Presence Of Colorectal Polyps Research Articles

Colorectal polyps risk factors: A case–control study in ABIDJAN (CÔTE D’IVOIRE)

Abstract Background and Objectives: Adenomas and certain serrated polyps have the potential to develop into colorectal cancer (CRC). Despite barriers limiting routine screening for CRCs in Côte d’Ivoire, it is important to focus on the risk factors for colorectal (CR) polyps. To facilitate the identification of individuals to prioritize for CRC screening, this study aimed to determine the risk factors of CR polyps in a hospital setting in Abidjan. Materials and Methods: From January 1st, 2023, to July 31st, 2023, a prospective analytical multicenter case–control study was conducted in four hospitals in Abidjan. Patients diagnosed with CR polyps (cases) were compared to those without polyps (controls), matched for age and gender at a 1:1 ratio. Logistic regression was employed to determine factors associated with the discovery of CR polyps. Results: Thirty-three cases were matched to 33 controls [age (P = 0.97), gender (P = 0.80), recruitment site (P = 1.00), indication for colonoscopy (P = 0.93)]. Adenomatous polyps represented 68.3% (n = 28) of cases. In univariate analysis, factors associated with CR polyps were body mass index (P = 0.004), personal or family history of CRC (P = 0.004) and/or CR polyps (P = 0.007), and consumption of red meat (P < 0.001). After multivariate analysis, only red meat consumption was statistically associated with CR polyps (P = 0.02) [odds ratio (OR) = 17.0 (1.5–189.3)]. Alcohol and tobacco were not statistically associated with the presence of CR polyps either in univariate analysis [alcohol (OR= 0.14) and tobacco (OR= 1.00)] or in multivariate analysis [alcohol (OR= 0.99) and tobacco (OR= 0.99)]. Conclusion: Our study found that increased consumption of red meat is associated with the presence of CR polyps. However, tobacco and alcohol did not show an association with CR polyps in our study. Larger studies are necessary to validate or challenge our findings.

Recurrence and survival in dogs with excised colorectal polyps: A retrospective study of 58 cases.

Compared to humans, colorectal polyps are relatively rare in dogs. Epidemiological and prognostic data remain accordingly sparse, although they could help veterinary clinicians in the management of these cases. To report the epidemiological data of dogs with colorectal polyps and identify factors associated with recurrence and survival. Fifty-eight client-owned dogs with colorectal polyps admitted to 7 veterinary hospitals (53 dogs from France, 5 dogs from Spain, and 4 dogs from Portugal) were included. Retrospective multicentric cohort study. Medical records and long-term outcome of the dogs were reviewed. When available, histological samples were reassessed by 2 board-certified pathologists according to the revised Vienna classification (RVC). The West Highland White Terrier (WHWT) breed was significantly associated with the presence of colorectal polyps (OR: 20; 95% CI: 7.5-52; P < .001). The overall median time to recurrence was not reached after 2000 days. The overall estimated median survival time was 1640 days. WHWT breed and larger polyps were significantly associated with a shorter time of polyp recurrence after surgical removal (respectively, P = .05 and P = .01). The probability of recurrence of colorectal polyps in dogs is low, but increased in WHWTs and larger polyps, which might benefit from routine screening after removal. No effective predictors of polyp recurrence and survival were identified using the RVC.

Atrophic gastritis rather than Helicobacter pylori infection can be an independent risk factor of colorectal polyps: a retrospective study in China

