Risk Factors For 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.

Characteristics and risk factors for colorectal polyps among children in an urban area of Wenzhou, China: a retrospective case control study

BackgroundScarce evidence exists on pediatric colorectal polyp risk factors. This study explored the clinical manifestations, morphological and pathological characteristics of, and risk factors for pediatric colorectal polyps.MethodsThis retrospective case-control study included children who received colonoscopy, divided into a colorectal polyp group and a normal control group based on colonoscopy results. The risk factors for colorectal polyps in children were analyzed through logistic regression analysis.ResultsThe mean age of children with polyps was 6.77 ± 3.44 years. Polyps were detected predominantly in males (72.9%); hematochezia was the primary clinical manifestation (80.25%). Most polyps were juvenile (88.9%) and solitary (87.7%); 50.6% were located in the rectosigmoid area. Univariate analysis showed that gender (P = 0.037), age (P < 0.001), family aggregation (P < 0.001), specific immunoglobulin E (sIgE) (P < 0.001), platelet count (P = 0.001), aspartate aminotransferase (AST) (P = 0.016), meat intake (P = 0.010), and vegetable intake (P < 0.001) were significantly associated with colorectal polyps. Age ≤ 6 years (3–6 years: OR: 26.601, 95% CI: 3.761–160.910; < 3 years: OR: 22.678, 95% CI: 1.873–274.535), positive family aggregation (OR: 3.540, 95% CI: 1.177–10.643), positive sIgE (OR:2.263, 95% CI: 1.076–4.761), and higher meat intake (OR:1.046, 95% CI: 1.029–1.063) were risk factors for pediatric colorectal polyps in logistic regression analysis. Higher vegetable intake (OR: 0.993, 95% CI: 0.986–1.000) was a protective factor against pediatric colorectal polyps. The area under the curve (AUC) of meat intake in the receiver operating characteristic (ROC) curve analysis for predicting colorectal polyps was 0.607; the best cut-off value was 92.14 g/d (P = 0.010, 95% CI: 0.527–0.687). The meat and vegetable intake combination AUC in predicting pediatric colorectal polyps was 0.781 (P < 0.001, 95% CI: 0.718–0.845).ConclusionsJuvenile, solitary, and located in the rectosigmoid region polyps are most common in children. Hematochezia is the main clinical manifestation. Most polyps were, but multiple and proximally located polyps were also detected. Age ≤ 6 years, especially 3–6 years, positive family aggregation, positive sIgE, and higher meat intake are risk factors for pediatric colorectal polyps. A higher vegetable intake is a protective factor.

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.

Predictors for Colorectal Polyps in an Asymptomatic Population Undergoing Medical Check-ups.

Colorectal cancer primarily arises from colorectal polyps. Early screening and removal is beneficial, especially in asymptomatic populations. This research aimed to reveal the risk factors detected in medical check-ups for colorectal polyps in asymptomatic people. Clinical data of 933 asymptomatic people who underwent colonoscopies from May 2014 to December 2021 was analyzed retrospectively. Data included sex, age, colonoscopy findings, polyp pathology, polyp number, and blood test results. The distribution of colorectal lesions was analyzed. Participants were divided into control and polyp groups, adenomatous and non-adenomatous polyp groups, and single and multiple adenoma groups. Participants' age, proportion of males, carcinoembryonic antigen (CEA), uric acid and glycosylated hemoglobin levels were significantly higher (P≤0.05) in the polyp group. Age (>40y), sex (male), and CEA level (>1.435ng/mL) were independent risk factors for polyps. CEA, uric acid, carbohydrate antigen 19-9, triglyceride, and total cholesterol levels were significantly higher (P<0.05) in the adenoma group than in the non-adenomatous group. CEA level (>1.435ng/mL) was an independent predictor for adenomas (P<0.05). Participants' age, proportion of males, CEA, glycosylated hemoglobin, and fasting blood glucose levels were significantly higher (P<0.05) in the multiple adenoma group than in the single group; the high-density lipoprotein cholesterol level was lower (P<0.05). No independent risk factors were found for the number of adenomas. Serum CEA level (>1.435ng/mL) was independent risk factor for colorectal polyps. It may be conducive to improve discriminative ability of colorectal cancer risk stratification model.

