Many medical associations have publicly announced their determination to help eliminate racial disparities – from health care outcomes, from the level and quality of patient treatment, from their own memberships. How have those pronouncements translated into programs that could have, or even have had, positive impacts?

For this article, this news organization asked several associations about tangible actions behind their vows to combat racism in health care. Meanwhile, a recent Medscape report focused on the degree to which physicians prioritize racial disparities as a leading social issue.
 

American Academy of Family Physicians

The American Academy of Family Physicians’ approach is to integrate diversity, equity, and inclusion (DEI) efforts into all existing and new projects rather than tackle racial disparities as a discrete problem.

“Our policies, our advocacy efforts, everything our commissions and staff do ... is through a lens of diversity, equity, and inclusiveness,” said AAFP Board Chair Ada D. Stewart, MD, FAAP.

That lens is ground by a DEI center the AAFP created in 2017. Run by AAFP staff, members, and chapters, the center focuses on five areas: policy, education and training, practice, diversifying the workplace, and strategic partnerships.

The center has established a special project called EveryONE to provide AAFP members with relevant research, policy templates, and other resources to address patient needs. One example is the Neighborhood Navigator, an online tool that shows food, housing, transportation, and other needs in a patient’s neighborhood.

Meanwhile, the DEI center has created training programs for AAFP members on topics like unconscious and implicit racial biases. And the AAFP has implemented several relevant governing policies regarding pushes to improve childbirth conditions and limit race-based treatment, among other areas.

In January, the AAFP established a new DEI commission for family medicine to set the academy’s agenda on racial issues moving forward. “We only had 10 physician positions available on the commission, and over 100 individuals applied, which gave us comfort that we were going in the right direction,” Dr. Stewart said.
 

Association of American Medical Colleges

The Association of American Medical Colleges, which represents nearly 600 U.S. and Canadian medical schools and teaching hospitals, has a “longstanding” focus on racial equity, said Philip Alberti, founder of the AAMC Center for Health Justice. However, in 2020 that focus became more detailed and layered.

Those layers include:

• Encouraging self-reflection by members on how personal racial biases and stereotypes can lead to systemic racism in health care.
• Working on the AAMC organizational structure. Priorities range from hiring a consultant to help guide antiracism efforts, to establishing a DEI council and advisors, to regularly seeking input from staff. In 2021, the AAMC launched a Center for Health Justice to work more closely with communities.
• Ramping up collaboration with national and local academic medicine organizations and partners. As one example, the AAMC and American Medical Association released a guide for physicians and health care professionals on language that could be interpreted as racist or disrespectful.
• Continuing to be outspoken about racial disparities in health care in society generally.

Meanwhile, the AAMC is supporting more specific, localized health equity efforts in cities such as Cincinnati and Boston.

Cincinnati Children’s Hospital research has found that children in poor neighborhoods are five times more likely to need hospital stays. AAMC members have helped identify “hot spots” for social needs among children and focused specifically on two neighborhoods in the city. The initiative has roped in partnerships with community and social service organizations as well as health care providers, and proponents say the number of child hospital stays in those neighborhoods has dropped by 20%.

Boston Medical Center researchers learned that Black and Latino patients experiencing problems with heart failure were less likely to be referred to a cardiologist. AAMC members assisted with a program to encourage physicians to make medically necessary referrals more often.
 

National Health Council

The National Health Council, an umbrella association of health organizations, similarly has made a “commitment, not just around policy work but anytime and anything the NHC is doing, to build around trying to identify and solve issues of health equity,” CEO Randall Rutta said.

The NHC has identified four strategic policy areas including race and in 2021 issued a statement signed by 45 other health care organizations vowing to take on systemic racism and advance equity, through public policy and law.

In relation to policy, Mr. Rutta said his organization is lobbying Congress and federal agencies to diversify clinical trials.

“We want to make sure that clinical trials are inclusive of people from different racial and ethnic groups, in order to understand how [they are] affected by a particular condition,” he said. “As you would imagine, some conditions hit certain groups harder than others for genetic or other reasons, or it may just be a reflection of other disparities that occur across health care.”

The organization has issued suggestions for policy change in the Food and Drug Administration’s clinical trial policy and separately targeted telemedicine policy to promote equity and greater patient access. For example, one initiative aims to ensure patients’ privacy and civil rights as telemedicine’s popularity grows after the COVID-19 pandemic. The NHC presented the initiative in a congressional briefing last year.
 

American Public Health Association

The American Public Health Association says it started focusing on racial disparities in health care in 2015, following a series of racially fueled violent acts. The APHA started with a four-part webinar series on racism in health (more than 10,000 live participants and 40,000 replays to date).

Shortly afterward, then-APHA President Camara Jones, MD, MPH, PhD, launched a national campaign encouraging APHA members, affiliates, and partners to name and address racism as a determinant of health.

More recently in 2021, the APHA adopted a “Truth, Racial Healing & Transformation” guiding framework and “Healing Through Policy” initiative that offer local leaders policy templates and best practices.

“We have identified a suite of policies that have actually been implemented successfully and are advancing racial equity,” said Regina Davis Moss, APHA’s associate executive director of health policy and practice. “You can’t advance health without having a policy that supports it.”

Montgomery County, Md., is one community that has used the framework (for racial equity training of county employees). Leaders in Evanston, Ill., also used it in crafting a resolution to end structural racism in the city.

A version of this article first appeared on Medscape.com.

Many medical associations have publicly announced their determination to help eliminate racial disparities – from health care outcomes, from the level and quality of patient treatment, from their own memberships. How have those pronouncements translated into programs that could have, or even have had, positive impacts?

For this article, this news organization asked several associations about tangible actions behind their vows to combat racism in health care. Meanwhile, a recent Medscape report focused on the degree to which physicians prioritize racial disparities as a leading social issue.
 

American Academy of Family Physicians

The American Academy of Family Physicians’ approach is to integrate diversity, equity, and inclusion (DEI) efforts into all existing and new projects rather than tackle racial disparities as a discrete problem.

