood glucose and EOCRC/LOCRC were estimated using Cox regression models. Restricted cubic spline (RCS) analysis and non-linear Mendelian randomization (MR) analysis using a 70-SNPs genetic instrument for fasting glucose were used to explore the potential non-linear associations. Results: Participants in the highest quintile of blood glucose had higher overall CRC risk compared to the lowest quintile (HR = 1.10 in the UK Biobank cohort, 95% CI: 1.01-1.21, P -trend = 0.012;HR = 1.23 in the Kailuan cohort, 95% CI: 1.01-1.51, P -trend = 0.036). Elevated glucose ( > 7.0 mmol/L) was more strongly associated with increased risk of EOCRC (HR = 1.61, 95% CI: 1.07-2.44) than with LOCRC (HR = 1.14, 95% CI: 1.02-1.27) in the UK Biobank cohort ( P- heterogeneity = 0.014). Elevated glucose ( > 7.0 mmol/L) was associated with increased risk of LOCRC (HR = 1.25, 95% CI: 1.04-1.65) in the Kailuan cohort as well. There was no evidence for non-linear associations between blood glucose and risks of EOCRC/LOCRC. Conclusions: This study showed a positive association between blood glucose and CRC risk in a dose-response manner, particularly for EOCRC, suggesting that tighter glucose control should be a priority for younger age groups.

Unraveling the biological link between diabetes mellitus and prostate cancer:Insights and implications

This article is a comprehensive study based on research on the connection between diabetes mellitus(DM)and prostate cancer(PCa).It investigates the potential role of DM as an independent risk factor for PCa,delving into the biological links,including insulin resistance and hormonal changes.The paper critically analyzes previous studies that have shown varying results and introduces mendelian randomization as a method for establishing causality.It emphasizes the importance of early DM screening and lifestyle modifications in preventing PCa,and proposes future research directions for further understanding the DM-PCa relationship.

Does Helicobacter pylori eradication therapy for peptic ulcer prevent gastric cancer?

AIM:To investigate the effects of Helicobacter pylori (H pylori)eradication therapy for treatment of peptic ulcer on the incidence of gastric cancer. METHODS:A multicenter prospective cohort study was conducted between November 2000 and December 2007 in Yamagata Prefecture,Japan.The study included patients with H pylori-positive peptic ulcer who decided themselves whether to receive H pylori eradication(eradication group)or conventional antacid therapy(non-eradication group).Incidence of gastric cancer in the two groups was determined based on the results of annual endoscopy and questionnaire surveys,as well as Yamagata Prefectural Cancer Registry data,and was compared between the two groups and by results of H pylori therapy.RESULTS:A total of 4133 patients aged between 13 and 91 years(mean 52.9 years)were registered,and 56 cases of gastric cancer were identified over a mean follow-up of 5.6 years.The sex-and age-adjusted incidence ratio of gastric cancer in the eradication group, as compared with the non-eradication group,was 0.58 (95%CI:0.28-1.19)and ratios by follow-up period(<1 year,1-3 years,>3 years)were 1.16(0.27-5.00),0.50 (0.17-1.49),and 0.34(0.09-1.28),respectively.Longer follow-up tended to be associated with better prevention of gastric cancer,although not to a significant extent.No significant difference in incidence of gastric cancer was observed between patients with successful eradication therapy(32/2451 patients,1.31%)and those with treatment failure(11/639 patients,1.72%).Among patients with duodenal ulcer,which is known to be more prevalent in younger individuals,the incidence of gastric cancer was significantly less in those with successful eradication therapy(2/845 patients,0.24%)than in those with treatment failure(3/216 patients,1.39%). CONCLUSION:H pylori eradication therapy for peptic ulcer patients with a mean age of 52.9 years at registration did not significantly decrease the incidence of gastric cancer.