Establishment of clinical predictive model based on the study of influence factors in patients with colorectal polyps.

Colorectal cancer (CRC) is the most common gastrointestinal malignancy and is generally thought to be caused by the transformation of colorectal polyps. It has been shown that early detection and removal of colorectal polyps may reduce the mortality and morbidity of colorectal cancer. Based on the risk factors associated with colorectal polyps, an individualized clinical prediction model was built to predict and evaluate the possibility of developing colorectal polyp. A case-control study was conducted. Clinical data were collected from 475 patients who underwent colonoscopy at the Third Hospital of Hebei Medical University from 2020 to 2021. All clinical data were then divided into training sets and validation sets by using R software (7:3). A multivariate logistic analysis was performed to identify the factors associated with colorectal polyps according to the training set, and a predictive nomogram was created by R software based on the multivariate analysis. The results were internally validated by receiver operating characteristic (ROC) curves, calibration curves, and externally validated by validation sets. Multivariate logistic regression analysis showed that age (OR = 1.047, 95% CI = 1.029-1.065), history of cystic polyp (OR = 7.596, 95% CI = 0.976-59.129), and history of colorectal diverticulums (OR = 2.548, 95% CI = 1.209-5.366) were independent risk factors for colorectal polyps. History of constipation (OR = 0.457, 95% CI = 0.268-0.799) and fruit consumption (OR = 0.613, 95% CI 0.350-1.037) were protective factors for colorectal polyps. The nomogram demonstrated good accuracy for predicting colorectal polyps, with both C index and AUC being 0.747 (95% CI = 0.692-0.801). The calibration curves showed good agreement between the predicted risk by the nomogram and real outcomes. Both internal and external validation of the model showed good results. In our study, the nomogram prediction model is reliable and accurate, which can help early clinical screening of patients with high-risk colorectal polyps, improve polyp detection rate, and reduce the incidence of colorectal cancer (CRC).

Awareness and Risk Factors of Colorectal Polys of Selected Adults in Imo State Nigeria

Background One of the greatest health issues in the world is colorectal cancer. It was formerly believed that this illness only affected residents of industrialized nations; however, recent research has shown a growing prevalence in underdeveloped nations. The majority of individuals in Nigeria report their cases at a stage when curative resection is not feasible; hence, increasing understanding and awareness of early symptoms as well as early detection techniques and screening tools have been highlighted as crucial for greater success. Aim This study elucidated the awareness, knowledge, and risk factors of colorectal polyps among studied adults aged 40–65 years of age in Imo State, Nigeria. Methods The sample of the study comprised a thousand (1000) adults drawn through a multistage sampling selection method and included urban and rural dwellers in selected communities in Imo State, Nigeria. A pre-tested, semi-structured questionnaire was the main instrument of data collection for awareness, knowledge, and risk factors for colorectal polyps. Statistical Package for Social Sciences (SPSS) Version 17 was used for analysis. Results Findings showed that more than half of the respondents (62.5%) were aware of colorectal polyps; however, factors such as lack of funds (34.8%), inaccessibility to screening services (24.0%), absence of screening facilities (24.5%), and passive behavior towards screening service providers (31.8%) in healthcare centers affected regular screening among participants. Respondents possessed good knowledge of colorectal polyps, although there is a need for thorough sensitization on the risk factors of colorectal polyps, especially lifestyle behaviors. People who smoked more cigarettes per day were found to be more likely to develop colorectal polyps (AHR 1.878; 95% CI 1.018–3.463; P = 0.044) than those who smoked less (AHR 1.811; 95% CI 1.003–3.270; P = 0.049). The study found that subjects with both smoking and drinking habits had a significantly higher risk for colorectal polyps (AHR 2.073; 95% CI 1.196–3.593; P = 0.009) than non-smokers and those who drank fewer alcoholic drinks. Conclusion Relevant educational and screening interventions are required to promote early detection and management of colorectal polyps among adults in Imo State, Nigeria.

Leveraging Natural Language Processing to Extract Features of Colorectal Polyps From Pathology Reports for Epidemiologic Study.