BackgroundColonoscopy is considered the most effective screening method for colorectal polyps. However, the longevity and complexity of the procedure makes it less desirable to screen for colorectal polyps in the general population. Therefore, it is essential to identify other independent risk factors. In this study, we explored the link between Hp infection, atrophic gastritis, and colorectal polyps to identify a new potential risk factors of colorectal polyps.MethodsIn this study, atrophic gastritis and intestinal polyps were diagnosed by endoscopy and pathology. All the 792 patients in this retrospective study were divided into sub-groups based on the presence of colorectal polyps. The correlation between polyps and atrophic gastritis was analyzed using the chi-square test and Kruskal-Wallis test. The receiver operating characteristic (ROC) curve was used to compare the predictive value for colorectal polyps between Hp infection and atrophic gastritis. Binary logistic regression was utilized to identify independent risk factors for colorectal polyps.ResultsPatients with colorectal polyps were primarily male with advanced age, and the number of patients with colorectal polyps had a higher association with smoking, alcohol drinking, and Hp infection than the control group. A positive correlation between the number of colorectal polyps and the severity of atrophic gastritis was observed. ROC analysis showed that atrophic gastritis was a better risk factors for colorectal polyps. Multivariate analysis identified atrophic gastritis as an independent risk factor for colorectal polyps (OR 2.294; 95% CI 1.597–3.296).ConclusionsAtrophic gastritis confirmed could be an independent risk factors for colorectal polyps.

The Secret Behind Anemia in Patients With Acromegaly

Introduction: The GH/IGF-1 axis has regulatory effects on erythropoiesis. GH deficiency is associated with normocytic anemia in adults, and hemoglobin (Hb) concentrations are normalized after GH replacement. Little is known about the significance of anemia in acromegalic patients. The aim of this study is to evaluate the factors associated with anemia in patients with acromegaly. Methods: A single‐center retrospective cohort study was conducted. A total of 381 acromegalic patients who admitted to the University Hospital from 1980 to 2018 were included. Information regarding the demographic features, the pre-operative and follow-up hormone levels, radiological features of adenoma, treatment modalities, comorbidities, presence of cancer, colonoscopy results, medication history, presence and type of anemia together with the CBC, iron parameters, 25(OH)D, and vitamin B12 levels at the time of anemia detected were retrieved from the patient record system. Anemia was defined as Hb levels <12.0 g/dL in women and <13.0 g/dL in men. Results: Of 381 acromegalic patients (120F/98M, age: 44±13yr/45±12 yr); 218 cases (57.2%) were diagnosed with anemia (67% normocytic, 33% microcytic) at a median duration of 6 months after the diagnosis of acromegaly. Hb values were 11.1±0.9 g/dL in women and 12.1±1.0 g/dL in men. Serum levels of ferritin and transferrin saturation were lower in anemic patients (p<0.001). The levels of 25(OH)D and vitamin B12 were lower in the anemic group, but the differences were not statistically significant. Anemia was detected more likely in patients who had macroadenoma (p=0.001), suprasellar extension (p=0.001), and cavernous sinus invasion (p<0.001) on pre-op MRI and residue tumor (p<0.001) on post-op MRI. Patients with anemia had higher GH, IGF-1 and PRL levels (p<0.01), and there was a significant difference related to the use of octreotide (p<0.001). Anemia was observed more frequently in patients with a history of radiotherapy (29% vs. 10%, p<0.001). Hypopituitarism was seen in 63 (29%) patients in the anemic group and 21 (13%) patients in the non-anemic group (p<0.001). Cancer prevalence in the study population was 14.2%, and the most commonly diagnosed cancers were thyroid, bladder, prostate, and breast. Although not statistically significant, the prevalence of cancer was higher in anemic patients compared to non-anemic patients (17% vs. 10%). There was no significant difference regarding the presence of colorectal polyps between groups, and only two anemic patients were diagnosed with colon cancer. Conclusion: This is the first study highlighting that anemia is a common comorbidity in patients with acromegaly, and that anemia can be related to characteristics of the tumor, hormonal status, type of treatment, and the presence of cancer in addition to nutritional factors. Therefore, a comprehensive evaluation is required for anemia in acromegalic patients.

Colon Capsule Endoscopy in Detecting Colonic Diverticula in a Japanese Population.