“Our policies, our advocacy efforts, everything our commissions and staff do ... is through a lens of diversity, equity, and inclusiveness,” said AAFP Board Chair Ada D. Stewart, MD, FAAP.

That lens is ground by a DEI center the AAFP created in 2017. Run by AAFP staff, members, and chapters, the center focuses on five areas: policy, education and training, practice, diversifying the workplace, and strategic partnerships.

The center has established a special project called EveryONE to provide AAFP members with relevant research, policy templates, and other resources to address patient needs. One example is the Neighborhood Navigator, an online tool that shows food, housing, transportation, and other needs in a patient’s neighborhood.

Meanwhile, the DEI center has created training programs for AAFP members on topics like unconscious and implicit racial biases. And the AAFP has implemented several relevant governing policies regarding pushes to improve childbirth conditions and limit race-based treatment, among other areas.

In January, the AAFP established a new DEI commission for family medicine to set the academy’s agenda on racial issues moving forward. “We only had 10 physician positions available on the commission, and over 100 individuals applied, which gave us comfort that we were going in the right direction,” Dr. Stewart said.
 

Association of American Medical Colleges

The Association of American Medical Colleges, which represents nearly 600 U.S. and Canadian medical schools and teaching hospitals, has a “longstanding” focus on racial equity, said Philip Alberti, founder of the AAMC Center for Health Justice. However, in 2020 that focus became more detailed and layered.

Those layers include:

• Encouraging self-reflection by members on how personal racial biases and stereotypes can lead to systemic racism in health care.
• Working on the AAMC organizational structure. Priorities range from hiring a consultant to help guide antiracism efforts, to establishing a DEI council and advisors, to regularly seeking input from staff. In 2021, the AAMC launched a Center for Health Justice to work more closely with communities.
• Ramping up collaboration with national and local academic medicine organizations and partners. As one example, the AAMC and American Medical Association released a guide for physicians and health care professionals on language that could be interpreted as racist or disrespectful.
• Continuing to be outspoken about racial disparities in health care in society generally.

Meanwhile, the AAMC is supporting more specific, localized health equity efforts in cities such as Cincinnati and Boston.

Cincinnati Children’s Hospital research has found that children in poor neighborhoods are five times more likely to need hospital stays. AAMC members have helped identify “hot spots” for social needs among children and focused specifically on two neighborhoods in the city. The initiative has roped in partnerships with community and social service organizations as well as health care providers, and proponents say the number of child hospital stays in those neighborhoods has dropped by 20%.

Boston Medical Center researchers learned that Black and Latino patients experiencing problems with heart failure were less likely to be referred to a cardiologist. AAMC members assisted with a program to encourage physicians to make medically necessary referrals more often.
 

National Health Council

The National Health Council, an umbrella association of health organizations, similarly has made a “commitment, not just around policy work but anytime and anything the NHC is doing, to build around trying to identify and solve issues of health equity,” CEO Randall Rutta said.

The NHC has identified four strategic policy areas including race and in 2021 issued a statement signed by 45 other health care organizations vowing to take on systemic racism and advance equity, through public policy and law.

In relation to policy, Mr. Rutta said his organization is lobbying Congress and federal agencies to diversify clinical trials.

“We want to make sure that clinical trials are inclusive of people from different racial and ethnic groups, in order to understand how [they are] affected by a particular condition,” he said. “As you would imagine, some conditions hit certain groups harder than others for genetic or other reasons, or it may just be a reflection of other disparities that occur across health care.”

The organization has issued suggestions for policy change in the Food and Drug Administration’s clinical trial policy and separately targeted telemedicine policy to promote equity and greater patient access. For example, one initiative aims to ensure patients’ privacy and civil rights as telemedicine’s popularity grows after the COVID-19 pandemic. The NHC presented the initiative in a congressional briefing last year.
 

American Public Health Association

The American Public Health Association says it started focusing on racial disparities in health care in 2015, following a series of racially fueled violent acts. The APHA started with a four-part webinar series on racism in health (more than 10,000 live participants and 40,000 replays to date).

Shortly afterward, then-APHA President Camara Jones, MD, MPH, PhD, launched a national campaign encouraging APHA members, affiliates, and partners to name and address racism as a determinant of health.

More recently in 2021, the APHA adopted a “Truth, Racial Healing & Transformation” guiding framework and “Healing Through Policy” initiative that offer local leaders policy templates and best practices.

“We have identified a suite of policies that have actually been implemented successfully and are advancing racial equity,” said Regina Davis Moss, APHA’s associate executive director of health policy and practice. “You can’t advance health without having a policy that supports it.”

Montgomery County, Md., is one community that has used the framework (for racial equity training of county employees). Leaders in Evanston, Ill., also used it in crafting a resolution to end structural racism in the city.

A version of this article first appeared on Medscape.com.

Many medical associations have publicly announced their determination to help eliminate racial disparities – from health care outcomes, from the level and quality of patient treatment, from their own memberships. How have those pronouncements translated into programs that could have, or even have had, positive impacts?

For this article, this news organization asked several associations about tangible actions behind their vows to combat racism in health care. Meanwhile, a recent Medscape report focused on the degree to which physicians prioritize racial disparities as a leading social issue.
 

American Academy of Family Physicians

The American Academy of Family Physicians’ approach is to integrate diversity, equity, and inclusion (DEI) efforts into all existing and new projects rather than tackle racial disparities as a discrete problem.

“Our policies, our advocacy efforts, everything our commissions and staff do ... is through a lens of diversity, equity, and inclusiveness,” said AAFP Board Chair Ada D. Stewart, MD, FAAP.

That lens is ground by a DEI center the AAFP created in 2017. Run by AAFP staff, members, and chapters, the center focuses on five areas: policy, education and training, practice, diversifying the workplace, and strategic partnerships.

