Risk Of Colon Adenomas Research Articles

Patients with breast cancer may be at higher risk of colorectal neoplasia.

BackgroundThe risk of colorectal neoplasia in breast cancer survivors is unclear. This study aimed to determine the colonic adenoma detection rate (ADR) in patients with breast cancer.MethodsWe conducted a retrospective study of patients with breast cancer who underwent a colonoscopy between 2000 and 2017. A control group (n=3295), comprising cancer-free patients undergoing their first screening colonoscopy, was used for comparison.ResultsOf 62,820 breast cancer patients, 3304 met the inclusion criteria. The mean age at the time of first colonoscopy was 59 years. ADR was 55%; 1803 patients had adenomas. High-grade dysplasia was evident in 28% of polyps and invasive adenocarcinoma was detected in 172 patients (5%). The median time from breast cancer diagnosis to adenoma detection was 3 years. The ADR was 21% in patients aged <40 years (n=63) and 39% in patients aged 40-50 years (n=314). The ADR was 26% in patients <50 years with a body mass index (BMI) lower than 30 kg/m2 or no family history of colorectal cancer. Multivariate logistic regression analysis revealed that the following independent factors were associated with a greater risk of colon adenoma: older age, higher BMI, family history of colorectal cancer, and personal history of breast cancer.ConclusionsIn patients with breast cancer, the ADR was higher than the reported rates for the general population. Screening colonoscopy should be considered soon after breast cancer diagnosis in patients <50 years of age. Further prospective studies investigating our findings are warranted.

Prevalence and characteristics of colonic adenoma in mainland China.

Background and aimTo investigate the prevalence and characteristics of colonic adenoma and advanced colonic adenoma in a large group of patients in mainland China.Materials and methodsWe conducted a cross-sectional study on patients who had undergone colonoscopy examination in a university hospital in mainland China. Colonic adenomas and advanced adenomas were recorded.ResultsThe prevalence of polyps, adenoma, and advanced adenoma was 23.9%, 13.3%, and 3.5%, respectively. Age and sex were independent risk factors for the prevalence of adenoma and advanced adenoma. Polyp size was associated with an increased risk of both colonic adenoma (OR 1.50, 95% CI 1.44–1.56) and advanced adenoma (OR 2.78, 95% CI 2.55–3.03) after sex and age adjustment. Proximal colon polyps were a risk factor for adenoma (OR 1.41, 95% CI 1.20–1.66) and also associated with a significant reduction (44%) in risk of advanced adenoma (OR 0.56, 95% CI 0.36–0.86) compared to distal colon adenoma after sex and age adjustment. A screening indication was associated with a statistically significant decrease in the odds of prevalence of adenoma (OR 0.90, 95% CI 0.81–0.99) and advanced adenoma (OR 0.72, 95% CI 0.59–0.88) compared to a no-screening indication.ConclusionThe overall prevalence of adenoma was low in mainland China. It exhibited a varied pattern with respect to age and sex. Polyp size was a risk factor for both colonic adenoma and its transition to advanced adenoma. Proximal colon polyps were a risk factor for adenoma, but a protective factor for advanced adenoma compared to distal colon adenoma.

Adiponectin, Leptin, IGF-1, and Tumor Necrosis Factor Alpha As Potential Serum Biomarkers for Non-Invasive Diagnosis of Colorectal Adenoma in African Americans.

The potential role of adiponectin, leptin, IGF-1, and tumor necrosis factor alpha (TNF-α) as biomarkers in colorectal adenoma is not clear. Therefore, we aimed to investigate the blood serum levels of these biomarkers in colorectal adenoma. The case–control study consisted of serum from 180 African American patients with colon adenoma (cases) and 198 healthy African Americans (controls) at Howard University Hospital. We used ELISA for adiponectin, leptin, IGF-1, and TNF-α detection and quantification. Statistical analysis was performed by t-test and multivariate logistic regression. The respective differences in median leptin, adiponectin, IGF-1, and TNF-α levels between control and case groups (13.9 vs. 16.4), (11.3 vs. 46.0), (4.5 vs. 12.9), and (71.4 vs. 130.8) were statistically significant (P < 0.05). In a multivariate model, the odds ratio for adiponectin, TNF-α, and IGF-1 were 2.0 (95% CI = 1.6–2.5; P < 0.001), 1.5 (95% CI = 1.5(1.1–2.0); P = 0.004), and 1.6 (95% CI = 1.3–2.0; P < 0.001), respectively. There was a positive correlation between serum adiponectin and IGF-1 concentrations with age (r = 0.17, P < 0.001 and r = 0.13, P = 0.009), TNF-α, IGF-1, and leptin concentration with body mass index (BMI) (r = 0.44, P < 0.001; r = 0.11, P = 0.03; and r = 0.48, P < 0.001), respectively. Also, there was a negative correlation between adiponectin and leptin concentrations with BMI (r = −0.40, P < 0.001), respectively. These data support the hypothesis that adiponectin, IGF-1, and TNF-α high levels correlate with higher risk of colon adenoma and can thus be used for colorectal adenomas risk assessment.