Histopathologic features are critical for studying risk factors of colorectal polyps, but remain deeply embedded within unstructured pathology reports, requiring costly and time-consuming manual abstraction for research. In this study, we developed and evaluated a natural language processing (NLP) pipeline to automatically extract histopathologic features of colorectal polyps from pathology reports, with an emphasis on individual polyp size. These data were then linked with structured electronic health record (EHR) data, creating an analysis-ready epidemiologic data set. We obtained 24,584 pathology reports from colonoscopies performed at the University of Utah's Gastroenterology Clinic. Two investigators annotated 350 reports to determine inter-rater agreement, develop an annotation scheme, and create a reference standard for performance evaluation. The pipeline was then developed, and performance was compared against the reference for extracting polyp location, histology, size, shape, dysplasia, and the number of polyps. Finally, the pipeline was applied to 24,225 unseen reports and NLP-extracted data were linked with structured EHR data. Across all features, our pipeline achieved a precision of 98.9%, a recall of 98.0%, and an F1-score of 98.4%. In patients with polyps, the pipeline correctly extracted 95.6% of sizes, 97.2% of polyp locations, 97.8% of histology, 98.3% of shapes, and 98.3% of dysplasia levels. When applied to unseen data, the pipeline classified 12,889 patients as having polyps, 4,907 patients without polyps, and extracted the features of 28,387 polyps. Tubular adenomas were the most common subtype (55.9%), 8.1% of polyps were advanced adenomas, and the mean polyp size was 0.57 (±0.4) cm. Our pipeline extracted histopathologic features of colorectal polyps from colonoscopy pathology reports, most notably individual polyp sizes, with considerable accuracy. This study demonstrates the utility of NLP for extracting polyp features and linking these data with EHR data to create an epidemiologic data set to study colorectal polyp risk factors and outcomes.

Relationship between endoscopic gastric abnormalities and colorectal polyps: a cross-sectional study based on 33439 Chinese patients.

Background: No study on the relationship between common abnormalities of the upper digestive tract and colorectal polyps (CPs) has been conducted. Methods: 33439 patients were enrolled in this cross-sectional study, of which 7700 had available Helicobacter pylori (H.pylori) information. All participants underwent colonoscopy and esophagogastroduodenoscopy (EGD) simultaneously or within six months at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2015 to November 2021. The study assessed whether the risk of CPs was affected by the following gastroesophageal diseases: atrophic gastritis (AG), gastric polyps, Barrett's esophagus and reflux esophagitis, bile reflux, gastric ulcer, gastric mucosal erosion, superficial gastritis, and gastric H.pylori infection. The crude and adjusted odds ratios (ORs) of H.pylori on the occurrence of CPs were computed by logistic regression. Additionally, we also evaluated whether AG had an impact on the relationship between H.pylori infection and CPs. Results: A total of 10600 cases (31.7%) were diagnosed as CPs. Multivariate logistic analysis showed that age, male (OR, 1.80; 95% confidence interval [CI], 1.61 to 2.02), gastric polyps (OR, 1.61; 95% CI, 1.05 to 2.46 for hyperplastic polyps; OR, 1.45; 95% CI, 1.09 to 1.94 for fundic gland polyps), H.pylori infection (OR, 1.21; 95% CI, 1.07 to 1.37) and atrophic gastritis (OR, 1.38; 95% CI, 1.21 to 1.56) were independent risk factors for colorectal polyps. Moreover, the combined effect of H.pylori infection and AG was slightly greater than the sum of their individual effects on the risk of CPs, but there was no additive interaction between them. Conclusions: Gastric conditions including gastric polyps, H.pylori infection, and AG increased the risk of CPs. However, Barrett's esophagus and reflux esophagitis, bile reflux, erosive gastritis, gastric ulcer, and superficial gastritis might not have relationship with CPs occurrence.

Clinical Features of Fecal Immunochemical Test-Negative Colorectal Lesions based on Colorectal Cancer Screening among Asymptomatic Participants in Their 50s.