The center has established a special project called EveryONE to provide AAFP members with relevant research, policy templates, and other resources to address patient needs. One example is the Neighborhood Navigator, an online tool that shows food, housing, transportation, and other needs in a patient’s neighborhood.

Meanwhile, the DEI center has created training programs for AAFP members on topics like unconscious and implicit racial biases. And the AAFP has implemented several relevant governing policies regarding pushes to improve childbirth conditions and limit race-based treatment, among other areas.

In January, the AAFP established a new DEI commission for family medicine to set the academy’s agenda on racial issues moving forward. “We only had 10 physician positions available on the commission, and over 100 individuals applied, which gave us comfort that we were going in the right direction,” Dr. Stewart said.
 

Association of American Medical Colleges

The Association of American Medical Colleges, which represents nearly 600 U.S. and Canadian medical schools and teaching hospitals, has a “longstanding” focus on racial equity, said Philip Alberti, founder of the AAMC Center for Health Justice. However, in 2020 that focus became more detailed and layered.

Those layers include:

• Encouraging self-reflection by members on how personal racial biases and stereotypes can lead to systemic racism in health care.
• Working on the AAMC organizational structure. Priorities range from hiring a consultant to help guide antiracism efforts, to establishing a DEI council and advisors, to regularly seeking input from staff. In 2021, the AAMC launched a Center for Health Justice to work more closely with communities.
• Ramping up collaboration with national and local academic medicine organizations and partners. As one example, the AAMC and American Medical Association released a guide for physicians and health care professionals on language that could be interpreted as racist or disrespectful.
• Continuing to be outspoken about racial disparities in health care in society generally.

Meanwhile, the AAMC is supporting more specific, localized health equity efforts in cities such as Cincinnati and Boston.

Cincinnati Children’s Hospital research has found that children in poor neighborhoods are five times more likely to need hospital stays. AAMC members have helped identify “hot spots” for social needs among children and focused specifically on two neighborhoods in the city. The initiative has roped in partnerships with community and social service organizations as well as health care providers, and proponents say the number of child hospital stays in those neighborhoods has dropped by 20%.

Boston Medical Center researchers learned that Black and Latino patients experiencing problems with heart failure were less likely to be referred to a cardiologist. AAMC members assisted with a program to encourage physicians to make medically necessary referrals more often.
 

National Health Council

The National Health Council, an umbrella association of health organizations, similarly has made a “commitment, not just around policy work but anytime and anything the NHC is doing, to build around trying to identify and solve issues of health equity,” CEO Randall Rutta said.

The NHC has identified four strategic policy areas including race and in 2021 issued a statement signed by 45 other health care organizations vowing to take on systemic racism and advance equity, through public policy and law.

In relation to policy, Mr. Rutta said his organization is lobbying Congress and federal agencies to diversify clinical trials.

“We want to make sure that clinical trials are inclusive of people from different racial and ethnic groups, in order to understand how [they are] affected by a particular condition,” he said. “As you would imagine, some conditions hit certain groups harder than others for genetic or other reasons, or it may just be a reflection of other disparities that occur across health care.”

The organization has issued suggestions for policy change in the Food and Drug Administration’s clinical trial policy and separately targeted telemedicine policy to promote equity and greater patient access. For example, one initiative aims to ensure patients’ privacy and civil rights as telemedicine’s popularity grows after the COVID-19 pandemic. The NHC presented the initiative in a congressional briefing last year.
 

American Public Health Association

The American Public Health Association says it started focusing on racial disparities in health care in 2015, following a series of racially fueled violent acts. The APHA started with a four-part webinar series on racism in health (more than 10,000 live participants and 40,000 replays to date).

Shortly afterward, then-APHA President Camara Jones, MD, MPH, PhD, launched a national campaign encouraging APHA members, affiliates, and partners to name and address racism as a determinant of health.

More recently in 2021, the APHA adopted a “Truth, Racial Healing & Transformation” guiding framework and “Healing Through Policy” initiative that offer local leaders policy templates and best practices.

“We have identified a suite of policies that have actually been implemented successfully and are advancing racial equity,” said Regina Davis Moss, APHA’s associate executive director of health policy and practice. “You can’t advance health without having a policy that supports it.”

Montgomery County, Md., is one community that has used the framework (for racial equity training of county employees). Leaders in Evanston, Ill., also used it in crafting a resolution to end structural racism in the city.

A version of this article first appeared on Medscape.com.

Key clinical point: Compared with circulating tumor DNA (ctDNA)-negative patients, ctDNA-positive patients are at a higher risk for recurrence and have a poorer prognosis for recurrence-free survival (RFS) after colorectal cancer (CRC) surgery and adjuvant chemotherapy (ACT).

Major finding: After CRC surgery and ACT, ctDNA-positive vs -negative patients were at a higher risk for CRC recurrence (relative risk [RR] 4.43 and RR 5.77, respectively; both P < .05) and had a worse prognosis for RFS (adjusted hazard ratio, 10.74 and adjusted RR 22.09, respectively; both P < .05).

Study details: This was a meta-analysis of 14 studies including 2393 patients who underwent radical R0 resection for primary CRC.

Disclosures: The study did not receive any funding. The authors declared no conflicts of interest.

Source: Mi J et al. Circulation tumour DNA in predicting recurrence and prognosis in operable colorectal cancer patients: A meta-analysis. Eur J Clin Invest. 2022 (Jul 20). Doi: 10.1111/eci.13842

Key clinical point: Compared with circulating tumor DNA (ctDNA)-negative patients, ctDNA-positive patients are at a higher risk for recurrence and have a poorer prognosis for recurrence-free survival (RFS) after colorectal cancer (CRC) surgery and adjuvant chemotherapy (ACT).

Major finding: After CRC surgery and ACT, ctDNA-positive vs -negative patients were at a higher risk for CRC recurrence (relative risk [RR] 4.43 and RR 5.77, respectively; both P < .05) and had a worse prognosis for RFS (adjusted hazard ratio, 10.74 and adjusted RR 22.09, respectively; both P < .05).

