Publications by authors named "Robert E Schoen"
Article Synopsis
- - The study critiques the current colonoscopy surveillance guidelines in the U.S., which only focus on adenoma features, and explores how incorporating demographic, environmental, and genetic risk factors can lead to more personalized monitoring. - Researchers analyzed data from over 14,000 participants in a cancer screening trial to model the risk of colorectal cancer based not just on adenomas, but also baseline characteristics and a polygenic risk score, finding that a significant percentage of patients without adenomas or with few adenomas could be classified as high risk and benefit from closer surveillance. - The findings suggest that a more individualized risk assessment could improve colorectal cancer detection by shortening surveillance intervals for those who may not fit the current guidelines but are still at elevated risk.
Background: Imaging biomarkers are emerging as non-invasive predictors of cancer prognosis and clinical outcome. We assessed tumor-specific ("radiomics") and body composition imaging features ("morphomics") extracted from baseline pre-treatment CT for prediction of recurrence in patients with stage III colorectal cancer (CRC).
Methods: Patients with newly diagnosed stage III CRC were enrolled in this prospective observational study.
Background: Cell-free DNA blood tests (cf-bDNA) and next-generation stool tests could change colorectal cancer (CRC) screening.
Objective: To estimate the clinical and economic impacts of novel CRC screening tests.
Design: Cost-effectiveness analysis using MOSAIC (Model of Screening and Surveillance for Colorectal Cancer).
Article Synopsis
- MUC1 peptide vaccines are being studied as a way to boost immunity against colon cancer in individuals with a history of premalignant colon adenomas, and trials showed varied responses among participants.
- Researchers analyzed blood samples from vaccine responders and non-responders to identify potential early biomarkers that could indicate long-term immune memory and reduce adenoma recurrence.
- The study found that MUC1 responders had distinct immune profiles, including higher CD4 cell counts and specific activated pathways, suggesting these factors could help predict who is likely to benefit from the vaccine and assist in developing personalized cancer preventive strategies.
Article Synopsis
- Colorectal cancer (CRC) is a major health concern, and understanding how genetic and environmental factors interact can help identify at-risk groups.
- This study analyzed data from over 45,000 CRC cases to assess both multiplicative and additive interactions between genetic risk scores and various environmental factors, finding no multiplicative interactions but significant additive ones for high genetic susceptibility individuals.
- Results suggest that individuals with high genetic risk could benefit more from lifestyle interventions like reducing alcohol intake or increasing fruit and fiber consumption, emphasizing the need for targeted prevention strategies in CRC care.
Multiplexed imaging technologies have made it possible to interrogate complex tissue microenvironments at sub-cellular resolution within their native spatial context. However, proper quantification of this complexity requires the ability to easily and accurately segment cells into their sub-cellular compartments. Within the supervised learning paradigm, deep learning-based segmentation methods demonstrating human level performance have emerged.
View Article and Find Full Text PDFA single arm trial (NCT007773097) and a double-blind, placebo controlled randomized trial ( NCT02134925 ) were conducted in individuals with a history of advanced colonic adenoma to test the safety and immunogenicity of the MUC1 tumor antigen vaccine and its potential to prevent new adenomas. These were the first two trials of a non-viral cancer vaccine administered in the absence of cancer. The vaccine was safe and strongly immunogenic in 43% (NCT007773097) and 25% ( NCT02134925 ) of participants.
View Article and Find Full Text PDFmutation is a driver mutation in the serrated pathway to colorectal cancers. BRAF drives tumorigenesis through constitutive downstream extracellular signal-regulated kinase (ERK) activation, but high-intensity ERK activation can also trigger tumor suppression. Whether and how oncogenic ERK signaling can be intrinsically adjusted to a 'just-right' level optimal for tumorigenesis remains undetermined.
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- * Researchers analyzed data from 52 studies, including nearly 31,000 CRC cases and over 41,000 controls, to explore the genetic interactions with regular aspirin/NSAID use.
- * They found significant interactions with genetic variants in two specific regions (6q24.1 and 5p13.1), which could help uncover new targets for understanding how aspirin provides its protective effects against colorectal cancer.
Self-antigens abnormally expressed on tumors, such as MUC1, have been targeted by therapeutic cancer vaccines. We recently assessed in two clinical trials in a preventative setting whether immunity induced with a MUC1 peptide vaccine could reduce high colon cancer risk in individuals with a history of premalignant colon adenomas. In both trials, there were immune responders and non-responders to the vaccine.
View Article and Find Full Text PDFBackground: Active surveillance pharmacovigilance is an emerging approach to identify medications with unanticipated effects. We previously developed a framework called pharmacopeia-wide association studies (PharmWAS) that limits false positive medication associations through high-dimensional confounding adjustment and set enrichment. We aimed to assess the transportability and generalizability of the PharmWAS framework by using medical claims data to reproduce known medication associations with Clostridioides difficile infection (CDI) or gastrointestinal bleeding (GIB).
