Lifestyle and Dietary Risk Factors for Colorectal Hyperplastic and Adenomatous Polyps

Abstract

Background: Increasing evidence suggests that colon hyperplastic polyps (HP) increases predisposition to the development of colon cancer, albeit to a lesser degree than colon adenoma. Data on behavioral and lifestyle risk factors for HP are limited. Methods: We compared the risk factor profiles for colon adenoma and colon HP in 1,826 patients without known history of colorectal cancer or polyps who are undergoing screening colonoscopy at our institution. Five hundred and eight patients were diagnosed with one or more colon adenomas, 215 with HP, 140 patients with both adenoma and HP, and 963 with negative colonscopic examination. Information on behavioral and lifestyle risk factors and dietary habits were collected by computer-assisted personal interview (CAPI) and Food Frequency Questionnaire prior to colonoscopy. We used multivariate unconditional logistic regressions to assess risk associations. Results: Positive association were found between adenomatous polyps and male gender (OR 1.702, 95% CI 1.210–2.394, p 0.002), current smoker (OR 1.598, 95% CI 1.091–2.340, p 0.016) and family history (OR 1.409, 95% CI 1.034–1.920, p 0.030). For hyperplastic polyps, positive associations were found between current smoker (OR 2.038, 95% CI 1.207–3.441, p 0.008) and regular alcohol drinker (OR 1.661, 95% CI 1.057–2.610, p 0.028). For both types of polyps positive associations were found between male gender (OR 2.282, 95% CI 1.233–4.222, p 0.009), current smoker (OR 2.692, 95% CI 1.475–4.912, p 0.001) and family history (OR 2.472, 95% CI 1.506–4.057, p 0.00). In a subgroup analysis by gender, regular alcohol consumption (OR 1.780, 95% CI 1.008–3.143, p 0.047) was associated with increased risk and HRT (OR 0.450, 95% CI 0.225–0.903, p 0.025) was associated with a decreased risk of hyperplastic polyps in females. Whereas in males, ever smokers (OR 3.074, 95% CI 1.357–6.965, p 0.007) and current smokers (OR 3.311, 95% CI 1.307–8.389, p 0.012) were associated with an increase risk of hyperplastic polyps. Conclusion: Our data indicate that there are several lifestyle and dietary risk factors that are associated with both colorectal adenomatous and hyperplastic polyps. These risk factors vary not only by type of polyp but also gender. This abstract is one of the 20 highest scoring abstracts of those submitted for presentation at the 36th Annual ASPO meeting held March 4–6, 2012, in Washington, DC.