Study details: This was a meta-analysis of 14 studies including 2393 patients who underwent radical R0 resection for primary CRC.

Disclosures: The study did not receive any funding. The authors declared no conflicts of interest.

Source: Mi J et al. Circulation tumour DNA in predicting recurrence and prognosis in operable colorectal cancer patients: A meta-analysis. Eur J Clin Invest. 2022 (Jul 20). Doi: 10.1111/eci.13842

Key clinical point: Compared with circulating tumor DNA (ctDNA)-negative patients, ctDNA-positive patients are at a higher risk for recurrence and have a poorer prognosis for recurrence-free survival (RFS) after colorectal cancer (CRC) surgery and adjuvant chemotherapy (ACT).

Major finding: After CRC surgery and ACT, ctDNA-positive vs -negative patients were at a higher risk for CRC recurrence (relative risk [RR] 4.43 and RR 5.77, respectively; both P < .05) and had a worse prognosis for RFS (adjusted hazard ratio, 10.74 and adjusted RR 22.09, respectively; both P < .05).

Study details: This was a meta-analysis of 14 studies including 2393 patients who underwent radical R0 resection for primary CRC.

Disclosures: The study did not receive any funding. The authors declared no conflicts of interest.

Source: Mi J et al. Circulation tumour DNA in predicting recurrence and prognosis in operable colorectal cancer patients: A meta-analysis. Eur J Clin Invest. 2022 (Jul 20). Doi: 10.1111/eci.13842

Key clinical point: After considering time-related biases such as immortal time bias (ITB), metformin use is nonsignificantly associated with subsequent colorectal cancer (CRC) incidence in patients with type‑2 diabetes (T2D).

Major finding: Time-dependent Cox regression, landmark, or nested case-control analysis did not reveal a significant association between metformin use and CRC incidence, with hazard ratios (95% CI) for metformin ever-use (≥90 days of metformin prescription throughout follow-up) being 0.88 (0.68-1.13), 0.86 (0.65-1.12), and 1.10 (0.86-1.40), respectively, and those for average metformin prescription days/year being 0.97 (0.90-1.04), 0.95 (0.88-1.04), and 1.02 (0.95-1.10), respectively.

Study details: This observational study employed statistical methods that avoid ITB to analyze the real-world data of 41,533 patients newly diagnosed with T2D who were cancer-free at T2D diagnosis from a prospectively maintained cohort.

Disclosures: No source of funding was disclosed. The authors reported no conflicts of interest.

Source: Zhang HS et al. Metformin use is not associated with colorectal cancer incidence in type-2 diabetes patients: Evidence from methods that avoid immortal time bias. Int J Colorectal Dis. 2022;37:1827–1834 (Jul 14). Doi: 10.1007/s00384-022-04212-9

Key clinical point: After considering time-related biases such as immortal time bias (ITB), metformin use is nonsignificantly associated with subsequent colorectal cancer (CRC) incidence in patients with type‑2 diabetes (T2D).

Major finding: Time-dependent Cox regression, landmark, or nested case-control analysis did not reveal a significant association between metformin use and CRC incidence, with hazard ratios (95% CI) for metformin ever-use (≥90 days of metformin prescription throughout follow-up) being 0.88 (0.68-1.13), 0.86 (0.65-1.12), and 1.10 (0.86-1.40), respectively, and those for average metformin prescription days/year being 0.97 (0.90-1.04), 0.95 (0.88-1.04), and 1.02 (0.95-1.10), respectively.

Study details: This observational study employed statistical methods that avoid ITB to analyze the real-world data of 41,533 patients newly diagnosed with T2D who were cancer-free at T2D diagnosis from a prospectively maintained cohort.

Disclosures: No source of funding was disclosed. The authors reported no conflicts of interest.

Source: Zhang HS et al. Metformin use is not associated with colorectal cancer incidence in type-2 diabetes patients: Evidence from methods that avoid immortal time bias. Int J Colorectal Dis. 2022;37:1827–1834 (Jul 14). Doi: 10.1007/s00384-022-04212-9

Key clinical point: After considering time-related biases such as immortal time bias (ITB), metformin use is nonsignificantly associated with subsequent colorectal cancer (CRC) incidence in patients with type‑2 diabetes (T2D).

Major finding: Time-dependent Cox regression, landmark, or nested case-control analysis did not reveal a significant association between metformin use and CRC incidence, with hazard ratios (95% CI) for metformin ever-use (≥90 days of metformin prescription throughout follow-up) being 0.88 (0.68-1.13), 0.86 (0.65-1.12), and 1.10 (0.86-1.40), respectively, and those for average metformin prescription days/year being 0.97 (0.90-1.04), 0.95 (0.88-1.04), and 1.02 (0.95-1.10), respectively.

Study details: This observational study employed statistical methods that avoid ITB to analyze the real-world data of 41,533 patients newly diagnosed with T2D who were cancer-free at T2D diagnosis from a prospectively maintained cohort.

Disclosures: No source of funding was disclosed. The authors reported no conflicts of interest.

Source: Zhang HS et al. Metformin use is not associated with colorectal cancer incidence in type-2 diabetes patients: Evidence from methods that avoid immortal time bias. Int J Colorectal Dis. 2022;37:1827–1834 (Jul 14). Doi: 10.1007/s00384-022-04212-9

Key clinical point: The risk for all-cause mortality and cancer progression or death is lower among patients with metastatic colorectal cancer (CRC) and a higher intake of vegetable fats.

Major finding: Patients with the highest (23.5% kcal/day; interquartile range [IQR] 21.6%-25.7% kcal/day) vs lowest (11.6% kcal/day; IQR 10.1%-12.7% kcal/day) median intake of vegetable fats showed a lower risk for all-cause mortality (adjusted hazard ratio [aHR] 0.79; 95% CI 0.63-1.00) and cancer progression or death (aHR 0.71; 95% CI 0.57-0.88).

