Modifiable lifestyle factors associated with risk of sessile serrated polyps, conventional adenomas and hyperplastic polyps.

Abstract

OBJECTIVE:

To identify modifiable factors associated with sessile serrated polyps (SSPs) and compare the association of these factors with conventional adenomas (ADs) and hyperplastic polyps (HPs).

DESIGN:

We used data from the Tennessee Colorectal Polyp Study, a colonoscopy-based case-control study. Included were 214 SSP cases, 1779 AD cases, 560 HP cases and 3851 polyp-free controls.

RESULTS:

Cigarette smoking was associated with increased risk for all polyps and was stronger for SSPs than for ADs (OR 1.74, 95% CI 1.16 to 2.62, for current vs never, ptrend=0.008). Current regular use of non-steroidal anti-inflammatory drugs was associated with a 40% reduction in SSP risk in comparison with never users (OR 0.68, 95% CI 0.48 to 0.96, ptrend=0.03), similar to the association with AD. Red meat intake was strongly associated with SSP risk (OR 2.59, 95% CI 1.41 to 4.74 for highest vs lowest intake, ptrend<0.001) and the association with SSP was stronger than with AD (ptrend=0.003). Obesity, folate intake, fibre intake and fat intake were not associated with SSP risk after adjustment for other factors. Exercise, alcohol use and calcium intake were not associated with risk for SSPs.

CONCLUSIONS:

SSPs share some modifiable risk factors for ADs, some of which are more strongly associated with SSPs than ADs. Thus, preventive efforts to reduce risk for ADs may also be applicable to SSPs. Additionally, SSPs have some distinctive risk factors. Future studies should evaluate the preventive strategies for these factors. The findings from this study also contribute to an understanding of the aetiology and biology of SSPs.

• Authors: James R Davenport, Timothy Su, Zhiguo Zhao, Helen G Coleman, Walter E Smalley, Reid M Ness, Wei Zheng, Martha J Shrubsole
• Journal: Gut (Gut) Vol. 67 Issue 3 Pg. 456-465 (03 2018) ISSN: 1468-3288 [Electronic] England
• PMID: 27852795 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Adenoma (epidemiology, pathology)
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Case-Control Studies
• Cigarette Smoking (epidemiology)
• Colonic Neoplasms (epidemiology, pathology)
• Colonic Polyps (epidemiology, pathology)
• Colonoscopy
• Diet
• Female
• Humans
• Hyperplasia (epidemiology, pathology)
• Life Style
• Male
• Middle Aged
• Protective Factors
• Red Meat
• Risk Factors
• Risk Reduction Behavior
• Tennessee (epidemiology)