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Title: Advances in the detection of colorectal cancer
Author: Mozdiak, Ella
ISNI:       0000 0004 8498 0033
Awarding Body: University of Warwick
Current Institution: University of Warwick
Date of Award: 2018
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Colorectal cancer (CRC) is a significant cause of mortality. In the UK, 1 in 14 men and 1 in 19 women will develop CRC in their lifetime. Overall, five-year survival is 60% and this compares poorly to many countries in Western Europe. Survival is directly linked to stage at presentation. The majority present at Dukes stage B or above. Better methods of detecting CRC at an earlier stage are needed to improve survival figures. Published evidence on the two-week wait pathway (TWW) for detecting CRC was evaluated using a systematic review. This showed low CRC detection and no difference in stage at presentation in the TWW group compared with the non-TWW pathways of referral. These results indicate the emphasis on TWW targets is not justified and should prompt consideration of better methods of risk stratification for those with suspected CRC. Biomarkers have the potential to improve the positive predictive value of referral criteria in the symptomatic population and also increase the sensitivity of the faecal occult blood test when used as an adjunct in the bowel screening population. Two potential urinary biomarker groups in the detection of CRC were explored: one based on volatile organic compounds (VOCs) and one on peptide markers. Analysis demonstrated that CRC could be correctly classified from control using a VOC or peptide biomarker-based test with a high degree of accuracy in pilot work. Further protein analysis using immunohistochemistry explored the role of Meprin alpha in the pathology of CRC with possible implications in aggressive disease. There is a need for better ways of detecting CRC and biomarkers hold huge potential. But there must be a culture change from the current fragmented approach to elucidating diagnostics in CRC. Collaborations between research groups and data-sharing is essential to validate pilot studies and share knowledge on methodology and results.
Supervisor: Not available Sponsor: Medical and Life Sciences Research Fund ; Midlands Gastroenterological Society
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RC Internal medicine