Study details: Findings are from a prospective analysis that included 1149 patients with metastatic CRC from the CALGB 80405 (Alliance)/SWOG 80405 study.

Disclosures: This study was supported by the US National Cancer Institute of the National Institutes of Health and partly by Bristol Myers Squibb, Genentech, Pfizer, and Sanofi. Some authors declared serving as advisory board members or consultants for or receiving research support or payments for research advice or services from various sources, including Pfizer and Genentech.

Source: Van Blarigan EL et al. Dietary fat in relation to all-cause mortality and cancer progression and death among people with metastatic colorectal cancer: Data from CALGB 80405 (Alliance)/SWOG 80405. Int J Cancer. 2022 (Jul 29). Doi: 10.1002/ijc.34230

Key clinical point: The risk for all-cause mortality and cancer progression or death is lower among patients with metastatic colorectal cancer (CRC) and a higher intake of vegetable fats.

Major finding: Patients with the highest (23.5% kcal/day; interquartile range [IQR] 21.6%-25.7% kcal/day) vs lowest (11.6% kcal/day; IQR 10.1%-12.7% kcal/day) median intake of vegetable fats showed a lower risk for all-cause mortality (adjusted hazard ratio [aHR] 0.79; 95% CI 0.63-1.00) and cancer progression or death (aHR 0.71; 95% CI 0.57-0.88).

Study details: Findings are from a prospective analysis that included 1149 patients with metastatic CRC from the CALGB 80405 (Alliance)/SWOG 80405 study.

Disclosures: This study was supported by the US National Cancer Institute of the National Institutes of Health and partly by Bristol Myers Squibb, Genentech, Pfizer, and Sanofi. Some authors declared serving as advisory board members or consultants for or receiving research support or payments for research advice or services from various sources, including Pfizer and Genentech.

Source: Van Blarigan EL et al. Dietary fat in relation to all-cause mortality and cancer progression and death among people with metastatic colorectal cancer: Data from CALGB 80405 (Alliance)/SWOG 80405. Int J Cancer. 2022 (Jul 29). Doi: 10.1002/ijc.34230

Key clinical point: The risk for all-cause mortality and cancer progression or death is lower among patients with metastatic colorectal cancer (CRC) and a higher intake of vegetable fats.

Major finding: Patients with the highest (23.5% kcal/day; interquartile range [IQR] 21.6%-25.7% kcal/day) vs lowest (11.6% kcal/day; IQR 10.1%-12.7% kcal/day) median intake of vegetable fats showed a lower risk for all-cause mortality (adjusted hazard ratio [aHR] 0.79; 95% CI 0.63-1.00) and cancer progression or death (aHR 0.71; 95% CI 0.57-0.88).

Study details: Findings are from a prospective analysis that included 1149 patients with metastatic CRC from the CALGB 80405 (Alliance)/SWOG 80405 study.

Disclosures: This study was supported by the US National Cancer Institute of the National Institutes of Health and partly by Bristol Myers Squibb, Genentech, Pfizer, and Sanofi. Some authors declared serving as advisory board members or consultants for or receiving research support or payments for research advice or services from various sources, including Pfizer and Genentech.

Source: Van Blarigan EL et al. Dietary fat in relation to all-cause mortality and cancer progression and death among people with metastatic colorectal cancer: Data from CALGB 80405 (Alliance)/SWOG 80405. Int J Cancer. 2022 (Jul 29). Doi: 10.1002/ijc.34230

Key clinical point: Neoadjuvant chemotherapy (NCT) is associated with higher carcinoembryonic antigen (CEA) levels and multiorgan resection rates owing to larger postoperative tumor size in patients with mismatch repair deficient (dMMR) colon cancer.

Major finding: Patients who received vs did not receive NCT had a higher incidence of abnormal CEA levels (51.6% vs 17.4%; P < .001) and multiorgan resection rate (38.7% vs 16.8%; P  =  .006) and larger postoperative tumor diameters (7.26 vs 6.21; P  =  .033).

Study details: This retrospective study analyzed the data of 335 patients with dMMR colon cancer who did (n = 31) or did not (n = 304) receive neoadjuvant chemotherapy after radical surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Yunlong W et al. The efficiency of neoadjuvant chemotherapy in colon cancer with mismatch repair deficiency. Cancer Med. 2022 (Jul 29). Doi: 10.1002/cam4.5076

Key clinical point: Neoadjuvant chemotherapy (NCT) is associated with higher carcinoembryonic antigen (CEA) levels and multiorgan resection rates owing to larger postoperative tumor size in patients with mismatch repair deficient (dMMR) colon cancer.

Major finding: Patients who received vs did not receive NCT had a higher incidence of abnormal CEA levels (51.6% vs 17.4%; P < .001) and multiorgan resection rate (38.7% vs 16.8%; P  =  .006) and larger postoperative tumor diameters (7.26 vs 6.21; P  =  .033).

Study details: This retrospective study analyzed the data of 335 patients with dMMR colon cancer who did (n = 31) or did not (n = 304) receive neoadjuvant chemotherapy after radical surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Yunlong W et al. The efficiency of neoadjuvant chemotherapy in colon cancer with mismatch repair deficiency. Cancer Med. 2022 (Jul 29). Doi: 10.1002/cam4.5076

Key clinical point: Neoadjuvant chemotherapy (NCT) is associated with higher carcinoembryonic antigen (CEA) levels and multiorgan resection rates owing to larger postoperative tumor size in patients with mismatch repair deficient (dMMR) colon cancer.

Major finding: Patients who received vs did not receive NCT had a higher incidence of abnormal CEA levels (51.6% vs 17.4%; P < .001) and multiorgan resection rate (38.7% vs 16.8%; P  =  .006) and larger postoperative tumor diameters (7.26 vs 6.21; P  =  .033).