ObjectiveThe assessment of colonic diverticula with colon capsule endoscopy (CCE) in a Japanese population provided unclear results. In this study, we retrospectively reviewed a cohort of Japanese patients who had undergone CCE to assess its safety and usefulness in the diagnosis of colonic diverticula.MethodsIn this study, 175 consecutive Japanese patients who had their entire colon observed via CCE from November 2013 to July 2018 were included. Patients were retrospectively stratified according to age, gender, colonic segment, and symptoms involvement. A multivariable regression analysis was performed to investigate the presence of any correlation among variables. The safety of CCE was assessed in terms of the incidence of adverse events (AEs).ResultsColonic diverticula were observed in 42.3% of all cases; of those; 36.5% were right-sided, 31.1% were left-sided, and 32.4% were bilateral. Moreover, one to two colonic diverticula were observed in 35.1%, while three or more diverticula were seen in 64.9%. Multivariable analysis showed that age (≥70 years) was positively associated with colonic diverticula, while male gender and the presence of colonic polyps were negatively associated with colonic diverticula. No correlation was found between colonic diverticula and symptoms. There was no significant difference between groups with and without colonic diverticula in the incidence of AEs. AEs were mild in severity, with no severe AE-related bowel preparation and capsule ingestion reported.ConclusionCCE was well-tolerated by the participants, and the incidence of colonic diverticula was 42.3%, with one to two and three or more diverticula being found in 35.1% and 64.9%, respectively. There was little difference in the frequency of colonic diverticula formation on the right side, left side, and on both sides. Age was a positive association factor, while male gender and the presence of colorectal polyps were negative association factors. No correlation was found between diverticula and symptoms.

Visceral Fat Quantitated From CT Colonography Is Associated With the Presence of Colorectal Polyps

Background: An adenomatous polyp is known as a precancerous lesion of colorectal cancer. Detection and removal of adenomatous polyps are essential for colon cancer prevention. Previous studies have found the association between obesity and adenomatous polyp using many parameters.&#x0D; Objective: To determine the association between visceral fat visualized on computed tomography (CT) colonography (CTC) and colorectal polyps.&#x0D; Methods: This retrospective case-control study consisted of 280 adult subjects who underwent colon cancer screening by CTC at Ramathibodi Hospital; 129 cases with CT detected colorectal polyps who underwent polypectomy within 6 months, and 151 control subjects who were negative for significant polyps on CTC. Visceral fat areas of all subjects were measured on CT at the umbilical level by a semiautomatic method. Statistical analysis was performed to ascertain associations with the presence of colorectal polyps.&#x0D; Results: Of 280 adult subjects, there were classified into 4 groups; no polyps (n = 151), hyperplastic polyp (n = 23), low-risk adenomatous polyp (n = 75), and high-risk adenomatous polyp (n = 31). The mean visceral fat areas in 4 groups were 125.1 ± 55.7 cm2, 140.2 ± 63.8 cm2, 147.9 ± 74.2 cm2, and 156.6 ± 63.7 cm2, respectively. There were statistically significant differences in these means visceral fat between the no polyp group and both the low-risk and high-risk adenomatous polyp groups. In multivariate analyses, subjects who had visceral fat areas more than 168.60 cm2 were more likely to have polyps than subjects whose visceral fat areas were less than 93.65 cm2 (P &lt; .05).&#x0D; Conclusions: Visceral fat was positively associated with the presence of adenomatous colorectal polyps.

Thyroid Nodules Are More Prevalent in Subjects with Colon Polyps, Independent of Insulin Resistance

Objective: Colorectal polyps and thyroid nodules are common disorders linked to hyperinsulinemia and metabolic syndrome (Mets). The direct association between these two diseases is not clear. We aimed to analyze the prevalence of thyroid nodules in subjects with and without colorectal polyps. The secondary aim was to establish the prevalence of Mets and its parameters in both disorders and to determine if insulin resistance and hyperinsulinemia are common underlying pathophysiological mechanisms. Subjects and Methods: One hundred and five subjects with colorectal polyps (71 males, 34 females) and 68 controls (28 males, 40 females) were enrolled. The parameters of Mets together with TSH, insulin, low-density lipoprotein cholesterol, and homeostasis model for assessment of insulin resistance levels were calculated. We performed thyroid ultrasonography in all participants. Results: The prevalence of Mets was similar in the colorectal polyp and control groups (37.1 vs. 37.3%, p = 0.982). The prevalence of Mets was nonsignificantly higher in subjects with a documented thyroid nodule compared to subjects without a thyroid nodule (43.0 vs. 32.6%, p = 0.205). The prevalence of thyroid nodules in subjects with colorectal polyps was significantly higher than in subjects without polyps (52.9 vs. 35.3%, p = 0.017). Compared to subjects with no colorectal polyps, we established a significant increase in the odds of having thyroid nodules (OR 2.05; 95% CI: 1.097–3.860, p = 0.017). The presence of colorectal polyps and age in the adjusted model were established to be independent risk factors for having thyroid nodules (p = 0.025 and p = 0.007, respectively). Conclusion: These results may support the presence of other common mechanisms in the development of these two pathologies other than insulin resistance and hyperinsulinemia.

