The Association between Molecular Markers in Colorectal Sessile Serrated Polyps and Colorectal Cancer Risk
Abstract
Background and Rationale: Colorectal cancer screening can prevent new cases of colorectal cancer by detecting and removing colorectal polyps before these polyps have a chance to progress to cancer. Some polyps have a high risk of progressing to cancer, but most colorectal polyps will not become cancerous. If doctors detect a high-risk polyp, they will completely remove that polyp and ask the patient to return in 1-5 years for a follow-up exam of the colon using colonoscopy. The recommended follow-up colonoscopy for patients with high-risk polyps is sooner than it is for patients with no colorectal polyps or those who only have low-risk polyps. Generally, these low-risk patients will be asked to return for a colonoscopy in 10 years. Another method doctors use to screen patients for colorectal cancer is testing a stool sample from the patient. If blood is detected in the stool, then the patient will be referred for a colonoscopy to examine the colon for cancer or polyps. New stool-based colorectal cancer screening tests also incorporate specific DNA markers that high-risk polyps and colorectal cancers can leave in stool. When these DNA markers are detected in stool, a complete colonoscopy exam is recommended. Sessile serrated polyps are a newly recognized group of colorectal polyps that were previously categorized with polyps that had no risk of developing into cancer. Now there is evidence that some sessile serrated polyps likely develop into an aggressive type of colorectal cancer. However, these polyps can be difficult to detect via colorectal cancer screening, and it is not clear which sessile serrated polyp features are associated with an increased risk of colorectal cancer. Objective: The objective of this research is to identify features and polyp DNA markers that predict which colorectal sessile serrated polyps are most likely to develop into colorectal cancer. Clinical Application: If polyp features and polyp DNA markers that predict an increased risk of colorectal cancer in patients with sessile serrated polyps can be identified, high-risk sessile serrated polyps may be easier to detect with stool-based screening and colonoscopy. Then, the patients harboring these high-risk sessile serrated polyps can be targeted to ensure complete polyp removal and increased monitoring for colorectal cancer. Such targeted interventions in other patients at high-risk for colorectal cancer have been associated with a reduced risk of colorectal cancer illness and death. Thus, the proposed research will provide a direct benefit in improving the effectiveness of colorectal cancer screening by informing colorectal cancer surveillance guidelines for sessile serrated polyps and aid in the development of new stool-based DNA colorectal cancer screening tests. Relevance to Military Beneficiaries: People who smoke cigarettes are more likely to develop sessile serrated polyps and cancers associated with these polyps. Because smoking rates in military beneficiaries are higher than in the general US population, military beneficiaries may particularly benefit from research that targets sessile serrated polyps. Also, stool-based testing is an important component of the Military Health System s colorectal cancer screening program. Improving the effectiveness of stool-based colorectal cancer screening will therefore benefit military beneficiaries. Principal Investigator Career Goals: Dr. Burnett-Hartman has a strong background in research aimed at understanding risk factors for colorectal cancer and colorectal polyps, and she received an award to recognize this work from the American Association for Cancer Research. Her goal is to build on this expertise by developing an independent research program in clinical research aimed at reducing colorectal cancer through improving detection of high-risk colorectal cancer precursors. This career development award will provide time to conduct clinical research, allow her to c
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 29, 2016
- Source ID
- W81XWH1510273
Entities
People
- Andrea N Burnett-Hartman
Organizations
- Kaiser Foundation Hospital
- United States Army