Study details: This retrospective study analyzed the data of 335 patients with dMMR colon cancer who did (n = 31) or did not (n = 304) receive neoadjuvant chemotherapy after radical surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Yunlong W et al. The efficiency of neoadjuvant chemotherapy in colon cancer with mismatch repair deficiency. Cancer Med. 2022 (Jul 29). Doi: 10.1002/cam4.5076

Key clinical point: An increase in consultation rates for colorectal cancer (CRC)-relevant symptoms and abnormal blood test results in the 2-year prediagnosis period hint at early initiation of specific investigations or referrals, thereby accelerating the diagnosis and treatment in some patients with symptomatic CRC.

Major finding: The earliest clinical feature to show increased recording rate from the baseline was rectal bleeding, at 10 months before colon cancer diagnosis (95% CI 8.3-11.7) and 8 months before rectal cancer diagnosis (95% CI 6.1-9.9). The rate of abnormal blood measurements (low hemoglobin levels, high platelet counts, etc) recorded increased from 9 months prediagnosis.

Study details: Findings are from a retrospective study that analyzed linked primary care and cancer registry data of patients with colon (n = 5033) or rectal (2516) cancer.

Disclosures: This study was supported by the National Institute for Health Research School for Primary Care Research and linked to the CanTest Collaborative funded by Cancer Research UK. Four authors are a part of the CanTest Collaborative.

Source: Moullet M et al. Pre-diagnostic clinical features and blood tests in patients with colorectal cancer: a retrospective linked-data study. Br J Gen Pract. 2022;72(721):e556-e563 (Jul 28). Doi: 10.3399/BJGP.2021.0563

Key clinical point: An increase in consultation rates for colorectal cancer (CRC)-relevant symptoms and abnormal blood test results in the 2-year prediagnosis period hint at early initiation of specific investigations or referrals, thereby accelerating the diagnosis and treatment in some patients with symptomatic CRC.

Major finding: The earliest clinical feature to show increased recording rate from the baseline was rectal bleeding, at 10 months before colon cancer diagnosis (95% CI 8.3-11.7) and 8 months before rectal cancer diagnosis (95% CI 6.1-9.9). The rate of abnormal blood measurements (low hemoglobin levels, high platelet counts, etc) recorded increased from 9 months prediagnosis.

Study details: Findings are from a retrospective study that analyzed linked primary care and cancer registry data of patients with colon (n = 5033) or rectal (2516) cancer.

Disclosures: This study was supported by the National Institute for Health Research School for Primary Care Research and linked to the CanTest Collaborative funded by Cancer Research UK. Four authors are a part of the CanTest Collaborative.

Source: Moullet M et al. Pre-diagnostic clinical features and blood tests in patients with colorectal cancer: a retrospective linked-data study. Br J Gen Pract. 2022;72(721):e556-e563 (Jul 28). Doi: 10.3399/BJGP.2021.0563

Key clinical point: An increase in consultation rates for colorectal cancer (CRC)-relevant symptoms and abnormal blood test results in the 2-year prediagnosis period hint at early initiation of specific investigations or referrals, thereby accelerating the diagnosis and treatment in some patients with symptomatic CRC.

Major finding: The earliest clinical feature to show increased recording rate from the baseline was rectal bleeding, at 10 months before colon cancer diagnosis (95% CI 8.3-11.7) and 8 months before rectal cancer diagnosis (95% CI 6.1-9.9). The rate of abnormal blood measurements (low hemoglobin levels, high platelet counts, etc) recorded increased from 9 months prediagnosis.

Study details: Findings are from a retrospective study that analyzed linked primary care and cancer registry data of patients with colon (n = 5033) or rectal (2516) cancer.

Disclosures: This study was supported by the National Institute for Health Research School for Primary Care Research and linked to the CanTest Collaborative funded by Cancer Research UK. Four authors are a part of the CanTest Collaborative.

Source: Moullet M et al. Pre-diagnostic clinical features and blood tests in patients with colorectal cancer: a retrospective linked-data study. Br J Gen Pract. 2022;72(721):e556-e563 (Jul 28). Doi: 10.3399/BJGP.2021.0563

Key clinical point: Select chemopreventive agents may effectively decrease the incidence of precursor colorectal adenomas, thus lowering the future burden of colorectal cancer (CRC).

Major finding: Compared with placebo, difluoromethylornithine plus sulindac led to the highest risk reduction (76%; relative risk [RR] 0.24; 95% credible intervals [CrI] 0.10-0.55), whereas despite comparable point estimates on the recurrence of any adenomas, celecoxib (RR 0.71; 95% CrI 0.49-1.05) and aspirin (RR 0.77; 95% CrI 0.59-1.00) led to a nonsignificant risk reduction.

Study details: This network meta-analysis included 33 randomized controlled trials, with the network comprising 12 interventions plus a placebo arm, including 20,925 patients at an increased risk for CRC who had previously undergone resection of an adenoma.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Heer E et al. The efficacy of chemopreventive agents on the incidence of colorectal adenomas: A systematic review and network meta-analysis. Prev Med. 2022;162:107169 (Jul 22). Doi:  10.1016/j.ypmed.2022.107169

Key clinical point: Select chemopreventive agents may effectively decrease the incidence of precursor colorectal adenomas, thus lowering the future burden of colorectal cancer (CRC).

Major finding: Compared with placebo, difluoromethylornithine plus sulindac led to the highest risk reduction (76%; relative risk [RR] 0.24; 95% credible intervals [CrI] 0.10-0.55), whereas despite comparable point estimates on the recurrence of any adenomas, celecoxib (RR 0.71; 95% CrI 0.49-1.05) and aspirin (RR 0.77; 95% CrI 0.59-1.00) led to a nonsignificant risk reduction.

