Hyperplastic Polyposis Syndrome Is Associated With Cigarette Smoking, Which May Be a Modifiable Risk Factor

Walker, Rowan G.; Landmann, J; Hewett, David G.; Worthley, Daniel L.; Buttenshaw, Ron; Knight, Ngaire; Webb, Penelope M.; Whiteman, David C.; Whitehall, Vicki; Leggett, Barbara A.

doi:10.1038/ajg.2009.757

Cited by 32 publications

(21 citation statements)

References 22 publications

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“…In another study, however, cigarette smoking was found to be strongly associated with SPS, suggesting that smoking may increase the occurrence of this condition (24). Although an epidemiological study reported associations between CRC and alcohol consumption and smoking (25), these findings were not confirmed by our study.…”

Section: Discussioncontrasting

confidence: 57%

Prevalence of serrated polyposis syndrome and its association with synchronous advanced adenoma and lifestyle

Toyoshima¹,

Sakamoto²,

Makazu³

et al. 2014

Molecular and Clinical Oncology

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Abstract.We assessed the clinicopathological characteristics of patients with serrated polyposis syndrome (SPS) and the incidence of advanced adenoma/colorectal cancer (CRC). We prospectively enrolled 249 consecutive patients who underwent colonoscopy at the National Cancer Center Hospital over a 6-month period. All the polyps were diagnosed using magnification colonoscopy and resection/biopsy. The enrolled patients were divided into two groups, i) those with ≥5 histologically diagnosed hyperplastic polyps (HPs) proximal to the sigmoid colon, with at least 2 polyps >10 mm in diameter and ii) those with ≥20 HPs distributed throughout the colon. The clinical characteristics of the two groups were compared, including lifestyle, family history of CRC and colonoscopic findings. HPs were identified in 228 patients, of whom 21 (8.4%) had SPS. All 21 patients had ≥20 HPs distributed throughout the colon, with none having >2 HPs ≥1 cm in diameter in the right colon. Synchronous advanced adenoma/CRC was diagnosed in 76̸249 (30.5%) patients. The prevalence of advanced adenoma/CRC was higher among patients with compared to those without SPS (P=0.075). SPS was also associated with older age and higher body mass index (BMI). Our results suggested that older age and higher BMI are independent risk factors for SPS. Advanced adenoma/CRC tended to occur more frequently among patients with compared to those without SPS, although the difference was not statistically significant.

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Section: Discussioncontrasting

confidence: 57%

Prevalence of serrated polyposis syndrome and its association with synchronous advanced adenoma and lifestyle

Toyoshima¹,

Sakamoto²,

Makazu³

et al. 2014

Molecular and Clinical Oncology

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“…Second, as the questionnaire was distributed to the patients shortly after the colonoscopy, the possibility of a recall bias cannot be excluded. Nevertheless, other studies, using a similar methodology as our study, found no differences in the reported risk factors among patients receiving the questionnaires before versus shortly after the colonoscopy (48). Third, the SP risk score proposed in our study was developed in a reallife cohort, including symptomatic and asymptomatic patients, and hence generalizability to a screening population needs to be further examined.…”

