Prediktory pokročilé kolorektální neoplazie ve screeningu kolorektálního karcinomu – průběžné výsledky multicentrické prospektivní studie

Abstract

ntroduction: The incidence of advanced colorectal neoplasia in the screening population shows great diversity with a prevalence of 3–12 %. Due to the uneven distribution in the population, potential risk factors that would allow the stratification of individuals according to the degree of risk of colorectal neoplasia are searched. Aim: To determine the risk factors associated with the occurrence of advanced colorectal neoplasia in the screening population. Methods: Asymptomatic individuals aged 45–75 years who underwent preventive colonoscopy in 2012–2016 in a multicenter prospective study monitoring metabolic risk factors for CRC (MRF CRC study) were included in the analysis. Data were analyzed using descriptive statistics. The Fisher’s exact test was used to compare the risk factors with the occurrence of advanced colorectal neoplasia. Results: There were 1,108 men (56.3%) and 859 women (43.7%) in the group; the average age of the individuals was 60 years. The majority of subjects were referred for primary screening colonoscopy (1,174 subjects; 59.7%) and 793 subjects (40.3%) underwent FOBT positive colonoscopy. The total number of advanced colorectal neoplasms in the cohort was 11,8% (233 individuals). The independent risk factors significantly associated with advanced colorectal neoplasia included age (p < 0.001), male gender (p = 0.001), smoking (p < 0.001), serum concentrations of triglycerides (p = 0.029; especially concentrations > 2 mmol/l) and low vitamin D (p = 0.033). These are preliminary results which will be specified in the following more detailed data analysis using logistic regression. Conclusion: The strongest risk factors associated with advanced colorectal neoplasia were age, gender and smoking. In addition to these factors, serum triglyceride levels and low vitamin D were significantly associated with advanced colorectal neoplasia. In the individuals with a higher incidence of advanced colorectal neoplasia according to the given factors, primary screening colonoscopy should be considered.