To improve the efficacy of colorectal cancer (CRC) screening, decreasing the occurrence of interval cancers is essential. Most interval CRCs develop from fecal immunochemical test (FIT)-negative CRC. This study examined the clinical characteristics of FIT-negative advanced neoplasms (AN) and sessile serrated lesions (SSL), which are main candidate precursors of FIT-negative CRC, and the eligibility criteria for total colonoscopy (TCS) screening following negative FIT. Asymptomatic participants in their 50s were divided into two groups. The FIT-negative group underwent TCS following negative FIT, and the TCS-only group underwent TCS without FIT. One endoscopist reviewed the endoscopic images. Plausible risk factors for colorectal polyps were extracted. The clinical features of AN and SSL were compared between the groups. Of 2,437 participants, 56.2% were included in the FIT-negative group. No between-group differences were recorded for the prevalence of different colorectal polyp types. By multivariate analysis, a significantly lower adjusted odds ratio (AOR) of AN was shown in women, and significantly higher AORs of AN were found for aging, smoking, and a family history of CRC. The AOR of SSL was higher for smokers. The proportion of AN in the right colon was higher in the FIT-negative group. No between-group differences were recorded for SSL. FIT screening was less likely to detect CRC and certain precancerous lesions in the right colon. Combining annual FIT with TCS for the high-risk population based on a scoring system, may detect FIT-negative CRC and colorectal polyps, thus, reducing interval cancer.

Difference in the prevalence of advanced colon adenoma between patients with gastric neoplasm and healthy people: A STROBE-compliant study.

We compared the prevalence of adenoma and cancerous colon polyps in patients undergoing endoscopic removal or gastric surgery for gastric adenoma or gastric cancer and in healthy individuals.The medical records of 707 patients with gastric neoplasm and 798 age- and sex-matched healthy subjects were retrospectively analyzed between January 2010 and July 2018. The clinicopathological characteristics, prevalence of colorectal neoplasm diagnosed by colonoscopy, and risk factors for colorectal polyps were also investigated.When comparing the two groups, the prevalence of overall colorectal polyps and its distribution was not different between the two groups (54.0% vs.49.5%, P = .079), whereas, the number of colon polyps (1.20 ± 1.71 vs 0.99 ± 1.54, P = .015) and the maximal size (3.53 ± 6.14 vs 2.08 ± 2.88, P < .001) were significantly larger in the gastric neoplasm group. The prevalence of advanced colon adenoma was significantly higher in the gastric neoplasm group (10.7% vs 3.8%, P < .001). Risk factors such as elevated glucose levels and the presence of gastric neoplasm were related to the prevalence of all colon polyps. The presence of gastric neoplasm is an important risk factor for advanced colon polyps.Patients with gastric neoplasms had a significantly higher prevalence of advanced colon adenoma. Advanced colon adenoma is associated with the chain from benign adenomas through malignant altered adenomas to advanced colon cancer. Thus, patients with gastric neoplasm are regarded as a high-risk group for colorectal cancer and are recommended for screening colonoscopy at the time of diagnosis.

The Relationship Between Colorectal Polyps and Serum Lipid Levels: A Systematic Review and Meta-analysis.

Colorectal polyp has been considered as the precancerous lesion of colorectal cancer, to which serum lipid levels are closely related. At present, there is no consensus on the relationship between colorectal polyps and serum lipid levels. We performed a meta-analysis to explore the effects of lipid levels on colorectal polyps. Relevant articles published from 2000 to 2020 were searched in PubMed, Web of Science, EMBASE, and Cochrane Library databases. The mean value and SD of serum lipid indexes and body mass index in colorectal polyps groups and control groups were extracted from the included articles. Combined weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated to assess the effect size of serum lipid levels on colorectal polyps. The publication bias of the included studies were assessed based on the Egger test. Thirty-seven articles containing 19,464 cases and 63,979 controls were included. There were no significant publication bias. The levels of high-density lipoprotein cholesterol in the cases were lower than those in the controls (WMD: -2.589 mg/dL, 95% CI: -3.273, -1.906). While the levels of triglyceride (WMD: 16.933 mg/dL, 95% CI: 13.131, 20.736), total cholesterol (WMD: 5.561 mg/dL, 95% CI: 3.477, 7.645), low-density lipoprotein cholesterol (WMD: 3.109 mg/dL, 95% CI: 0.859, 5.359) and body mass index (WMD: 0.747 mg/dL, 95% CI: 0.588, 0.906) were higher in the cases. Colorectal polyps were associated with serum lipid levels and obesity. Hyperlipidemia and obesity may be the risk factors for colorectal polyps.

