Colorectal Advanced Neoplasia Are Associated with Aging, Current Smoking, and Metabolic Factors in Japan: Analyses of Comprehensive Health Checkup Data

Abstract

Introduction: For the past decades, the incidence and mortality rate of colorectal cancer (CRC) have increased in Japan and CRC is the third leading cause of cancer death in Japan. The association of metabolic syndrome (MetS) and CRC has been reported in several studies, however, individual factors contributing to CRC occurrence have been obscure, especially in Japan. In the present study, we investigated the risk factors such as metabolic and lifestyle factors for colorectal advanced neoplasia (AN) using comprehensive health checkup data. Methods: We conducted a retrospective analysis in clinical practice at a single center. Among 10138 subjects who took comprehensive health checkup at our hospital between in August 2012 and December 2016, 2769 subjects who underwent screening colonoscopy were enrolled. In the present study, AN was defined as cancer or adenoma that was at least 10 mm in diameter, had high-grade dysplasia, had villous or tubulovillous histologic characteristics, or any combination thereof. A diagnosis of MetS was made by Metabolic Syndrome Diagnostic Criteria Exploratory Committee in Japan. We evaluated demographic characteristics, anthropometric measurements, visceral fat area (VFA) measured by CT, hematological metabolic parameters, degree of liver fat evaluated by ultrasonography, and current smoking and drinking habits as variables. Association between variables and AN was evaluated by univariate analysis using t-test, ?2 test, Mann-Whitney test, and then by multivariate analysis using multiple logistic regression model. A pvalue < 0.05 was considered statistically significant. Results: Of 2769 subjects (men: 1843, women: 926) analyzed, 676 subjects were diagnosed as MetS (24.4%; 31.3 % in men, 10.8 % in women) and 99 subjects had AN (3.6%). Subjects with MetS had significantly more AN (37 subjects, 5.5%) compared with those without MetS (62 subjects, 3.0%) (p = 0.004). Univariate analysis identified significant association of age, body mass index (BMI), VFA, systolic blood pressure, fatty liver, current smoking habits and ≥ 10 kg weight gain compared with the body weight at the age of twenty with AN prevalence. Logistic regression analysis revealed that age, current smoking, low-density lipoprotein (LDL)-cholesterol and triglycerides were independent factors associated with AN prevalence (Table). Conclusion: The present study demonstrated that colorectal AN was associated with MetS and aging, current smoking and dyslipidemia might be risk factors for CRC in Japan.210 Figure 1. OR; odds ratio, CI; confidence interval, N.S.; not significant