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      Molecular pathology of colorectal cancer : The Saudi situation in perspective

      review-article
      Author(s): , PhD
      Publication date (Print):
      Journal: Saudi Medical Journal
      Publisher: Saudi Medical Journal
      Keywords: colorectal cancer, Saudi Arabia, molecular pathology, genetic alterations

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          Abstract

          Colorectal cancer (CRC) is one of the most common cancers worldwide, and one of the most common causes of cancer deaths. In recent times, significant advancements have been made in elucidating the molecular alterations of the disease, and the results have been an improved understanding of CRC biology, as well as the discovery of biomarkers of diagnostic, prognostic, and therapeutic significance. In this review, an evaluation is carried out of the molecular pathology research of CRC emanating from Saudi Arabia. The verdict is that the data on the molecular alterations in CRC from Saudi patients is at best modest. This dearth of molecular pathology data is aptly reflected in the paucity of molecular markers recommended for testing by the Saudi National Cancer Centre guidelines for CRC management. Large scale multi-institutional and multiregional translational studies are required to generate molecular data that would inform diagnostic, prognostic, and risk-stratification guidelines for Saudi CRC patients.

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)
          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            The Consensus Molecular Subtypes of Colorectal Cancer

            Justin Guinney, Rodrigo Dienstmann, Xin Ke Wang … (2015)
            Colorectal cancer (CRC) is a frequently lethal disease with heterogeneous outcomes and drug responses. To resolve inconsistencies among the reported gene expression–based CRC classifications and facilitate clinical translation, we formed an international consortium dedicated to large-scale data sharing and analytics across expert groups. We show marked interconnectivity between six independent classification systems coalescing into four consensus molecular subtypes (CMS) with distinguishing features: CMS1 (MSI Immune, 14%), hypermutated, microsatellite unstable, strong immune activation; CMS2 (Canonical, 37%), epithelial, chromosomally unstable, marked WNT and MYC signaling activation; CMS3 (Metabolic, 13%), epithelial, evident metabolic dysregulation; and CMS4 (Mesenchymal, 23%), prominent transforming growth factor β activation, stromal invasion, and angiogenesis. Samples with mixed features (13%) possibly represent a transition phenotype or intra-tumoral heterogeneity. We consider the CMS groups the most robust classification system currently available for CRC – with clear biological interpretability – and the basis for future clinical stratification and subtype–based targeted interventions.
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              Cancer statistics for the year 2020: An overview

              Jacques Ferlay, Murielle Colombet, Isabelle Soerjomataram … (2021)
              Article 0 comments Cited 1209 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Saudi Med J
                Journal ID (iso-abbrev): Saudi Med J
                Journal ID (hwp): smj
                Journal ID (publisher-id): SAMJDI
                Title: Saudi Medical Journal
                Publisher: Saudi Medical Journal
                ISSN (Print): 0379-5284
                ISSN (Electronic): 1658-3175
                Publication date (Print): September 2023
                Volume: 44
                Issue: 9
                Pages: 836-847
                Affiliations
                From the Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
                Author notes
                Address correspondence and reprint request to: Dr. Abdulaziz Alfahed, Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia. E-mail: a.alfahed@ 123456psau.edu.sa
                Author information
                https://orcid.org/0000-0001-7961-343X
                Article
                Publisher ID: SaudiMedJ-44-9-836
                DOI: 10.15537/smj.2023.44.9.20230257
                PMC ID: 10505285
                PubMed ID: 37717975
                SO-VID: d833929f-d531-4e7b-83b0-e874f1102027
                Copyright © Copyright: © Saudi Medical Journal
                License:

                This is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work.

                History
                Categories
                Subject: Review Article

                Keywords: colorectal cancer,saudi arabia,molecular pathology,genetic alterations
                Data availability:
                Keywords: colorectal cancer, saudi arabia, molecular pathology, genetic alterations

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