Risk factors and correlation of colorectal polyps with type 2 diabetes mellitus.

Colorectal polyp is a common disease of the gastrointestinal tract, which is closely related to colorectal cancer. Diabetes mellitus (DM) is a major public health disease that seriously threatens human health. This study aimed to investigate the risk factors of colorectal polyps and its relationship with type 2 DM (T2DM). A total of 352 patients with colorectal polyps (diagnosed by colonoscopy) in our hospital from June 2018 to June 2020 were enrolled as the observation group, and 201 healthy people with normal colonoscopy results were selected as the control group. The levels of blood lipids, blood glucose, liver function, serum uric acid (UA), and glycosylated hemoglobin (HbA1c) were compared between the two groups. Univariate and multiple logistic regression analyses were performed to analyze the risk factors related to colorectal polyps. Compared to the control group, the levels of HbA1c, fasting plasma glucose (FPG), 2-hour post-meal blood glucose (2hPG), total cholesterol (TC), and serum UA in the observation group were significantly higher (P<0.05). Univariate analysis showed that the incidence of colorectal polyps was significantly correlated with gender, smoking, age, non-alcoholic fatty liver disease (NAFLD), and type 2 diabetes mellitus (T2DM) (P<0.05). Multiple Logistic regression analysis showed that gender (male), age (≥60 years), and T2DM were independent risk factors for colorectal polyps (P<0.05). Abnormal metabolic indices may be closely related to the development of colorectal polyps. Gender (male), age (≥60 years), smoking, NAFLD, T2DM, as well as increased blood glucose, UA, and TC were identified as the risk factors for colorectal polyps.

The predictive value of routine laboratory tests for colorectal polyps: a retrospective study

Colorectal cancer (CRC) has become the malignant tumor of the digestive tract with the highest incidence in our country, posing a serious threat to the health of our people. Early colon cancer is mostly due to the malignant transformation of colon polyps, so that early detection and resection have been shown to be effective in reducing the incidence and mortality of CRC. This study tried to investigate the related risk factors of and construct a predictive nomogram for colorectal polyps, providing meaningful guidance basis for risk stratification and screening. A total of 1,799 patients who underwent colonoscopies in the Health Management Centre of the Affiliated Hospital of Yangzhou University were recruited to this study. Univariate and multivariate logistic analyses were performed to determine the risk factors for colorectal polyps, and a predictive nomogram was constructed based on the multivariable model. We determined the predictive value of the nomogram by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analyses (DCAs). The logistic regression analysis showed that age (P<0.001), gender (P<0.001), eosinophil count (P=0.005), hemoglobin level (P=0.039), and LDL-C/HDL-C ratio (LHR; P<0.001) were independent predictors of the development of colorectal polyps. The above independent risk factors were incorporated, and an individualized nomogram model was successfully established. The C-index of the nomogram was 0.679 in our model, and with the bootstrap method, the prediction curve fit well with the ideal curve, suggesting that the prediction curve constructed in this study has good predictive ability. Age, gender, eosinophil count, hemoglobin level, and LHR are risk factors for the development of colorectal polyps. Establishing a nomogram prediction model for colorectal polyps is helpful for the early clinical screening of high-risk patients with colorectal polyps, improving the detection rate of polyps and reducing the incidence of colorectal cancer (CRC).

Hp-Positive Chinese Patients Should Undergo Colonoscopy Earlier and More Frequently: The Result of a Cross-Sectional Study Based on 13,037 Cases of Gastrointestinal Endoscopy.