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- Menopausal hormone therapy (MHT) may lower the risk of colorectal cancer (CRC), especially in women with a higher genetic predisposition to the disease.
- In a study of nearly 30,000 postmenopausal women, those in the highest genetic risk quartile saw a significantly greater reduction in CRC risk when using MHT compared to those in the lowest quartile.
- The findings suggest that integrating genetic risk information could improve CRC risk predictions and inform the assessment of MHT benefits in postmenopausal women.
Article Synopsis
- Colorectal cancer (CRC) screening is effective but underutilized; blood-based tests could enhance participation by overcoming barriers associated with traditional screening methods.* -
- A study comparing blood-based tests to established methods (like multi-target stool DNA, FIT, and colonoscopy) found that while a blood test meeting CMS standards reduces CRC incidence and mortality, it is less effective and more costly than these alternatives.* -
- For blood-based tests to be a viable substitute for traditional screening methods, they need to achieve higher sensitivity for CRC and advanced precancerous lesions (APL) to match or exceed the participation rates and effectiveness of current tests.*
Importance: Randomized clinical screening trials have shown that sigmoidoscopy screening reduces colorectal cancer (CRC) incidence and mortality. Colonoscopy has largely replaced sigmoidoscopy for CRC screening, but long-term results from randomized trials on colonoscopy screening are still lacking.
Objective: To estimate the additional screening benefit of colonoscopy compared with sigmoidoscopy.
Article Synopsis
- Obesity is linked to various types of colorectal cancer (CRC), but the strength and cause of these links are not fully understood.
- By using Mendelian randomization, researchers studied how body size traits like BMI, waist circumference, and body fat percentage affect risks for different CRC subtypes.
- Results showed that higher BMI and body fat significantly increased the risks for serrated and alternate CRC pathways (Jass types 1, 2, and 3), while associations with the traditional pathway (Jass type 4) were weaker.
We previously described an approach called RealSeqS to evaluate aneuploidy in plasma cell-free DNA through the amplification of ~350,000 repeated elements with a single primer. We hypothesized that an unbiased evaluation of the large amount of sequencing data obtained with RealSeqS might reveal other differences between plasma samples from patients with and without cancer. This hypothesis was tested through the development of a machine learning approach called Alu Profile Learning Using Sequencing (A-PLUS) and its application to 7615 samples from 5178 individuals, 2073 with solid cancer and the remainder without cancer.
View Article and Find Full Text PDFBackground: Sedentary behaviours have been associated with increased risks of some common cancers in epidemiological studies; however, it is unclear if these associations are causal.
Methods: We used univariable and multivariable two-sample Mendelian randomisation (MR) to examine potential causal relationships between sedentary behaviours and risks of breast, colorectal and prostate cancer. Genetic variants associated with self-reported leisure television watching and computer use were identified from a recent genome-wide association study (GWAS).
Article Synopsis
- FABP-4 is a lipid-binding protein linked to obesity that may influence tumor growth and insulin resistance, potentially impacting colorectal cancer (CRC) development.
- A study using pre-diagnostic plasma levels of FABP-4 involved 1,324 CRC cases compared with matched controls, and also used a Mendelian randomization approach with genetic data from over 58,000 CRC cases.
- Results showed no significant overall association between FABP-4 levels and CRC risk; however, a noteworthy correlation was found in women using the cis-MR approach, suggesting a possible link specifically in that demographic.
Article Synopsis
- Polygenic risk scores (PRS) can help identify individuals at higher risk for colorectal cancer (CRC), but current models based on European ancestry data don't perform well for non-European populations.
- A study expands PRS development by adding Asian ancestry data alongside European data, resulting in improved predictive accuracy across diverse racial and ethnic groups in the US.
- The findings emphasize the need for including more non-European ancestry populations to enhance risk prediction and ensure equitable clinical application of PRS in CRC prevention.
Article Synopsis
- Scientists are finding new ways to test for colorectal cancer that are easier and less invasive than traditional methods.
- A group of experts updated the rules for how to evaluate these new tests to make sure they're effective.
- The new tests should be compared to the existing reliable tests and go through several phases of research to ensure they're safe and useful in real-world situations.
Background: There is an urgent need to identify biomarkers for advanced adenoma, an important precursor of colorectal cancer (CRC). We aimed to determine alterations in ileal juice bile acids associated with colorectal advanced adenoma.
Methods: We quantified a comprehensive panel of primary and secondary bile acids and their conjugates using an ultraperformance liquid chromatography triple-quadrupole mass spectrometric assay in ileal juice collected at colonoscopy from 46 study subjects (i.