Study details: This network meta-analysis included 33 randomized controlled trials, with the network comprising 12 interventions plus a placebo arm, including 20,925 patients at an increased risk for CRC who had previously undergone resection of an adenoma.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Heer E et al. The efficacy of chemopreventive agents on the incidence of colorectal adenomas: A systematic review and network meta-analysis. Prev Med. 2022;162:107169 (Jul 22). Doi:  10.1016/j.ypmed.2022.107169

Key clinical point: Select chemopreventive agents may effectively decrease the incidence of precursor colorectal adenomas, thus lowering the future burden of colorectal cancer (CRC).

Major finding: Compared with placebo, difluoromethylornithine plus sulindac led to the highest risk reduction (76%; relative risk [RR] 0.24; 95% credible intervals [CrI] 0.10-0.55), whereas despite comparable point estimates on the recurrence of any adenomas, celecoxib (RR 0.71; 95% CrI 0.49-1.05) and aspirin (RR 0.77; 95% CrI 0.59-1.00) led to a nonsignificant risk reduction.

Study details: This network meta-analysis included 33 randomized controlled trials, with the network comprising 12 interventions plus a placebo arm, including 20,925 patients at an increased risk for CRC who had previously undergone resection of an adenoma.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Heer E et al. The efficacy of chemopreventive agents on the incidence of colorectal adenomas: A systematic review and network meta-analysis. Prev Med. 2022;162:107169 (Jul 22). Doi:  10.1016/j.ypmed.2022.107169

Key clinical point: First-line bevacizumab (BEV) is more effective than cetuximab or panitumumab (CET/PAN) against right-sided RAS wild-type (WT) metastatic colorectal cancer (mCRC), but comparably effective against left-sided RAS WT mCRC.

Major finding: Patients who received BEV vs CET/PAN had a significantly longer overall survival (hazard ratio [HR] 0.52; 95% CI 0.28-0.96) in the right-sided group, but similar overall survival in the left-sided group (HR 0.78; 95% CI 0.58-1.07).

Study details: This real-world multicenter retrospective study propensity score-matched patients with right-sided (n = 110) and left-sided (n = 450) RAS WT mCRC who received first-line treatment with BEV or CET/PAN plus fluoropyrimidine-based doublet chemotherapy (oxaliplatin or irinotecan).

Disclosures: The study received no specific funding. Some authors declared receiving grants, personal fees, honoraria for lecture and advisory roles, or research funding from various sources.

Source: Ito T et al. Primary tumor location as a predictor of survival in patients with RAS wild-type colorectal cancer who receive molecularly targeted drugs as first-line therapy: A multicenter real-world observational study by the Japanese Society for Cancer of the Colon and Rectum. Int J Clin Oncol. 2022 (Jul 21). Doi: 10.1007/s10147-022-02208-7

Key clinical point: First-line bevacizumab (BEV) is more effective than cetuximab or panitumumab (CET/PAN) against right-sided RAS wild-type (WT) metastatic colorectal cancer (mCRC), but comparably effective against left-sided RAS WT mCRC.

Major finding: Patients who received BEV vs CET/PAN had a significantly longer overall survival (hazard ratio [HR] 0.52; 95% CI 0.28-0.96) in the right-sided group, but similar overall survival in the left-sided group (HR 0.78; 95% CI 0.58-1.07).

Study details: This real-world multicenter retrospective study propensity score-matched patients with right-sided (n = 110) and left-sided (n = 450) RAS WT mCRC who received first-line treatment with BEV or CET/PAN plus fluoropyrimidine-based doublet chemotherapy (oxaliplatin or irinotecan).

Disclosures: The study received no specific funding. Some authors declared receiving grants, personal fees, honoraria for lecture and advisory roles, or research funding from various sources.

Source: Ito T et al. Primary tumor location as a predictor of survival in patients with RAS wild-type colorectal cancer who receive molecularly targeted drugs as first-line therapy: A multicenter real-world observational study by the Japanese Society for Cancer of the Colon and Rectum. Int J Clin Oncol. 2022 (Jul 21). Doi: 10.1007/s10147-022-02208-7

Key clinical point: First-line bevacizumab (BEV) is more effective than cetuximab or panitumumab (CET/PAN) against right-sided RAS wild-type (WT) metastatic colorectal cancer (mCRC), but comparably effective against left-sided RAS WT mCRC.

Major finding: Patients who received BEV vs CET/PAN had a significantly longer overall survival (hazard ratio [HR] 0.52; 95% CI 0.28-0.96) in the right-sided group, but similar overall survival in the left-sided group (HR 0.78; 95% CI 0.58-1.07).

Study details: This real-world multicenter retrospective study propensity score-matched patients with right-sided (n = 110) and left-sided (n = 450) RAS WT mCRC who received first-line treatment with BEV or CET/PAN plus fluoropyrimidine-based doublet chemotherapy (oxaliplatin or irinotecan).

Disclosures: The study received no specific funding. Some authors declared receiving grants, personal fees, honoraria for lecture and advisory roles, or research funding from various sources.

Source: Ito T et al. Primary tumor location as a predictor of survival in patients with RAS wild-type colorectal cancer who receive molecularly targeted drugs as first-line therapy: A multicenter real-world observational study by the Japanese Society for Cancer of the Colon and Rectum. Int J Clin Oncol. 2022 (Jul 21). Doi: 10.1007/s10147-022-02208-7

Key clinical point: Postoperative additive chemotherapy does not increase the rate of second cancer development in patients with Union for International Cancer Control (UICC)-stage III/IV colon cancer.

Major finding: The 5-year cumulative rates for the development of a subsequent second cancer were not significantly different in patients who received vs did not receive additive chemotherapy (8.8% vs 9.0%; hazard ratio [HR] 0.944; P  =  .685), with the findings being similar even after adjusting for further risk factors (adjusted HR 1.066; P  =  .673).

Study details: This retrospective study included 2856 patients with UICC-stage III/IV colon cancer, of which 1520 patients received additive chemotherapy after R0 resection of the primary tumor and metastatic lesions.

Disclosures: The study received no funding. The authors declared no conflicts of interest.