BackgroundIn China, the prevalence and mortality of colorectal cancer (CRC) have always been high, and more than 95% of CRC cases have evolved from colorectal polyps (CPs), especially adenoma. Early detection and treatment of CPs through colonoscopy is essential to reduce the incidence of CRC. Helicobacter pylori (Hp) is regarded as a risk factor for gastritis and gastric cancer and may also be a risk factor for CPs and CRC. However, few studies based on vast clinical cases exist in China to clarify whether Hp is a risk factor for CPs and CRC, and whether Hp-positive patients need to undergo colonoscopy checks earlier. This article attempts to make up for that deficiency.MethodThis cross-sectional study was conducted based on 13,037 patients without a treatment history of Hp who underwent their first gastroscopy and colonoscopy simultaneously at The First Affiliated Hospital of Zhejiang Chinese Medical University from January 2018 to December 2019. Pearson χ2 test and logistic regression were used to determine whether Hp is a risk factor for CPs and CRC. Multifactor analysis of variance was used to define the impact of Hp on CPs prevalence with different ages, sexes.ResultsFor Chinese individuals, Hp is a risk factor for CPs and CRC. The odds ratio (OR) value are 1.228 (95% CI, 1.130 to 1.336) and 1.862 (95% CI 1.240-2.796), respectively. Hp-positive patients have a higher probability of multiple or large intestinal polyps. However, Hp infection does not increase the incidence of adenomas, nor does it affect the pathological type of adenomas. The OR of Hp on the risk of CPs was 1.432 (95%CI 1.275-1.608) for males but increased to 1.937 (95%CI 1.334-2.815) for those aged 35 to 40. For females, the results were similar.ConclusionsFor the Chinese, Hp is a risk factor for CPs and CRC (OR>1); the infection of Hp increased CPs risk in Chinese of all ages, especially aged 35-40, suggesting that Hp-positive patients should undergo colonoscopy frequently.

Relationship between insulin resistance, serum VCAM-1, FGF19, IGF-1 and colorectal polyps

Objective: To explore the relationship between insulin resistance, glucose and lipid metabolism related molecules and colorectal polyps. Methods: A total of 262 healthy people who underwent colonoscopy in Shandong cancer hospital from June 2019 to September 2020 were selected. The levels of serum vascular cell adhesion molecule-1 (VCAM-1), fibroblast growth factor 19 (FGF19), insulin like growth factor (IGF-1), fasting blood glucose and fasting blood insulin were detected by enzyme-linked immunosorbent assay (ELISA). Insulin resistance index (HOMA-IR) was calculated, and the influencing factors of occurrence, pathological type, size and number of polyps were analyzed. Results: Among 262 cases, 116 cases were polyp free, 113 cases were adenomatous polyp and 33 cases were inflammatory polyp. HOMA-IR, VCAM-1 and FGF19 in polyp group were 2.904±1.754, (334.415±139.573) ng/ml and (135.865±98.470) pg/ml, respectively, which were higher than 2.369±1.306, (302.480±99.946) ng/ml and(110.694±76.044) ng/ml in non-polyp group, respectively (P<0.05). Multivariate Logistic regression analysis showed that the gender (OR=4.269, 95%CI: 1.963-9.405) and FGF19 (77.0-131.4 pg/ml: OR=2.385, 95%CI: 1.155-4.926) were independent factors of colorectal polyps. The gender (OR=3.799, 95%CI: 1.650-8.748) and FGF19 (77.0-131.4 pg/ml: OR=2.290, 95%CI: 1.072-4.891) were independent factors of colorectal adenomatous polyps. The gender(OR=6.725, 95%CI: 1.853-24.410) and fasting plasma glucose (≥6.5 mmol/L: OR=0.047, 95%CI: 0.009-0.245) were independent factors of colorectal inflammatory polyps. The gender (OR=3.539, 95% CI: 1.293-9.689) was an independent factor for the occurrence of single polyp. The gender (OR=5.063, 95% CI: 2.048-12.515), FGF19 (77.0-131.4 pg/ml: OR=2.502, 95%CI: 1.102-5.681), fasting plasma glucose (≥6.5 mmol/L: OR=0.282, 95%CI: 0.095-0.839) were independent factors of multiple polyps. The gender (OR=3.416, 95% CI: 1.134-10.289) and fasting insulin (≥9.4 μU/ml: OR=9.480, 95% CI: 1.485-60.521) were independent risk factors for colorectal polyps<0.5 cm. The gender (OR=3.151, 95%CI: 1.244-7.984) and fasting plasma glucose (≥6.5 mmol/L: OR=0.310, 95%CI: 0.102-0.941) were independent risk factors for colorectal polyps with the size of 0.5-0.9 cm. The gender (OR=22.649, 95%CI: 4.154-123.485), age (55 to 64 years old: OR=4.473, 95%CI: 1.070-18.704; ≥65 years old: OR=5.815, 95%CI: 1.300-26.009), BMI (≥28 kg/m(2): OR=5.310, 95%CI: 1.224-23.032) and FGF19 (77.0-131.4 pg/ml: OR=7.474, 95%CI: 1.903-29.351) were independent factors for colorectal polyps with size ≥ 1.0 cm. Gender stratification analysis showed that FGF19 was an independent factor for the occurrence of male polyps (77.0-131.4 pg/ml: OR=6.109, 95%CI: 1.688-22.104) and adenomas (77.0-131.4 pg/ml: OR=6.401, 95%CI: 1.717-23.864). The age (55 to 64 years old: OR=3.783, 95%CI: 1.052-13.611) and VCAM-1 (≥352.8 ng/ml: OR=4.341, 95%CI: 1.142-16.493) were independent risk factors of female polyps. The age (55 to 64 years old: OR=5.743, 95%CI: 1.205-27.362, ≥65 years old: OR=6.885, 95%CI: 1.143-41.467), VCAM-1 (≥352.8 ng/ml: OR=6.313, 95%CI: 1.415-28.159) and IGF-1 (≥7.6 ng/ml: OR=5.621, 95%CI: 1.069-29.543) were independent factors of female adenoma. Conclusions: The occurrences of colorectal polyps and adenomatous polyps are related to insulin resistance and glucose and lipid metabolism. Serum FGF19 is an independent influencing factor for the occurrence of colorectal polyps and adenomatous polyps, and is a potential serological diagnostic marker and therapeutic target for colorectal polyps and adenomatous polyps.

