Recently, Fight CRC attended the 2019 Digestive Disease Week Conference in San Diego, Calif. along with over 14,000 researchers, clinicians, and patient advocates. In addition to attending research sessions and raising awareness about Fight CRC’s patient resources, our team continued the momentum from the first Early-Age Onset Colorectal Cancer (EAO CRC)  workgroup meeting by reconvening the group to continue the discussion about next steps for researching sporadic EAO-CRC (see more below)!

Following the conference, Fight CRC caught up with epidemiologists Caitlin Murphy from the University of Texas Southwestern, and Josh Demb from the University of California San Diego. They were excited to break down the research and highlights from the conference for us.

Josh Demb, Ph.D., Cancer Epidemiologist, UCSD

I had the unique opportunity to enjoy five jam-packed days learning about the developments in digestive disease being led by a wide array of clinicians, epidemiologists, biostatisticians, advocacy groups, and biotech companies. While it is hard to distill all of this into a few brief lines, there were three particularly interesting themes I saw in colorectal cancer research:

  1. Improving the quality of a colonoscopy. Two Sunday sessions were devoted to the importance of improving the quality and safety of a colonoscopy to maximize benefits for the patient. Topics ranged from how detection of adenomas is associated with colorectal cancer risk to measuring how incorporation of artificial intelligence can improve colonoscopy skills among endoscopists.
  2. Improving colorectal cancer screening uptake. In light of the 2018 American Cancer Society guideline update recommending screening start at age 45, many presentations focused on early findings when screening adults ages 45-49 as well as ways maximize screening uptake across the entire screening-eligible population. The consistent theme in these talks/posters was making sure screening was accessible to patients, and I am excited to see how it influences upcoming guideline updates.
  3. Early-Age Onset Colorectal Cancer (EAO CRC) Research. For me, one of the highlights of DDW was the Tuesday session on early-age onset colorectal cancer. Notably, a study on dietary factors and EAO CRC found that a Western-style diet was associated with increased risk for early-onset adenomas, whereas a more prudent diet was associated with lower-early onset adenoma risk. Also, a research team assessing trends in EAO CRC cases in the U.S. found a sharp rise in EAO CRC incidence between ages 49 and 50. They argued that these findings represent an “iceberg effect”, the idea that we are underestimating the burden of EAO CRC in adults in their 40s, and justifies screening adults under 50 to prevent CRC development and later stage detection.

Caitlin Murphy, Ph.D., Assistant Professor, UT Southwestern Medical Center

DDW! It’s hard to imagine that a convention center full of gastroenterologists and researchers could feel like home, but it’s where I feel most connected to and inspired by science. I always look forward to catching up with others and learning what the field has accomplished since we last met. This year we had the privilege of celebrating the 50th anniversary of DDW in sunny (it rained!) San Diego. Some of my favorite moments were:

  1. New findings in colorectal cancer screening. We learned about the optimal timing of surveillance colonoscopy for and outcomes of patients with high- and low-risk adenomas. Because patients with smaller or low-risk adenomas have no increased risk of colorectal cancer incidence or death, they may not require an intensive surveillance regimen. And, researchers from Kaiser Permanente showed us how a simple, interactive training can improve adenoma detection rates across a variety of practice settings.
  2. Strategies for improving uptake of screening.  Researchers from UPenn and UC San Diego presented results from trials comparing different screening outreach strategies. UPenn found that offering patients a choice of colonoscopy or FIT increased screening compared to offering only colonoscopy. In a predominantly Hispanic population, UC San Diego showed that mailed FIT kits nearly tripled screening uptake compared to usual care. I encourage us to disseminate these promising strategies into new settings and make progress toward our goal of 80% screened.
  3. Virtual reality improves symptoms for patients with gastrointestinal pain. During the AGA Plenary, Dr. Brennan Spiegel shared his exciting work on using virtual reality (yes, video games!) to improve patient symptoms. He shared a video of a woman with severe pain from liver ascites describing immense pain relief after a virtual reality experience that took her far from her hospital room. The possibilities for extending this technology to other patients seem endless – I can imagine how beneficial it might be in alleviating symptoms of patients diagnosed with cancer.

Research conferences are an exciting time to get the latest breaking news and the information keeps flooding in! Shortly after DDW, the Fight CRC team landed in Chicago, IL for the American Society of Clinical Oncology Annual Conference.

Check the Fight CRC Facebook Page for Facebook Lives featuring Drs. Christopher Lieu and Christopher Heery, Radha Chitale from Inspire, and Fight CRC Research Advocate Karen Wehling. In addition, make sure to register for our June 25th Post-ASCO Webinar, featuring Dr. Scott Kopetz!

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