Detrimental association between betel nut chewing and colorectal polyps in adult populations.

Adverse systemic effect caused by betel nut had been reported for decades. Our aim was to determine whether betel nut had detrimental impact on the development of colorectal polyps in general population. Participants who attended health examinations at the Tri-Service General Hospital (TSGH) from 2010 to 2016 were included in the study. The habit of betel nut chewing was obtained from a self-reported questionnaire. Colorectal polyps were diagnosed by colonoscopies operated by experienced physicians. A logistic regression model was used for the association between betel nut chewing with the presence of colorectal polyps. After adjustment for pertinent information such as age, gender, biochemistry data and personal history, the odd ratios (ORs) of colorectal polyps among betel nut chewers was 1.49 (95%CI: 1.14–1.94). Besides, betel nut chewers in the higher percentage body fat (PBF) group had higher risk for developing colorectal polyps with ORs of 2.07 (95%CI:1.23–3.47). Subjects with habit of betel nut chewing were associated with an increased risk of colorectal polyps in Taiwanese general population. Screening for betel nut chewing history and encouraging cessation might offer improved quality of life. A further research for this association was warranted.

Estrogen receptor beta as target for colorectal cancer prevention

Colorectal cancer (CRC) is a leading cause of death in the United States. Despite its slow development and the capacity for early diagnosis, current preventive approaches are not sufficient. However, a role for estrogen has been demonstrated in multiple epidemiologic studies, which may benefit CRC prevention. A large body of evidence from preclinical studies indicates that expression of the estrogen receptor beta (ERβ/ESR2) demonstrates an inverse relationship with the presence of colorectal polyps and stage of tumors, and can mediate a protective response. Natural compounds, including phytoestrogens, or synthetic ERβ selective agonists, can activate or upregulate ERβ in the colon and promote apoptosis in preclinical models and in clinical experience. Importantly, this activity has been associated with a reduction in polyp formation and, in rodent models of CRC, has been shown to lower incidence of colon adenocarcinoma. Collectively, these findings indicate that targeted activation of ERβ may represent a novel clinical approach for management of colorectal adenomatous polyps and prevention of colorectal carcinoma in patients at risk for this condition. In this review, we discuss the potential of new chemopreventive or dietary approaches based on estrogen signaling.

Association between colonic diverticulosis and prevalence of colorectal polyps.

Diverticulosis and colorectal polyps increase in frequency as the population ages. Proposed common mechanisms for both include lack of dietary fiber, increased saturated fats, and slow colonic transit time. The association of diverticulosis and colorectal polyps has been previously reported with conflicting results. Despite sharing common epidemiologic predisposing factors, the association between diverticulosis and colon polyps remains unclear and needs better clarification. The primary aim of our study is to evaluate if there is any association between diverticular disease and colorectal polyps. This is a retrospective cohort study. All consecutive patients who underwent colonoscopy between January 2009 and December 2011 were included, except those with history of inflammatory bowel disease, polyposis syndrome, and poor bowel preparation. Univariate and multivariate logistic regression analysis was conducted to analyze the association between colon polyps and diverticulosis. Hyperplastic polyps were excluded from the statistical analysis, and only pre-cancerous adenomas were included. A total of 2,223 patients met the inclusion criteria. The prevalence of colorectal polyps in patients with diverticulosis was significantly higher than those without diverticulosis (odds ratio (OR) 1.54; 95 % confidence interval (CI) 1.27-1.80, p = 0.001). This association was found significant for all locations of polyps and all histological subtypes. There was also a statistically significant association between age, presence of diverticulosis, and colorectal polyps (OR 1.03; 95 % CI 1.02-1.04). The incidence of colorectal polyps increases as age advances in patients with diverticulosis, with the highest association in patients >70 years of age (OR 3.55; 95 % CI 2.50-5.04). There was no significant association between indication for colonoscopy and presence of colorectal polyps in patients with diverticulosis (OR 0.98; 95 % CI 0.95-1.01). The incidence of diverticulitis was low (<1 %), and there was no association between diverticulitis and colon polyps. There is a significant association between diverticulosis and synchronous pre-cancerous colorectal polyps (adenomas). Patients with diverticulosis have a higher risk of colorectal polyps as compared to those without. This observation needs further validation by a large prospective cohort study.

