Publications by authors named "Ker Kan Tan"

Background: Colorectal cancer (CRC) incidence and mortality in those aged 50 years and above have decreased over the last 2 decades. However, there is a rising incidence in CRC among individuals under 50 years of age, termed early-onset colorectal cancer (EOCRC). EOCRC patients are more advanced stage at diagnosis and may suffer more psychosocial, emotional and financial distress.

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Notch1 plays various roles in cancer development, and Notch1-induced transactivation is controlled by phosphorylation of its cleaved intracellular domain. However, it is unclear whether there are phosphatases capable of dephosphorylating the cleaved Notch1 transmembrane/intracellular region (NTM) to regulate its function. Here, we show that DUSP6 can function as a phosphatase for Notch1, thereby regulating NTM stability and transcriptional activity, thus influencing colorectal cancer (CRC) development.

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Objectives: To identify the range of factors that impact health behaviours pertaining to the uptake of pneumococcal vaccination (PV) among older persons.

Study Design: Scoping review.

Methods: This review followed Arksey and O'Malley's framework.

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Article Synopsis
  • * This study combined short- and long-read scRNA-seq to create a detailed transcriptomic atlas of CRC, revealing 394 dysregulated transcript structures and identifying specific genes and isoforms linked to different tumor cell subpopulations with varied prognoses.
  • * An algorithm was developed to link novel peptides from these recurrent tumor-specific transcripts with mass spectrometry data, leading to the discovery of recurring neoepitopes that could potentially inform the creation of new cancer vaccines.
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Background: Colorectal cancer (CRC) is one of the few cancers for which screening has been associated with better survival and morbidity, but screening uptake has been underexplored in spouses of existing patients with CRC. The objective of this study was to evaluate whether a brief, structured behavioral intervention delivered to spouses of patients with CRC in a colorectal clinical setting could increase fecal immunochemical test (FIT) uptake within 3 months of the study period.

Methods: This study was designed as a block randomized, unblinded, parallel trial conducted in the colorectal outpatient clinics of 2 public tertiary hospitals in Singapore from December 2017 to February 2023.

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Background: Colorectal cancer (CRC) is the second most deadly form of cancer, inducing an estimated 1.9 million incidence cases and 0.9 million deaths worldwide in 2020.

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Article Synopsis
  • - The study investigates how effectively PET/MRI can predict treatment response in localized rectal cancer patients undergoing preoperative chemoradiotherapy (CRT), focusing on sensitivity and specificity of imaging parameters.
  • - Out of 31 recruited patients with rectal adenocarcinoma, 20 completed the study; results showed that 20% of patients were good responders to treatment, while 80% had a poor response based on histopathological assessments.
  • - Key imaging metrics like percent maximum thickness reduction and percent apparent diffusion coefficient (ADC) change demonstrated promising predictive values, suggesting their potential use in identifying good responders, highlighting the need for larger studies to validate these findings.
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Purpose: Chemotherapy is one of the common treatments in cancer management. However, chemotherapy-induced cognitive impairment (CICI) is one notable side effect that can greatly impact a patient's quality of life. Literature on CICI in gastrointestinal (GI) cancers are few and inconsistent.

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Background: Lymph node metastasis (LNM) occurs in 20-25% of patients with T2 colorectal cancer (CRC). Identification of risk factors for LNM in T2 CRC may help identify patients who are at low risk and thereby potential candidates for endoscopic full-thickness resection. We examined risk factors for LNM in T2 CRC with the goal of establishing further criteria of the indications for endoscopic resection.

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Objective: Patient-reported outcome measures (PROM) are frequently adopted to evaluate colorectal cancer (CRC) care, but the use of patient-reported experience measures (PREM) appears to be underdeveloped and not widely validated. This scoping review aims to understand the contexts for deployment of PREMs in CRC care, reliability of measures, gaps in current use of PREMs, and how PREMs are associated with PROMs when deployed together.

Methods: Four scientific databases (PubMed, CINAHL, PsycINFO, Scopus) were systematically searched from January 2011 to December 2023.

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Background: The effectiveness of somatic neoantigen-based immunotherapy is often hindered by the limited number of mutations in tumors with low to moderate mutation burden. Focusing on microsatellite-stable colorectal cancer (CRC), this study investigates the potential of tumor-associated circular RNAs (circRNAs) as an alternative source of neoepitopes in CRC.

Methods: Tumor-associated circRNAs in CRC were identified using the MiOncoCirc database and ribo-depletion RNA sequencing of paired clinical normal and tumor samples.

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Globally, colorectal cancer (CRC) is the third most frequently occurring cancer. Progression on to an advanced metastatic malignancy (metCRC) is often indicative of poor prognosis, as the 5-year survival rates of patients decline rapidly. Despite the availability of many systemic therapies for the management of metCRC, the long-term efficacies of these regimens are often hindered by the emergence of treatment resistance due to intratumoral and intertumoral heterogeneity.

