Colorectal Cancer (CRC) & Inflammatory Bowel Disease (IBD)

Among cancers that affect both men and women, colorectal cancer (CRC) is the second leading cause of death in the United States and Europe. In Cyprus there are ~300 new cases of CRC every year. Interestingly, more than 90% of CRC cases occur in people 50 years or older. This fact is in line with the notion that sporadic cancers are diseases of old age and indicates that changes that accompany aging exert major influences on the biology and evolution of cancer. Nevertheless, the factors that change with age are not well understood. Symptoms used as indicators of colon cancer usually manifest rather advanced stages of disease. These include blood in stools, irregular bowel movement and anaemia. Accordingly, the standard physician routine screening recommendation is a non-invasive test, such as the stool occult blood test, every year and colonoscopy every 5 years for men and women over 50 years old. More frequent screening is proposed for high-risk patients with family history of colonic polyp or cancer or inflammatory bowel disease. Nevertheless, an advanced molecular screening that will indicate early stage cancer or cancer risk is missing and our study aims to provide that. Inflammatory bowel disease (IBD) is a condition caused by inflammation of the small or large intestine. It is increasingly prevalent in Western countries, and impacts on the patients’ quality of life and the risk for CRC. A number of disorders are classified as IBD, including the most common ones, Crohn’s disease (CD) and ulcerative colitis (UC). CD can occur discontinuously anywhere along the digestive tract and throughout the intestinal wall. It is usually associated with granulomas and can develop fistulas and intestinal stenosis. UC generally affects the large intestine causing inflammation continuously along the colon, and is usually limited to the mucosa. Epidemiological data showed in 2013 that in the United States 1,171,000 people have IBD, 565,000 of which are CD and 593,000 UC patients. In Europe 0.3 % of the population, that is, 2.5–3 million people, suffer from IBD. Of those approximately 1.1 million suffer from CD and 1.5 million from UC. This imposes a substantial public health burden because IBD is usually chronic and cannot be easily treated.