Most missed colonoscopy appointments resulted from potentially preventable travel- and scheduling-related issues. Because barriers to keeping colonoscopy appointments are different across health systems, each health system might need to develop unique interventions to reduce missed colonoscopy appointments.
Background and objectives: Production of lipopolysaccharides (LPS) from the outer membrane of Gram-negative bacteria promotes the survival of cancer cells. Systemic level of LPS is considered a biomarker for microbial translocation. The association between LPS and the risk of colorectal tumors is not well known. The goal of this study was to examine the association between LPS serum levels and risk of advanced colorectal adenoma (ACA). Methods: In this colonoscopy clinic-based case-control study, cases were male patients with a diagnosis of ACA, and controls were polyp-free male participants. Cases and controls were individually matched by age, ethnicity, and blood collection time. Information on demographics, lifestyle, and medical history was obtained using structured questionnaires. Serum levels of LPS were quantitated using the kinetic limulus amebocyte lysate assay. Multivariable conditional logistic regression model was used to estimate the odds ratio and its 95% confidence interval of the ACA in association with serum LPS adjusting for cigarette smoking, body mass index, and medical history. Results: We examined 43 cases and 43 paired controls, with a mean age of 62 years. There was no significant difference in serum LPS levels between the cases and controls (0.28 vs. 0.25 endotoxin units (EU)/mL, P = 0.58 for the non-parametric test). The adjusted odds ratio and its 95% confidence interval of ACA was 1.83 (0.40-8.24) in multivariable logistic regression model. Conclusions: Serum levels of LPS were not statistically significantly associated with an increased risk of ACA in this preliminary study.
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