Tianzuo Zhan1,2, Felix Hahn3, Thomas Hielscher4, Asmé Bilge3, Jürgen Grüger5,6, Jürgen Weers7, Johannes Betge8,3, Timo Gaiser9, Georg Kähler10, Matthias P Ebert3, Sebastian Belle11. 1. Division of Signaling and Functional Genomics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany. t.zhan@dkfz.de. 2. Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Universitätsmedizin Mannheim, Theodor-Kutzer Ufer 1-3, D-68167, Mannheim, Germany. t.zhan@dkfz.de. 3. Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Universitätsmedizin Mannheim, Theodor-Kutzer Ufer 1-3, D-68167, Mannheim, Germany. 4. Division of Biostatistics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany. 5. Heilig Geist Hospital, Rodensteinstraße 94, 64625, Bensheim, Germany. 6. Praxis Dr. Knapp und Kollegen, Mathildenstraße 30, 64625, Bensheim, Germany. 7. Gastroenterologische Schwerpunktpraxis, Lameystr. 2, 68165, Mannheim, Germany. 8. Division of Signaling and Functional Genomics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany. 9. Institute of Pathology, Medical Faculty Mannheim, Heidelberg University, Universitätsmedizin Mannheim, Theodor-Kutzer Ufer 1-3, D-68167, Mannheim, Germany. 10. Central Interdisciplinary Endoscopy Unit, Medical Faculty Mannheim, Heidelberg University, Universitätsmedizin Mannheim, Theodor-Kutzer Ufer 1-3, D-68167, Mannheim, Germany. 11. Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Universitätsmedizin Mannheim, Theodor-Kutzer Ufer 1-3, D-68167, Mannheim, Germany. sebastian.belle@umm.de.
Abstract
PURPOSE: The prevalence of advanced dysplasia and synchronous lesions is particularly high in patients with large, flat colorectal polyps. However, the impact of lifestyle on the development of such polyps is poorly investigated. Hence, this study aims to identify associations between behavioral factors and the occurrence of large, flat colorectal polyps. METHODS: Behavioral factors were retrospectively analyzed in patients with large, flat polyps and control patients with at most one diminutive polyp. Information on lifestyle factors, comorbidities, and demographic parameters were determined by a structured, self-administered questionnaire. RESULTS: Questionnaires of 350 patients with large, flat polyps and 489 control patients were included in the analysis. Most large, flat colorectal polyps contained adenoma with low-grade neoplasia and were located in the right colon. Multivariate analysis showed that advanced age (per 1-year increase-OR 1.09, CI 1.07-1.11, p < 0.0001), frequent cigarette smoking (OR 2.04, CI 1.25-3.32, p = 0.0041), daily consumption of red meat (OR 3.61, CI 1.00-12.96, p = 0.0492), and frequent bowel movements (OR 1.62, CI 1.13-2.33, p = 0.0093) were independent risk factors for occurrence of large, flat colorectal polyps. In contrast, frequent intake of cereals (OR 0.62, CI 0.44-0.88, p = 0.0074) was associated with a reduced risk. CONCLUSION: Multiple behavioral factors modulate the risk for developing large, flat colorectal polyps. This knowledge can be used to improve prevention of colorectal cancer.
PURPOSE: The prevalence of advanced dysplasia and synchronous lesions is particularly high in patients with large, flat colorectal polyps. However, the impact of lifestyle on the development of such polyps is poorly investigated. Hence, this study aims to identify associations between behavioral factors and the occurrence of large, flat colorectal polyps. METHODS: Behavioral factors were retrospectively analyzed in patients with large, flat polyps and control patients with at most one diminutive polyp. Information on lifestyle factors, comorbidities, and demographic parameters were determined by a structured, self-administered questionnaire. RESULTS: Questionnaires of 350 patients with large, flat polyps and 489 control patients were included in the analysis. Most large, flat colorectal polyps contained adenoma with low-grade neoplasia and were located in the right colon. Multivariate analysis showed that advanced age (per 1-year increase-OR 1.09, CI 1.07-1.11, p < 0.0001), frequent cigarette smoking (OR 2.04, CI 1.25-3.32, p = 0.0041), daily consumption of red meat (OR 3.61, CI 1.00-12.96, p = 0.0492), and frequent bowel movements (OR 1.62, CI 1.13-2.33, p = 0.0093) were independent risk factors for occurrence of large, flat colorectal polyps. In contrast, frequent intake of cereals (OR 0.62, CI 0.44-0.88, p = 0.0074) was associated with a reduced risk. CONCLUSION: Multiple behavioral factors modulate the risk for developing large, flat colorectal polyps. This knowledge can be used to improve prevention of colorectal cancer.
Authors: G C Parkes; N B Rayment; B N Hudspith; L Petrovska; M C Lomer; J Brostoff; K Whelan; J D Sanderson Journal: Neurogastroenterol Motil Date: 2011-11-09 Impact factor: 3.598
Authors: Edward D Gorham; Cedric F Garland; Frank C Garland; William B Grant; Sharif B Mohr; Martin Lipkin; Harold L Newmark; Edward Giovannucci; Melissa Wei; Michael F Holick Journal: Am J Prev Med Date: 2007-03 Impact factor: 5.043
Authors: John A Baron; Elizabeth L Barry; Leila A Mott; Judy R Rees; Robert S Sandler; Dale C Snover; Roberd M Bostick; Anastasia Ivanova; Bernard F Cole; Dennis J Ahnen; Gerald J Beck; Robert S Bresalier; Carol A Burke; Timothy R Church; Marcia Cruz-Correa; Jane C Figueiredo; Michael Goodman; Adam S Kim; Douglas J Robertson; Richard Rothstein; Aasma Shaukat; March E Seabrook; Robert W Summers Journal: N Engl J Med Date: 2015-10-15 Impact factor: 91.245
Authors: Sheila A Bingham; Nicholas E Day; Robert Luben; Pietro Ferrari; Nadia Slimani; Teresa Norat; Françoise Clavel-Chapelon; Emmanuelle Kesse; Alexandra Nieters; Heiner Boeing; Anne Tjønneland; Kim Overvad; Carmen Martinez; Miren Dorronsoro; Carlos A Gonzalez; Timothy J Key; Antonia Trichopoulou; Androniki Naska; Paolo Vineis; Rosario Tumino; Vittorio Krogh; H Bas Bueno-de-Mesquita; Petra H M Peeters; Göran Berglund; Göran Hallmans; Eiliv Lund; Guri Skeie; Rudolf Kaaks; Elio Riboli Journal: Lancet Date: 2003-05-03 Impact factor: 79.321