Screening colonoscopy in first-degree relatives of patients with colorectal cancer.

Colorectal cancer (CRC), one of the most important causes of morbidity and mortality, has earned the attention of healthcare systems widely. Screening programs are designed to detect patients at risk as effectively as possible. One of the major CRC risk factors is having a family member with diagnosed CRC. To investigate the association between presence of polyps on colonoscopy and family history of CRC. This was a retrospective cohort study in which the data was collected from colonoscopy reports of patients with/without familial history of CRC in Masoud private clinic, Tehran, Iran from October 1, 2011 to October 1, 2012. The association between presence of colorectal polyps on colonoscopy and family history of CRC was then assessed. A total of 210 patients were included in the study, constituting two groups with/without familial history of CRC with a 1:1 ratio (105 subjects in each group). Compared to subjects with a negative family history of CRC, a 2.7-fold (CI 95%: 1.2-6.24) fold increase was observed in those with a positive family history to have colorectal polyps. In multivariate regression analysis, family history of CRC was the only independent variable associated with presence of colorectal polyps (odds ratio: 3.12, CI 95%:1.22-8). A positive family history of CRC is a risk factor for colorectal polyps.

Colorectal Polyps in Urban Multiethnic Asian Population as Compared to Other Ethnicities during Screening Colonoscopy

Purpose: To find out the demographics, prevalence, and histology of colorectal polyps in multiethnic Asian population living in the urban area as compared to other ethnicities. Methods: Retrospective chart review identifying patients who had screening colonoscopy done for average risk of colon cancer during the year of 2012 at Thomas Jefferson University Hospital and its Methodist division in Philadelphia. High-risk patients like patients with inflammatory bowel disease (IBD), family history of colon cancer, familial adenomatous polyposis (FAP) coli, and hereditary non-polyposis colon cancer (HNPCC) syndrome, or with any genetic risk factor for colon cancer were excluded from the study. Data included patients' age, sex, race, presence of colorectal polyps, and their histology. These data was analyzed in computer software (SPSS). Each ethnicity was compared to Caucasians for all variables. Results: Total number of patients included in this study was 1,001. Out of these patients, 567 were Caucasians, 319 were African Americans, 37 were Hispanics, and 78 were Asians. Colon polyp was detected in 200 Caucasians, 92 African Americans, 14 Hispanics, and 18 Asians. The number of polyp was similar among different ethnicities, except in Asians who had significantly lower number of polyp than Caucasians (0.9 vs. 0.4; p=0.01). The age was similar (mean 58 years) in each group. In Asians, 38.5% were male, in Caucasians 42.3%, in African Americans 39.4%, and in Hispanics 8.1%. Many patients had more than one histology of polyps. Histologically, tubular adenoma was found in 19.4% of Caucasians, 14.1% of African Americans, 8% of Hispanics, and 6% of Asians. Hyperplastic polyp was found in 15.7% of Caucasians, 12.2% of African Americans, 10.8% of Hispanics, and 12.8% of Asians. Serrated adenoma was found in 1.1% of Caucasians and 1.6% of African Americans. Tubulovillous adenoma was found in 0.9% of Caucasians. High-grade dysplasia was found in 0.4% of Caucasians. Colon cancer was found in 0.2% of Caucasians. Tubular adenoma was significantly less in Asians (p=0.01) and Hispanics (p=0.05) compared to Caucasians. Conclusion: Asians had significantly less number of colorectal polyp and tubular adenoma compared to Caucasians. Hispanic patients were female predominant unlike other ethnicities. Hispanics had less tubular adenoma than Caucasians. Further larger study is warranted to investigate these phenomena.

