Background Colorectal cancer (CRC) is one of the most common cancers with high morbidity and mortality among both genders and yet it carries a better prognosis when detected early. Colorectal cancer screening using faecal occult blood test (FOBT) is proven to be cost-effective, however worldwide FOBT uptake rate is suboptimal which directly affects the cost-effectiveness of the screening program. Identifying those factors that influence the uptake of colorectal cancer screening using FOBT will allow implementation of relevant measures when planning a population based screening program. Methods A structured electronic search using PubMed and Medline was conducted in order to identify studies that included factors influencing the uptake of CRC screening by using FOBT. Qualities of included studies were assessed by quality assessment checklist STROBE. Results Factors that contributed to the low uptake rate of CRC screening by FOBT were identified and summarized. They were broadly divided into 3 groups. Demographic factors: age, gender, social economic status, insurance status and education, for ethnicity, employment status and obesity further studies in the future may be needed. Subject factors: subject’s attitudes and knowledge towards CRC screening, type of FOBT screening, health concerned behavior, frequency of clinical visit and physiciancomment. Provider factors: health care system factor and physicians’ factors. Conclusion Different factors, in particular those factors that were associated with low FOBT uptake rate in CRC screening, were reviewed and summarized in this paper. With the continuous effort from worldwide as well as local investigators, timely measures can be implemented to tackle this deathly disease and to ensure cost effectiveness of a screening program. / published_or_final_version / Public Health / Master / Master of Public Health

BACKGROUND: Colorectal cancer is usually asymptomatic until later stage and the 5-year survival for stage III or IV are 68% and 10 % because of delayed diagnosis. Worldwide, it is the 4th leading cause of death among cancers which accounted for 694,000 deaths in 2012. While healthy diet and lifestyle helps prevent colorectal cancer, increased surveillance through screening has been suggested to attribute to the decreasing trend of colorectal cancer incidence in the United States in the past decade. Identifying what type of colorectal cancer screening methods is more effective is of public health relevance to Hong Kong where colorectal cancer ranks the top leading cancer. OBJECTIVES: To conduct a systematically review on current literatures to examine whether endoscopy screening by flexible sigmoidoscopy or colonoscopy is more effective for reducing the mortality and incidence of colorectal cancer than no screening as many colorectal cancers arise from adenomatous polyps, which polypectomy is hypothesized to be protective. Meanwhile, different countries adopt different kinds of colorectal cancer screening modalities, but yet, there is no agreement for the types of screening. METHODS: Four databases, Medline (OVIDSP), Pubmed, CINAHL plus (EBSCOhost), Embase (OVIDSP) were used to search for published journals. Reference list of the identified articles were screened for more relevant studies. RESULTS: A total of 8 studies were included in this systematic review. There were only 2 randomized controlled trials (RCTs) on screening for colorectal cancer using flexible sigmoidoscopy in asymptomatic and average-risk people and no RCT was found for colonoscopy. Based on the studies reviewed, findings were inconsistent on whether endoscopy screening is more effective in reducing overall colorectal cancer incidence and mortality than no screening. Endoscopy screening, either sigmoidoscopy or colonoscopy was associated with lower incidence of distal colorectal cancer. CONCLUSION: Screening by flexible sigmoidoscopy or colonoscopy is not clearly associated with lower overall colorectal cancer risks based on current systematic review. Randomized controlled trials or retrospective cohorts are required to clarify the effectiveness of endoscopy screening before considering the implementation of population-wide colorectal cancer screening. / published_or_final_version / Public Health / Master / Master of Public Health

Colorectal cancer is a serious health problem that has concerned people for decades. In Hong Kong, it is the most common cancer and the second leading cause of death. Among colorectal cancer patients, around 40-50% of them will develop metastatic disease. Chemotherapy is playing an important role all the time in the treatment of advanced colorectal cancer. In the past decade, the application of targeted therapies in treatment has largely improved efficacy and prolonged survival. Bevacizumab and cetuximab are two commonly used targeted agents in daily clinical practice of Hong Kong. Since multiple clinical trials have studied bevacizumab and cetuximab in combination with other chemotherapies, limited data is available in Asian patients. Therefore, we conduct three 5-year retrospective analyses based on patients received treatment in Hong Kong Queen Mary Hospital, to investigate the clinical efficacy and toxicity of those two drugs. The first study examined the use of bevacizumab in treating KRAS mutated type patients. We found the efficacy and results were consistent with historical data. In the next analysis of cetuximab, comparable data were shown which suggested the consistency with previous studies. The last study is aim to compare bevacizumab and cetuximab in previously untreated wild-type KRAS patients. Identical response rates, progression-free survival and overall survival were finally reported. / published_or_final_version / Medicine / Master / Master of Philosophy

Colorectal cancer is the third most common cancer and cause of death due to cancer in the United States. Death due to colorectal cancer is generally caused by hepatic metastasis rather than the primary tumor itself. The five-year survival rate is only 10% for patients whose colorectal cancer metastasized, which indicates the need for more effective therapies to treat colon cancer. The diet contains (1) preformed vitamin A as retinyl esters in animal-derived food sources and (2) provitamin A carotenoids in plant-derived food sources. Once absorbed, retinol is re-esterified and transported to the liver, the major site of vitamin A storage. Therefore, dietary vitamin A supplementation can increase retinol levels in the colon and liver, potentially affecting both primary colon tumors and liver metastases of the primary tumors. All-trans--retinoic acid (ATRA) is thought to regulate most of the effects of retinoids, via the ATRA/RAR/RARE pathway exerting an inhibitory effect on cancer growth and progression. As cancer progresses, colon cancer acquires the resistance to ATRA. The purpose of this study is to understand the mechanism by which retinol decreased the growth and progression of ATRA-resistant human colon cancer in vivo and in vitro. We first demonstrated that retinol decreased the growth of ATRA-resistant colon cancer cells by arresting cell cycle progression independent of the ATRA/RAR/RARE pathway. Next, we showed retinol inhibited ATRA-resistant human colon cancer cell invasion by decreasing MMP-2, -9 and PI3K activity in vitro. Finally, dietary vitamin A supplementation decreased the incidence and multiplicity of liver metastases in nude mice intrasplenically injected with ATRA-resistant human colon cancer cells. Taken together, these data suggest the possibility of dietary vitamin A supplementation for colon cancer therapy and prevention.

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

No description available.

Secondly, we incorporate knowledge of the physiology, or how we expect the anatomy to change due to treatment. We can represent these changes using the Jacobian of the deformation, which describes the local size and type of change. This is used to regularise the registration, and can be incorporated simultaneously with the iterations of the registration. The final result is an accurate and robust registration result that is clinically useful for finding corresponding features on pre- and post-treatment datasets.

Errata pasted onto t.p. verso. / Bibliography: leaves 129-148. / 148 leaves : [3] col. ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Investigates the relationship between folate states and colorectal cancer risk using the rat AOM intestinal cancer model. Results indicate that folate status can play an important role in modulating colorectal carcinogenesis. / Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 2000

Thesis (Ph. D.)--Rutgers University, 2007. / "Graduate Program in Psychology." Includes bibliographical references (p. 70-74).

Thesis (Ph. D.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 138-152).