ABSTRACT
Background:Colorectal cancer (CRC) is one of the leading causes of cancer incidence worldwide. In Saudi Arabia, it is ranked first most common cancer in males and second most common in females. CRC is an ideal for prevention because of the high incidence rate and the relative slow progression into an adenocarcinoma. Primary health care (PHC) setting is the ideal place where CRC screening should take place. This study was intended to evaluate awareness, knowledge and attitude towards CRC screening.Methods:A survey was performed among PHC physicians in Qassim province, Saudi Arabia. An electronic questionnaire adopted from the national cancer institute was formulated. Demographic data, specialty, qualifications, years of experience, knowledge and attitudes towards CRC screening, and perceived barriers regarding CRC screening were obtained.Results:A total of 94 physicians were recruited. 39.4% from the sample are females, and 60.6% are males. 99% of physicians agree that colorectal cancer screeningis needed when age appropriate. However, 68% were very compliant in CRC screening in clinical practice. Only 52% of physicians were familiar with national CRC cancer screening guidelines. 53% of physicians scored correct on the age appropriate to initiateCRC screening for average risk patients.Conclusions:More efforts should be given to improve knowledge of primary healthcare providers regarding CRC prevention. More funding and planning are needed to provide primary health care providers with the required tools and systems in order to make CRC prevention more efficient.
ABSTRACT
We determined the effect of fish oil (FO) ingestion on colonic carcinogenesis in rats. Male Wistar rats received 4 subcutaneous injections (40 mg/kg body weight each) of 1,2-dimethylhydrazine (DMH) at 3-day intervals and were fed a diet containing 18 percent by weight FO (N = 10) or soybean oil (SO, N = 10) for 36 weeks. At sacrifice, the colon was removed, aberrant crypt foci were counted and the fatty acid profile was determined. Intestinal tumors were removed and classified as adenoma or carcinoma. Liver and feces were collected and analyzed for fatty acid profile. FO reduced the mean (± SEM) number of aberrant crypt foci compared to SO (113.55 ± 6.97 vs 214.60 ± 18.61; P < 0.05) and the incidence of adenoma (FO: 20 percent vs SO: 100 percent), but carcinoma occurred equally in FO and SO rats (2 animals per group). The polyunsaturated fatty acid (PUFA) profile of the colon was affected by diet (P < 0.05): total ù-3 (FO: 8.18 ± 0.97 vs SO: 1.71 ± 0.54 percent) and total ù-6 (FO: 3.83 ± 0.59 vs SO: 10.43 ± 1.28 percent). The same occurred in the liver (P < 0.05): total ù-3 (FO: 34.41 ± 2.6 vs SO: 6.46 ± 0.59 percent) and total ù-6 (FO: 8.73 ± 1.37 vs SO: 42.12 ± 2.33 percent). The PUFA profile of the feces and liver polyamine levels did not differ between groups (P > 0.05). In conclusion, our findings indicate that chronic FO ingestion protected against the DMH-induced preneoplastic colon lesions and adenoma development, but not against carcinoma in rats.