ABSTRACT
Colorectal cancer is the second most prevalent cancer in Germany. The governmental program for early detection of colorectal cancer intends to increase the chances of recovery by identifying colorectal cancer in an early, more treatable stage. Citizens need quality-assured, balanced, and target-group-specific information to be able to make an informed decision. On the basis of the current state of research, of extensive studies, and of expert and user interviews, the Federal Center for Health Education (BZgA) developed an information module on"early detection of colorectal cancer" for the women's health portal of the BZgA. The information module contains information on colorectal cancer, on the governmental program for early detection, as well as on the program's benefits and risks. The information offered is intended to be up to date and is approved by experts. The BZgA approves the quality of this information using methods of process and outcome evaluation.
Subject(s)
Colorectal Neoplasms/diagnosis , Consumer Health Information/organization & administration , Early Detection of Cancer , Health Promotion/organization & administration , Information Dissemination/methods , Informed Consent , Internet , Colorectal Neoplasms/prevention & control , Female , Germany , Humans , Women's HealthSubject(s)
Heart Neoplasms/pathology , Hemangiosarcoma/pathology , Magnetic Resonance Imaging , Adult , Humans , MaleABSTRACT
PURPOSE: Adjuvant postoperative treatment with fluorouracil (5-FU) and levamisole in curatively resected stage III colon cancer significantly reduces the risk of cancer recurrence and improves survival. Biochemical modulation of 5-FU with leucovorin has resulted in increased remission rates in metastatic colorectal cancer, thus reflecting an increased tumor-cell kill. The impact of 5-FU plus leucovorin on survival and tumor recurrence was analyzed in comparison with the effects of 5-FU plus levamisole in the prospective multicentric trial adjCCA-01. PATIENTS AND METHODS: Patients with a curatively resected International Union Against Cancer stage III colon cancer were stratified according to T, N, and G category and randomly assigned to receive one of the two adjuvant treatment schemes: 5-FU 400 mg/m(2) body-surface area intravenously in the first chemotherapy course, then 450 mg/m(2) x 5 days; 12 cycles, plus leucovorin 100 mg/m(2) (arm A), or 5-FU plus levamisole (Moertel scheme; arm B). RESULTS: Six hundred eighty (96.9%) of 702 patients enrolled onto this study were eligible. After a median follow-up time of 46.5 months, the 5-FU plus leucovorin combination significantly improved disease-free survival (P =.037) and significantly decreased overall mortality (P =.0089) in comparison with 5-FU plus levamisole. In a multivariate proportional hazards model, adjuvant chemotherapy emerged as a significant prognostic factor for survival (P =.0059) and disease-free survival (P =.03). Adjuvant treatment with 5-FU plus levamisole as well as with 5-FU plus leucovorin was generally well tolerated; only a minority of patients experienced grade 3 and 4 toxicities. CONCLUSION: After a curative resection of a stage III colon cancer, adjuvant treatment with 5-FU plus leucovorin is generally well tolerated and significantly more effective than 5-FU plus levamisole in reducing tumor relapse and improving survival.