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Objectives: Perceptions towards advanced care planning (ACP) amongst individuals with Ischemic Heart Disease before or after a life-threatening Acute Myocardial Infarction event is underexamined and could impact the appropriate timing for ACP advocacy. This cross-sectional study assessed awareness and intentions regarding ACP in individuals with Ischemic Heart Disease, both before and after an Acute Myocardial Infarction, and explored the motivating effect of a near-fatal Acute Myocardial Infarction event on its engagement.

Methods: This study was conducted from 24 August 2021 through 13 March 2023, whereby patients were administered a one-time questionnaire with no follow-up required.

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Viruses are a key component of the colon microbiome, but the relationship between virome and colorectal cancer (CRC) remains poorly understood. We seek to identify alterations in the viral community that is characteristic of CRC and examine if they persist after surgery. Forty-nine fecal samples from 25 non-cancer (NC) individuals and 12 CRC patients, before and 6-months after surgery, were collected for metagenomic analysis.

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Background: Health-related quality of life (HRQOL) is an increasingly important outcome in colorectal cancer (CRC) treatment. Established thresholds for clinical importance (TCI) permit an absolute interpretation of HRQOL scores but less emphasis has been placed on whether these can be used in a predictive manner. This study aimed to examine if patients' baseline HRQOL functioning scores, subgrouped based on TCI, would significantly predict HRQOL over time.

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The current standard treatment for muscularis propria-invasive (T2) colorectal cancer is surgical colectomy with lymph node dissection. With the advent of new endoscopic resection techniques, such as endoscopic full-thickness resection or endoscopic intermuscular dissection, T2 colorectal cancer, with metastasis to 20%-25% of the dissected lymph nodes, may be the next candidate for endoscopic resection following submucosal-invasive (T1) colorectal cancer. We present a novel endoscopic treatment strategy for T2 colorectal cancer and suggest further study to establish evidence on oncologic and endoscopic technical safety for its clinical implementation.

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Self-isolation was common in the first year of COVID-19. While necessary, it also increased vulnerability to adverse mental health among elderly (i.e.

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Purpose: During the COVID-19 pandemic, home-based and remote learning-particularly using electronic devices-was rapidly pushed out. Increased near-work, screen time exposure and lack of outdoor time are risk factors that contribute to childhood myopia, but it is difficult to adopt recommendations from prior publications as a consistent limitation in the literature is the heterogeneity of research methodology. This review seeks to systematically evaluate how observational studies published during the pandemic have quantified and measured risk factors and myopia in school-going children and adolescents.

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Article Synopsis
  • Lip, oral, and pharyngeal cancers pose significant global health challenges, making it essential to analyze their burden for effective health policies.
  • The study utilized data from the 2019 Global Burden of Diseases, Injuries, and Risk Factors Study to assess cancer incidence, mortality, and life years lost across 204 countries, linking these to socio-demographic factors.
  • Findings revealed approximately 370,000 cases and 199,000 deaths for lip and oral cavity cancer, and 167,000 cases and 114,000 deaths for other pharyngeal cancers in 2019, with smoking being the leading risk factor for these cancers, especially in low and middle SDI regions.
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Background: Surgical high dependency (SHD) allows for intermediate care provision between general ward (GW) and intensive care unit (ICU) for surgical patients but no universally accepted admission criteria exists. Unnecessary SHD admissions should be minimized to limit resource wastage and maintain spare critical care capacity. This study evaluates the utility of SHD admissions following elective laparoscopic colectomy by comparing post-operative outcomes and interventions performed between SHD and GW patients.

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: It remains unclear which domains of preoperative health-related quality of life (HRQOL) and mental health are predictive of postoperative clinical and patient-reported outcomes in colorectal cancer (CRC) patients. A prospective cohort of 78 CRC patients undergoing elective curative surgery was recruited. The EORTC QLQ-C30 and HADS questionnaires were administered preoperatively and one month after surgery.

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Mis-sense mutations affecting TP53 promote carcinogenesis both by inactivating tumor suppression, and by conferring pro-carcinogenic activities. We report here that p53 DNA-binding domain (DBD) and transactivation domain (TAD) mis-sense mutants unexpectedly activate pro-carcinogenic epidermal growth factor receptor (EGFR) signaling via distinct, previously unrecognized molecular mechanisms. DBD- and TAD-specific TP53 mutants exhibited different cellular localization and induced distinct gene expression profiles.

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Objective: The uptake of breast and cervical cancer screening services among women in Singapore remains inadequate. Little is known about how gender norms influence women's decision to undergo these screening services in a multi-ethnic Asian context. This research aimed to explore how gender-based qualitative factors influence women's decision to screen.

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