Helicobacter pylori eradication for preventing gastric cancer

Helicobacter pylori(H.pylori)infection is a major riskfactor for gastric cancer(GC)development,which isone of the most challenging malignant diseases worldwide with limited treatments.In the multistep pathogenesis of GC,H.pylori infection slowly induces chronicactive gastritis,which progresses through the premalignant stages of atrophic gastritis,intestinal metaplasia,and dysplasia,and then finally to GC.Although eradication of H.pylori is a reasonable approach for the prevention of GC,there have been some contradictory reports,with only some long-term follow-up data showingefficacy of this approach.The inconsistencies are likely due to the insufficient number of participants,relatively short follow-up periods,poor quality of study designs,and the degree and extent of preneoplastic changes atthe time of H.pylori eradication.This review analyzesrecent high-quality studies to resolve the discrepancies regarding the eradication of H.pylori for GC prevention.The relationship between H.pylori eradication and GC/precancerous lesions/metachronous GC is examined,and the cost-effectiveness of this strategy in the prevention of GC is assessed.Although it is assumed that eradication of H.pylori has the potential to prevent GC,the feasibility and appropriate timing of this strategy for cancer prevention remain to be determined.As a result,additional well-designed trials with longer followup periods are needed to clarify this issue.

Consumption of garlic and risk of colorectal cancer:An updated meta-analysis of prospective studies

AIM: To conduct an updated meta-analysis of prospective studies addressing the association between garlic consumption and colorectal cancer.

Metachronous gastric cancer after successful Helicobacter pylori eradication

The high incidence of gastric cancer in Japan initially resulted in establishment of a country-wide gastric cancer screening program to detect early and treatable cancers. In 2013 countrywide Helicobacter pylori(H. pylori) eradication was approved coupled with endoscopy to assess for the presence of chronic gastritis. Current data support the notion that cure of the infection in those with non-atrophic gastritis will prevent development of gastric cancer. However, while progression to more severe damage is halted in those who have already developed, atrophic gastritis/gastric atrophy remain at risk for subsequent development of gastric cancer. That risk is directly related to the extent and severity of atrophic gastritis. Methods to stratify cancer risk include those based on endoscopic assessment of the atrophic border, histologic grading, and non-invasive methods based on serologic testing of pepsinogen levels. Continued surveillance is required because those with atrophic gastritis/gastric atrophy retain considerable gastric cancer risk even after H. pylori eradication. Those who have already experienced a resectable early gastric cancer are among those at highest risk as metachronous lesions are frequent even after H. pylorieradication. We review the role of H. pylori and effect of H. pylori eradication indicating the incidence and the predictive factors on development of metachronous cancer after endoscopic therapy of early gastric cancer. Studies to refine risk markers to stratify for risk, surveillance methods, intervals, and duration after successful H. pylori eradication, and whether adjuvant therapy would change risk are needed.

Non-steroidal anti-inflammatory drugs and statins in relation to colorectal cancer risk

AIM： To investigate the association between individual or combined use of non-steroidal anti-inflammatory drugs （NSAIDs） or statins and colorectal cancer risk.METHODS： In a population-based case-control study in women, we examined the association between NSAIDs and statin use and the risk of colorectal cancers. We further investigated whether the use of statins modifies the protective effect of NSAIDs. Female cases （n = 669）of colorectal cancer aged 50-74 years were identified from a storewide registry in Wisconsin during 1999-2001. Community control women （n = 1375） were randomly selected from lists of licensed drivers and Medicare beneficiaries. Medication use and risk factor information were gathered during a structured telephone interview. A multivariable logistic regression model was used to calculate odds ratio （OR） and 95% confidence interval （CI）.RESULTS： Overall, NSAIDs users had a 30% reduction in risk of colorectal cancer （95% CI： 0.56-0.88）. Statin use was not associated with colorectal cancer risk （OR = 1.17, 95% CI： 0.74-1.85）, regardless of structural type （lipophilic or hydrophilic）, duration of use, or recency. There was no evidence of an interaction between NSAIDs and statins and colorectal cancer risk （P-interaction = 0.28）.CONCLUSION： Although our results confirm the inverse association between NSAIDs use and colorectal cancer risk, they do not support a risk reduction in statin users, or an interaction effect of combined NSAIDs and statin use.