Correlation of liver-to-spleen ratio on computed tomography with colorectal polyps.

Aim of the studyTo explore the correlation of the liver-to-spleen (L/S) ratio on computed tomography (CT) with colorectal polyps.Material and methodsConsecutive participants from Jinling Hospital Affiliated to Nanjing University who underwent routine biochemical tests, colonoscopies, and CT between January 2018 and December 2019 were selected. The L/S ratio on CT was used to measure the liver fat content. Colonoscopy findings were applied to create the polyp-free group and colorectal polyp group. All included subjects were also classified in the non-alcoholic fatty liver disease (NAFLD) group or the non-NAFLD group according to the CT (L/S) ratio to identify risk factors for colorectal polyps. All data were analysed with SPSS 25 software.ResultsAmong 481 participants, 27.8% (79/284) of the patients were diagnosed with NAFLD in the colorectal group, which was higher than the corresponding proportion of the polyp-free group [9.1% (18/197)]. In NAFLD patients, most adenomatous polyps were found in the transverse colon, and hyperplastic polyps were largely located in the rectum. Linear regression suggested that the CT (L/S) ratio correlated with the number of colorectal polyps and with the number of adenomatous polyps. After adjusting for confounding factors, multivariate analysis indicated that NAFLD was an independent risk factor for adenomatous polyps and hyperplastic polyps.ConclusionsA lower CT (L/S) ratio (higher liver fat content) was significantly correlated with a higher risk of colorectal polyps. This finding suggested that NAFLD patients with a reduced CT (L/S) ratio need to undergo colonoscopy examinations to detect high-risk colorectal polyps in a timely manner.

Prevalence and risk factors for colorectal polyps in a Chinese population: a retrospective study

The incidence of colorectal polyps is rising. Certain types of polyps are considered to be the precursor lesions for colorectal cancers. To investigate the prevalence and related factors of colorectal polyps in Chinese subjects, we first performed a cross-sectional study. A total of 3066 subjects were documented, and the prevalence of colorectal polyps was 18.1%. Then we evaluated the incidence and risk factors of polyps via a retrospective cohort study in the same population. 561 subjects who received at least twice surveillance colonoscopies with available reports during the study period and had no polyp at the first endoscopy were included in the retrospective cohort study, of whom 19.1% developed colorectal polyps. Regular smoking was independently associated with the presence and development of colorectal polyps. Further analyses indicated that polyps were associated with smoking status, daily cigarette consumption, and drinking habit. Moreover, smoking tends to be more relavent to rectal, small and single polyp. In conclusion, colorectal polyp is a common disease in China. Exploring the epidemiology and risk factors may improve the prevention of colorectal polyps, even colorectal cancer.

