Risk Factors for Advanced Colonic Neoplasia and Hyperplastic Polyps in Asymptomatic Individuals

Abstract

for the VA Cooperative Study Group 380 C OLORECTAL CANCER IS THE SECond leading cause of cancer death in North America. Evidence exists that screening asymptomatic populations beginning at age 50 years can reduce mortality due to colorectal cancer 1-8 and that removal of precursor adenomas may reduce the incidence of colorectal cancer. 9,10 Identification of important risk factors for advanced colonic neoplasia could inform both risk stratification and development of risk reduction strategies. Many potential risk factors for colorectal neoplasia have been investigated previously. 11,12 Few studies have evaluated risk factors for advanced colorectal neoplasia in asymptomatic individuals, compared risk factors between persons with and without polyps, or included most purported risk factors in a multivariate analysis. We conducted a cross-sectional study to determine risk factors for advanced colonic neoplasia in asymptomatic persons undergoing a complete screening colonoscopic examination. The unique features of this study are (1) the inclusion of persons known to be free of colonic polyps based on colonoscopy as a comparison group vs patients with advanced neoplasia and (2) a sample size sufficient to analyze Author Affiliations are listed at the end of this article. Members of the VA Cooperative Study Group 380 are listed at the end of this article.

Body Mass Index, sex, non-steroidal anti-inflammatory drug medications, smoking and alcohol are differentially associated with World Health Organisation criteria and colorectal cancer risk in people with Serrated Polyposis Syndrome: an Australian case-control study

“…A 2016 German population-based study found protective effects on the survival of CRC-affected patients with small consumption of wine [ 55 ]. However, in contrast to our study, two previous prospective studies found current moderate to heavy alcohol increased the odds of HP and CRC in the distal colon [ 56 , 57 ], with a further retrospective case-control study of 132 HP cases identifying alcohol as a risk factor for the association between HP and CRC [ 58 ].…”

Association Between Risk Factors for Colorectal Cancer and Risk of Serrated Polyps and Conventional Adenomas

“…Interestingly, in contrast to most previous studies 13, 16, 45 , we found that the association was stronger for SPs than conventional adenomas. However, prior studies have several limitations, including insufficient control for confounding 45 , retrospective case-control 13 or cross-sectional 16 study design with potential recall bias 16 and selection bias 13 . Obesity is known to be associated with increased levels of bioavailable insulin-like growth factor 1 (IGF-1), which is implicated in colorectal adenoma formation.…”

Risk prediction rule for advanced neoplasia on screening colonoscopy for average-risk individuals

“…This either suggests that our study was not powered to adequately detect subtle differences in red meat intake, or possibly that red meat consumption only causes a significant effect when larger quantities are consumed. Other factors that were not found to correlate with risk of AN were alcohol use and the presence of diabetes, in contrast to findings of prior studies[ 31 ] Regarding alcohol use, 18% of patients with AN reported intake of at least one drink daily, compared to 9.8% of those with no AN, a non-significant difference. Similarly, 12% of those with AN reported diabetes, compared to 8% with no AN.…”