High Body Mass Index (BMI) and Smoking as Potential Risk Factors Associated with Adenomatous Polyp Detection in Young Patients

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Introduction: Adenomatous polyps (AP) are the most common precursor lesions for colon cancer. Colonoscopy can effectively detect and remove these lesions justifying it an irreplaceable cancer prevention method. The prevalence of AP is variable and an older age is a major risk factor. In fact, AP in young patients (under 40 years old) is quite rare, particularly in individuals without any known genetic syndromes associated with a possible risk of colon cancer. To study associated factors (comorbidities and risk behaviors) in such young patients may help to identify potential new risks factors for colon cancer development. Methods: Thirty-four patients were identified who were under 40 years old and had AP including sessile serrated polyp/adenoma (SSP/A) detected by colonoscopy during the years of 2013 to 2015. Patients age, sex, colonic pathology and location of polyp, and bmi were reviewed. To obtain this information, the review was done in the electronic medical record through review of epic patients' charts and endoscopy reports through Provation Results: Forty- seven percent (16/34) patients were female, sixty percent (18/34) were male. Thirty-two percent of patients (11/34) had polyp sizes less than 5 mm. Forty-seven percent of patients (16/34) had polyp sizes between 5 mm and 10 mm. Twenty-one percent of patients (7/34) had polyp sizes over 10 mm. Twelve percent of patients (4/34) had a BMI less than 24.9. Forty-one percent of patients (14/34) had a BMI between25 and 29.9 classified as overweight. Forty-seven percent of patients (16/34) had a BMI over 30 classified as obese. Fifty three percent of patients (18/34) reported a positive smoking history or were a current smoker. The majority of polyps (56%) (19/34) were detected in the sigmoid colon. Conclusion: Based on this retrospective chart review, in a young patient population (age range between 30-49), a BMI over 25 and a positive smoking history or being a current smoker was associated with a higher likelihood of detection of tubular adenoma on colonscopy. Follow-up surveillance colonscopy intervals were variable, with the most common follow-up interval being approximately 5 years.