Risk Factors for Recurrent Colorectal Polyps.

The recurrence of colorectal polyps is caused by various factors and leads to the carcinogenesis of colorectal cancer, which ranks third in incidence and fourth in mortality among cancers worldwide. The potential risk factors for colorectal polyp recurrence have been demonstrated in multiple trials. However, an article that pools and summarizes the various results is needed. This review enumerates and analyzes some risk factors in terms of patient characteristics, procedural operations, polyp characteristics, and dietary aspects to propose some effective prophylactic measures. This review aimed to provide a reference for clinical application and guide patients to prevent colorectal polyp recurrence in a more effective manner.

Common habitual behaviors and synchronous colorectal cancer risk: a retrospective case-control study.

The association of habitual behaviors with the prevalence of synchronous colorectal cancer (sCRC) is unknown. Here, we investigated whether these behaviors, which are known risk factors for colorectal polyps, may be related to sCRC risk. We enrolled 17,093 patients who underwent cancer treatment between January 1995 and December 2016 and examined the association of age, sex, familial history of hereditary colorectal cancer (CRC), and status of three common habitual behaviors (smoking and alcohol and coffee consumption) with the prevalence of sCRC. Of the enrolled patients, 960 (5.6%) patients had sCRC. The independent risk factors for sCRC prevalence included advanced age, male sex, hereditary CRC, smoking, and daily alcohol consumption of more than one bottle (> 600mL). Contrary to these factors, daily coffee consumption of more than one cup seemed to provide a protection from sCRC. In the Kaplan-Meier test, the significantly worse 5-year overall survival (OS) was noted in smokers with stage 0-III CRC. The effect of alcohol consumption on 5-year OS was significant in stages II and III. Compared with those without daily coffee consumption, patients with daily coffee consumption had significantly higher 5-year OS in stages I (93.0% vs. 86.4%), II (87.1% vs. 77.2%), III (71.5% vs. 61.9%), and IV (18.0% vs. 13.0%). sCRC prevalence was significantly associated with habitual behaviors. Patients with smoking or with daily alcohol consumption of one bottle had higher sCRC prevalence than did those without these habits. Coffee consumption could be a protective factor for lowering sCRC risk.

Genetic impact of methylenetetrahydrofolate reductase (MTHFR) polymorphism on the susceptibility to colorectal polyps: a meta-analysis

BackgroundThere are several studies with inconsistent conclusions regarding the association between the rs1801133 and rs1801131 polymorphisms within the MTHFR (methylenetetrahydrofolate reductase) gene and colorectal polyp risk. This discrepancy led us to assess the genetic impact of the two polymorphisms on the susceptibility to colorectal polyps.MethodsA meta-analysis was carried out for quantitative synthesis. According to the inclusion/exclusion criteria, we retrieved, screened and selected all published articles related to colorectal polyps and the MTHFR rs1801133 and rs1801131 polymorphisms. The P value of association test, RRs (risk ratios) and 95% CIs (confidence intervals) were mainly produced.ResultsA total of twenty-three case-control studies were included from twenty-two eligible articles. Pooling the results of both rs1801133 and rs1801131 polymorphisms in the overall population suggested a nonsignificant association between colorectal polyp cases and controls, in that all P values in the test of association were larger than 0.05. Nevertheless, pooling results in the “UK” subgroup of rs1801131, comprising five studies (1257 cases/1407 controls), indicated an elevated risk in colorectal polyp cases in comparison with controls, under the genetic models of CC vs. AA (P = 0.032, RR = 1.27, 95% CIs = 1.02, 1.57) and CC vs. AA+AC (P = 0.036, RR = 1.27, 95% CIs = 1.02, 1.60).ConclusionThe C/C genotype of MTHFR rs1801131 is more likely to be a genetic risk factor for colorectal polyps in the UK region, although this finding should be verified with a larger sample size.