Inverse associations between serum concentrations of zeaxanthin and other carotenoids and colorectal neoplasm in Japanese

To investigate the associations between serum concentrations of carotenoids and the presence of colorectal polyps and cancers in Japanese using a cross-sectional study. 893 subjects who underwent colorectal endoscopy between 2001 and 2002 provided serum samples and information on lifestyle factors. Serum concentrations of six carotenoids were compared among patients with polyps, cancers, and controls. In males, high serum zeaxanthin was associated with decreased rates of polyps [odds ratio (OR) = 0.48, 95 % confidence interval (CI) 0.27-0.87] and cancer (OR = 0.35, 95 % CI 0.12-1.06), adjusting for age, body mass index, serum cholesterol, smoking status, and alcohol intake. In females, zeaxanthin (OR = 0.25, 95 % CI 0.07-0.82), lutein (OR = 0.30, 95 % CI 0.10-0.94), alpha-carotene (OR = 0.30, 95 % CI 0.10-0.90), and beta-carotene (OR = 0.27, 95 % CI 0.09-0.85) showed significant inverse associations with cancer development. These associations were consistent with findings of inverse associations between the ingestion of green-yellow vegetables (OR = 0.44, 95 % CI 0.23-0.84), carrots and pumpkins (OR = 0.46, 95 % CI 0.25-0.86), and fruits (OR = 0.53, 95 % CI 0.30-0.94) and polyp in males, and between carrots and pumpkins (OR = 0.30, 95 % CI 0.09-0.99), legumes (OR = 0.14, 95 % CI 0.04-0.44), and seaweed (OR = 0.23, 95 % CI 0.07-0.75) and cancer development in females. These results provide further support for the protective effects of carotenoids contained in green-yellow vegetables and fruits against colorectal neoplasm in Japanese.

The Effect Of Cardiopulmonary Fitness On Colorectal Polyps Incidence

PURPOSE: The results of previous epidemiologic studies showed that dietary and life style factors are associated with colon polyps. Physical activity is associated with a reduced risk of colon cancer, but the effect of activity on colorectal adenomas, which are precursors to colon cancer, is uncertain. Despite the high prevalence of colon polyps, little is known about its risk factors in Korean male adults. The aim of this study was to investigate the relationship between cardiopulmonary fitness(VO2max) and the presence of colorectal polyps. METHODS: In 1075 subjects aged between 40 and 60years, colonoscopy was performed at Asan Medical Center Health Promotion Center(HPC) from October 2005 to august 2007. All subjects were identified on routine checkup at the HPC. We selected data from subject who did stress test with gas analyzer on the treadmill for cardiopulmonary fitness(VO2max). For getting Odds ratio between fitness level and incidence of polyps, we classified fitness level to quartile. Also, we compared fitness level with polyp size above 0.5cm and smaller. All data were evaluated retrospectively. Drinking, smoking and other confounding factors were assessed by self-administered questionnaire. After adjusting for age, sex, physical activity, obesity, and total energy intake, data was analyzed by logistic regression. RESULTS: For the incidence of polyps and cardiopulmonary fitness(VO2max), the incidence rate was lowered with subjects who had High fitness in their fourties but fifties and sixties. The Odds ratio was 2.124(CI:1.105-4.084, P=0.024) in the lower fitness group(lower 25 percentile) compared with high fitness group(upper 25 percentile group). Also, we evaluated relationship between polyps size above 0.5cm and Cardiopulmonary fitness. We could get the same result as polyps incidence ratio at only fourties. Unfourtunately, no significance was detected from age fifties and sixties. CONCLUSIONS: High cardiopulmonary fitness is associated with a reduced incidence of colorectal polyps among Korean adult men during their fourties