卫生署日间医疗中心牌照
医思专汇(PHF No. DP000104)、医思联汇(PHF No. DP000110)

卫生署日间医疗中心牌照
醫思專匯(PHF No. DP000104)
醫思聯匯(PHF No. DP000110)

Keep the Gut Out of Mischief | Dr. Fong Ka Leuk

Dr. Fong Ka Leuk
Dr. Fong Ka Leuk

The Advancement in Diagnosis for Colorectal Cancer

Colorectal cancer (CRC) is the most common cancer, accounting for 16.6% of all new cancer cases in 2018, in Hong Kong. The disease is also the second leading cause of local cancer deaths. Essentially, an uprising trend in incidence rate of CRC has been observed since 19831. To tackle with the increasing disease burden of CRC, preventive measures such as having a healthy lifestyle and balanced diet are promoted. In line with this, regular check-up for CRC are recommended for high-risk populations. In the current interview, Dr. Fong Ka Leuk, Specialist in Gastroenterology and Hepatology, shared his expertise in diagnosing CRC and his opinions on recent advancement in diagnostic tests for the disease.

Where Are We in the Prevention of CRC?

Figure 1.
Age-standardised incidence rate of CRC in Hong Kong, 1983-2018 1

The Obstacles to CRC Screening among People at Risk

CRC Diagnosis in Practice

The Non-stop Evolution of CRC Diagnosis

Faecal Bacterial DNA Testing
Developing diagnostic tests for CRC is a hot topic in gastroenterology and cancer research. Particularly, the application of faecal DNA testing has launched a new era in the non-invasive part of CRC screening. In particular, a research team of the Chinese University of Hong Kong (CUHK) has recently identified a novel faecal Lachnoclostridium marker for the non-invasive diagnosis of colorectal adenoma and cancer. Based on metagenomic analysis of two independent Asian groups, which included 274 CRC, 353 adenoma and 385 controls, “m3” from a Lachnoclostridium sp., Fusobacterium nucleatum (Fn) and Clostridium hathewayi (Ch) were found to be significantly enriched in adenoma. Faecal m3 and Fn were significantly increased from normal to adenoma to CRC (p<0.0001, Figure 2). Essentially, the combination of m3 with Fn, Ch, Bacteroides clarus and FIT performed best for diagnosing CRC, with specificity =81.2% and sensitivity =93.8%7

 

Figure 2.
Quantitative detection of faecal m37, N: healthy control, A: adenoma

Artificial Intelligence (AI)

Trust Your Gut? Check Your Gut!

As a final remark, Dr. Fong stressed that maintaining a healthy lifestyle is crucial since many risk factors for CRC, such as obesity and smoking, can be controlled by lifestyle modification. Further, he reminded that it is important to consult a physician if abnormalities, such as a persistent change in bowel habit, have been observed so as to facilitate early diagnosis and timely treatment. “Early-stage cancers are curable,” he emphasised.

References
1. Centre for Health Protection – Colorectal Cancer. https://www.chp.gov.hk/en/healthtopics/content/25/51.html. 2. Recommendations on prevention and screening for colorectal cancer in Hong Kong. Hong Kong Med J 2018; 24: 521-6. 3. Anderson e tal. Biomed Res Int 2015; 2015. DOI:10.1155/2015/871613. 4. Eligibility of Colorectal Cancer Screening Programme updated. https://www.info.gov.hk/gia/general/202012/30/P2020123000566.htm. 5. Tsang et al. Hong Kong Med J 2020; 26: 546-8. 6. Rex et al. Am J Gastroenterol 2017; 112:

資源轉載:V-Pulse
https://www.vpulsehk.com/detail.php?id=236&fid=4&obname=Feature%20Story

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