Section: Discussionmentioning

confidence: 99%

Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice

Bouwens

Winkens

Rondagh

et al. 2013

Cancer Prevention Research

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Large, proximal, or dysplastic (LPD) serrated polyps (SP) need accurate endoscopic recognition and removal as these might progress to colorectal cancer. Herewith, we examined the risk factors for having 1 LPD SP. We developed and validated a simple SP risk score as a potential tool for improving their detection. We reviewed clinical, endoscopic, and histologic features of serrated polyps in a study of patients undergoing elective colonoscopy (derivation cohort). A self-administered questionnaire was obtained. We conducted logistic regression analyses to identify independent risk factors for having 1 LPD SP and incorporated significant variables into a clinical score. We subsequently tested the performance of the SP score in a validation cohort. We examined 2,244 patients in the derivation and 2,402 patients in the validation cohort; 6.3% and 8.2% had 1 LPD SP, respectively. Independent risk factors for LPD SPs were age of more than 50 years [OR 2.2; 95% confidence interval (CI), 1.3-3.8; P ¼ 0.004], personal history of serrated polyps (OR 2.6; 95% CI, 1.3-4.9; P ¼ 0.005), current smoking (OR 2.2; 95% CI, 1.4-3.6; P ¼ 0.001), and nondaily/no aspirin use (OR 1.8; 95% CI, 1.1-3.0; P ¼ 0.016). In the validation cohort, a SP score 5 points was associated with a 3.0-fold increased odds for LPD SPs, compared with patients with a score <5 points. In the present study, age of more than 50 years, a personal history of serrated polyps, current smoking, and nondaily/no aspirin use were independent risk factors for having LPD SPs. The SP score might aid the endoscopist in the detection of such lesions. Cancer Prev Res; 6(8); 855-63. Ó2013 AACR.

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“…5 Type 1 serrated polyposis is associated with a high frequency of BRAF mutations and CpG island promoter hypermethylation (CpG island methylation phenotype, CIMP) in serrated lesions. Type 2 serrated polyposis is a more heterogeneous condition characterized by numerous (20) small hyperplastic polyps (HPs) distributed throughout the colon; lesions in type 2 serrated polyposis generally have KRAS mutations. The risks of cancer and the molecular pathways of carcinogenesis may differ: Cancers with a high degree of microsatellite instability (MSI-High, MSI-H) are more closely linked to the type 1 entity, which seems to bear a higher risk of CRC as compared to type 2.…”

Section: Introductionmentioning

confidence: 99%

Type 1 serrated polyposis represents a predominantly female disease with a high prevalence of dysplastic serrated adenomas, without germline mutation in MUTYH, APC, and PTEN genes

et al. 2016

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Aim: The aim of this article is to clarify the epidemiologic, clinical, endoscopic, biological and genetic characteristics of type 1 serrated polyposis patients. Patients and methods: Consecutive patients responding to the WHO definition of type 1 serrated polyposis in one reference center for polyposis patients accepted genetic counseling. Detailed data on previous endoscopies, histology, and life habits were recorded, after informed consent, germline analysis of MUTYH, APC, and PTEN germline mutations. Molecular biology was tested on available fixed tissue from different lesion types. Results: We included 29 patients (mean age 53.5 years, 21 women (72.4%)), four with a personal history of colorectal cancer (CRC), with a mean of 11.6 SSAs, with associated hyperplastic polyps in 93.1% and adenomas in 82.8%. SSAs showed no dysplasia in 46.9% of lesions (three of 29 patients), LGD in 51.9% (22/29 patients), and HGD in 1.2% (four of 29 patients). Dysplasia was more frequent in proximal SSAs and in women. Colectomy 15 patients (51.7%), upper digestive neoplasms: eight patients (27.5%); smokers: 24 patients (82.8%); family history of CRC: 16 patients (55.2%). Biology: MSI-H phenotype in one SSA, V600E BRAF mutation in 95% of SSAs; MGMT hypermethylation in three of 17 SSAs. No germline mutation was detected in MYH, APC or PTEN genes. Conclusion: Type 1 serrated polyposis corresponds to a majority of women, with a high prevalence of smokers, a high prevalence of dysplastic serrated adenomas, particularly in females, without identified germline mutation in targeted predisposing genes.

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Hyperplastic Polyposis Syndrome Is Associated With Cigarette Smoking, Which May Be a Modifiable Risk Factor

Abstract: Cigarette smoking is strongly associated with HPS, thus suggesting that smoking exposure may increase the expression of this condition. Further studies should examine the possible benefits of quitting smoking in HPS patients.

Cited by 32 publications

References 22 publications

Prevalence of serrated polyposis syndrome and its association with synchronous advanced adenoma and lifestyle

Prevalence of serrated polyposis syndrome and its association with synchronous advanced adenoma and lifestyle

Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice

Type 1 serrated polyposis represents a predominantly female disease with a high prevalence of dysplastic serrated adenomas, without germline mutation in MUTYH, APC, and PTEN genes

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