Role of life events in the presence of colon polyps among African Americans

Hassan Ashktorab,Cheryl L Holt,Adeyinka O Laiyemo,Hassan Brim,Hassan Hassanzadeh Namin,Carla Williams,Thomas Mellman,Babak Shokrani,Teletia Taylor,Mehdi Nouraie

doi:10.1186/1471-230x-13-101

Hassan Ashktorab, Cheryl L Holt + Show 8 more

Open Access

https://doi.org/10.1186/1471-230x-13-101

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Abstract

BackgroundAfrican Americans have disproportionately higher incidence and death rates of colorectal cancer among all ethnic groups in the United States. Several lifestyle factors (e.g. diet, physical activity and alcohol intake) have been suggested as risk factors for colorectal cancer. Stressful life events have also been identified as risk factors for colorectal cancer. The association between stressful life events and colon polyps, which are precursors of colorectal cancer, has yet to be determined.We aimed to evaluate the relationship between stressful life events and the presence of colon polyps and adenomas in African American men and women.MethodsIn this cross-sectional study, 110 participants were recruited from a colon cancer screening program at Howard University Hospital. Participants completed an 82-item Life Events Questionnaire (Norbeck 1984), assessing major events that have occurred in the participants’ life within the past 12 months. Participants also reported whether the event had a positive or negative impact. Three scores were derived (total, positive, and negative).ResultsTotal life events scores were higher (Median [M] = 29 and Interquartile range [IQR] = 18-43) in patients with one or more polyps compared to patients without polyps (M, IQR = 21,13-38; P = 0.029). Total, positive or negative Life Events scores did not differ significantly between normal and adenoma patients. Total, negative and positive Life Events scores did not differ between patients who underwent diagnostic colonoscopy (symptomatic) and patients who underwent colonoscopy for colon cancer screening (asymptomatic) and patients for surveillance colonoscopies due to a personal history of colon polyps. Linear regression analysis indicated that male gender is associated with 9.0 unit lower total Life Events score (P = 0.025).ConclusionThis study suggests that patients who experienced total life events may be at higher risk of having colon polyps and adenomas which indicates an association between stress and the development of colorectal polyps.

Highlights

African Americans have disproportionately higher incidence and death rates of colorectal cancer among all ethnic groups in the United States
African Americans have a high incidence of Colorectal cancer (CRC)
Patient recruitment African American patients coming to a university teaching hospital in the mid-Atlantic region for colonoscopy were recruited from June 2011 to October 2011 in a cross-sectional sampling

Summary

Introduction

African Americans have disproportionately higher incidence and death rates of colorectal cancer among all ethnic groups in the United States. Stressful life events have been identified as risk factors for colorectal cancer. The association between stressful life events and colon polyps, which are precursors of colorectal cancer, has yet to be determined. We aimed to evaluate the relationship between stressful life events and the presence of colon polyps and adenomas in African American men and women. Apart from age, sex, and ethnicity; lifestyle factors such as obesity, smoking, high fat diet, and physical inactivity increase the risk of CRC [4]. About potential associations between psychosocial events and biological processes relevant to colon cancer [19]

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