Mo1701 PREDICTORS OF ADVANCED COLORECTAL ADENOMA: CASE-CONTROL ANALYSIS

Abstract

Advanced colorectal adenomatous polyps (ACRAP) is a subtype of adenomas that may progress to carcinoma. Early detection and successful removal of advanced adenomas may reduce the incidence of colorectal carcinoma. We performed this single institution case-control study to analyze the clinico-epidemiological characteristics and risk factors of ACRAP. ACRAP has been defined as adenomatous polyps with 10 mm or larger in size, contains a significant villous component, or has high-grade dysplasia. Between 2013 and 2019, 860 patients were referred for screening colonoscopy among whom 158 had ACRAP and 391 had no evidence of colorectal polyps. We reviewed the electronic medical records of all patients (N=549) and retrieved detailed baseline epidemiological and clinical characteristic of all participants at time of colorectal screening. STATA program was used for data management and statistical analyses. Logistic regression was performed to estimate univariate and multivariate Odd ratio (OR) and 95% confidence interval (95% CI) after adjustment for significant confounding factors. Table-1 presents the baseline characteristics of 158 patients ACRAP. Descriptive analysis indicated a significantly high prevalence of cirrhosis and alcohol consumption among patients with ACRAP as compared to non-polyp population, P <.05. In addition, ACRAP was common among whites. The estimated univariate ORs (95% CIs) for cirrhosis, white race, and alcohol consumption were 1.8 (1.2-2.6), 1.8 (1.2-2.6), and 1.7 (1.2-2.5) respectively; p<.05. Multivariate logistic regression analysis showed that the risk for ACRAP development has increased by 50% among cirrhotic patients and by 60% among white population. The estimated multivariate ORs (95% CIs) are 1.5 (1.1-2.2) p=.03 and 1.6 (1.1-2.3) p=.04, for cirrhosis and white race, respectively. The study showed a significant impact of cirrhosis on ACRAP development and higher risk of white race as compared to other races. Future study with a large sample size is warranted to validate our findings.