Source: Teufel A et al. Second cancer after additive chemotherapy in patients with colon cancer. Clin Colorectal Cancer. 2022 (Jul 15). Doi: 10.1016/j.clcc.2022.07.002

Key clinical point: Postoperative additive chemotherapy does not increase the rate of second cancer development in patients with Union for International Cancer Control (UICC)-stage III/IV colon cancer.

Major finding: The 5-year cumulative rates for the development of a subsequent second cancer were not significantly different in patients who received vs did not receive additive chemotherapy (8.8% vs 9.0%; hazard ratio [HR] 0.944; P  =  .685), with the findings being similar even after adjusting for further risk factors (adjusted HR 1.066; P  =  .673).

Study details: This retrospective study included 2856 patients with UICC-stage III/IV colon cancer, of which 1520 patients received additive chemotherapy after R0 resection of the primary tumor and metastatic lesions.

Disclosures: The study received no funding. The authors declared no conflicts of interest.

Source: Teufel A et al. Second cancer after additive chemotherapy in patients with colon cancer. Clin Colorectal Cancer. 2022 (Jul 15). Doi: 10.1016/j.clcc.2022.07.002

Key clinical point: Postoperative additive chemotherapy does not increase the rate of second cancer development in patients with Union for International Cancer Control (UICC)-stage III/IV colon cancer.

Major finding: The 5-year cumulative rates for the development of a subsequent second cancer were not significantly different in patients who received vs did not receive additive chemotherapy (8.8% vs 9.0%; hazard ratio [HR] 0.944; P  =  .685), with the findings being similar even after adjusting for further risk factors (adjusted HR 1.066; P  =  .673).

Study details: This retrospective study included 2856 patients with UICC-stage III/IV colon cancer, of which 1520 patients received additive chemotherapy after R0 resection of the primary tumor and metastatic lesions.

Disclosures: The study received no funding. The authors declared no conflicts of interest.

Source: Teufel A et al. Second cancer after additive chemotherapy in patients with colon cancer. Clin Colorectal Cancer. 2022 (Jul 15). Doi: 10.1016/j.clcc.2022.07.002

Key clinical point: Neoadjuvant treatment with folinic acid, 5-fluorouracil, oxaliplatin, and irinotecan (mFOLFOXIRI) plus selective radiotherapy offers better disease-free survival (DFS) than neoadjuvant chemoradiotherapy (CRT; fluorouracil plus radiotherapy) in patients with locally advanced rectal cancer (LARC).

Major finding: Patients receiving mFOLFOXIRI without routine radiotherapy vs CRT had a significantly higher 3-year DFS rate (87.6% vs 75.8%; hazard ratio 0.46; P  =  .037).

Study details: This phase 2 study, FORTUNE, studied propensity score-matched patients with LARC who received neoadjuvant mFOLFOXIRI without routine radiotherapy (n = 73) with those who received neoadjuvant CRT in the phase 3 FOWARC study (n = 73).

Disclosures: This study was sponsored by the National Key Research and Development Program of China and Science and Technology Program of Guangzhou. The authors declared no conflicts of interest.

Source: Zhang J et al. Neoadjuvant mfolfoxiri with selective radiotherapy in locally advanced rectal cancer: Long-term outcomes of phase II study and propensity-score matched comparison with chemoradiotherapy. Dis Colon Rectum. 2022 (Jul 12). Doi: 10.1097/DCR.0000000000002424

Key clinical point: Neoadjuvant treatment with folinic acid, 5-fluorouracil, oxaliplatin, and irinotecan (mFOLFOXIRI) plus selective radiotherapy offers better disease-free survival (DFS) than neoadjuvant chemoradiotherapy (CRT; fluorouracil plus radiotherapy) in patients with locally advanced rectal cancer (LARC).

Major finding: Patients receiving mFOLFOXIRI without routine radiotherapy vs CRT had a significantly higher 3-year DFS rate (87.6% vs 75.8%; hazard ratio 0.46; P  =  .037).

Study details: This phase 2 study, FORTUNE, studied propensity score-matched patients with LARC who received neoadjuvant mFOLFOXIRI without routine radiotherapy (n = 73) with those who received neoadjuvant CRT in the phase 3 FOWARC study (n = 73).

Disclosures: This study was sponsored by the National Key Research and Development Program of China and Science and Technology Program of Guangzhou. The authors declared no conflicts of interest.

Source: Zhang J et al. Neoadjuvant mfolfoxiri with selective radiotherapy in locally advanced rectal cancer: Long-term outcomes of phase II study and propensity-score matched comparison with chemoradiotherapy. Dis Colon Rectum. 2022 (Jul 12). Doi: 10.1097/DCR.0000000000002424

Key clinical point: Neoadjuvant treatment with folinic acid, 5-fluorouracil, oxaliplatin, and irinotecan (mFOLFOXIRI) plus selective radiotherapy offers better disease-free survival (DFS) than neoadjuvant chemoradiotherapy (CRT; fluorouracil plus radiotherapy) in patients with locally advanced rectal cancer (LARC).

Major finding: Patients receiving mFOLFOXIRI without routine radiotherapy vs CRT had a significantly higher 3-year DFS rate (87.6% vs 75.8%; hazard ratio 0.46; P  =  .037).

Study details: This phase 2 study, FORTUNE, studied propensity score-matched patients with LARC who received neoadjuvant mFOLFOXIRI without routine radiotherapy (n = 73) with those who received neoadjuvant CRT in the phase 3 FOWARC study (n = 73).

Disclosures: This study was sponsored by the National Key Research and Development Program of China and Science and Technology Program of Guangzhou. The authors declared no conflicts of interest.

Source: Zhang J et al. Neoadjuvant mfolfoxiri with selective radiotherapy in locally advanced rectal cancer: Long-term outcomes of phase II study and propensity-score matched comparison with chemoradiotherapy. Dis Colon Rectum. 2022 (Jul 12). Doi: 10.1097/DCR.0000000000002424