Abstract A18: Association of anthropometric factors with risk of colorectal neoplasia in the Black Women's Health Study

Abstract Evidence for the association of anthropometric factors with colorectal neoplasms is limited for African Americans. Association of 6 anthropometric measures with the risk of both colorectal adenomas and colorectal cancer (CRC) in the ongoing Black Women's Health Study cohort was examined. Using a nested case-control design for the adenoma analyses, 954 cases of colorectal adenoma were compared with 3,816 controls without a colorectal polyp, matched on age and follow-up time. For the CRC analyses, 413 incident CRC cases were identified over a 16-year follow up (802,783 person-years). Cases of adenoma and CRC were verified by medical record review. We used multivariable logistic regression analyses (for adenoma) and Cox proportional hazards analyses (for CRC) that included anthropometric exposures and selected confounders. Among postmenopausal women, risk of adenoma increased by 10% (95% CI: 1.00, 1.22), 11% (95% CI: 1.01, 1.29), and 9% (1.00, 1.19) with 1 standard deviation increase in body mass index, waist circumference, and weight change since age 18 , respectively. Anthropometric factors were not associated with adenoma risk among premenopausal women. None of the anthropometric factors were associated with CRC risk among either pre- or postmenopausal women. Future research should attempt to replicate the modest association of obesity with colon adenoma risk but not CRC risk among postmenopausal African American women. Citation Format: Chiranjeev Dash, Lynn Rosenberg, Jeffrey Yu, Sarah Nomura, Julie Palmer, Lucile L. Adams-Campbell. Association of anthropometric factors with risk of colorectal neoplasia in the Black Women's Health Study [abstract]. In: Proceedings of the AACR International Conference: New Frontiers in Cancer Research; 2017 Jan 18-22; Cape Town, South Africa. Philadelphia (PA): AACR; Cancer Res 2017;77(22 Suppl):Abstract nr A18.

Synergistic Effect of Hyperglycemia and Helicobacterpylori Infection Status on Colorectal Adenoma Risk.

Both Helicobacter pylori and type 2 diabetes mellitus are possible risk factors for colon adenoma. The purpose of this study was to assess the interaction between H. pylori and hyperglycemia status on the risk of colon adenoma. This was a cross-sectional, retrospective study conducted at the MacKay Memorial Hospital, Taiwan. The study included 3943 subjects aged >40 years undergoing bidirectional gastrointestinal endoscopy on the same day between July 2006 and June 2015. All subjects had a gastric biopsy specimen tested for H. pylori. Colon adenoma with and without H. pylori infection at different hemoglobin A1c (HbA1c) levels. The prevalence of colorectal adenomas in patients who were H. pylori-positive and H. pylori-negative was 37.3% and 27.29%, respectively. Multivariate logistic regression analysis identified male sex, age, body mass index, H. pylori infection, and HbA1c ≥6.5% as independent risk factors for adenoma; use of hypoglycemic agents decreased this risk. The prevalence of adenoma was increased with elevated HbA1c levels regardless of H. pylori status. The odds ratio (OR) for adenoma was 1.44 (95% confidence interval [CI], 1.20 to 1.73) if H. pylori was present or 1.68 (95% CI, 1.05 to 2.70) in patients who were H. pylori-negative but had HbA1c ≥7.0%. If both conditions were present, the OR was 4.79 (95% CI, 2.92 to 7.84). A 1% increase in HbA1c was associated with an increased prevalence of adenoma by 42.4% in H. pylori-positive subjects. The combination of H. pylori infection and elevated HbA1c is associated with an increased risk of colon adenoma.

Abdominal obesity as the colorectal adenomas risk factor

Obesity is a risk factor for many diseases, including colorectal cancer. Aim: to study association of the constitutional features (height, weight, waist circumference) with detection of colon polyps on the screening colonoscopy. Materials and methods: Constitutional features (height, weight, waist circumference) of 145 patients were assessed with detection of colon polyps on the screening colonoscopy for the period from 2013to 2015. Exclusion criteria were: cancer of any location in history, surgery within the past two years, the inflammatory bowel diseases (Crohn's disease, ulcerative colitis), autoimmune diseases (rheumatoid arthritis, HIV, AIDS, SLE), diabetes, chronic liver or kidney disease, family polyposis. Results: the presence of adenomas (OR = 6.0 CI: 2,2-16,7); multiplicity of polyps (the possibility that there will be ≥ 3 polyps was 6.4, CI: 1,4-29,9) were significantly higher in obese patients than in those with normal weight. Subjects with a waist circumference in the highest tertile (>115 cm), were 4.6 times more likely to identify ≥ 3 polyps than those with waist circumference in the lowest tertile (<96 cm) . The probability of detection of adenomas in patients with a waist circumference in the highest tertile were 6.2 times higher than in the lowest tertile. Conclusions. Visceral obesity is associated with a morphological type and number of colon polyps. The presence of visceral obesity significantly increases the risk of colon adenomas. Increased visceral fat layer is an indication for colonoscopy especially of the right half of the colon examination. Screening colonoscopy should be recommended for the obese patients after 50 y.o. in order to diagnose adenomas of the colon and colorectal cancer.

Accelerated Premalignant Polyposis and Second Colon Cancers: Incriminating Immunosuppression, Radiotherapy, and Systemic Chemotherapy Agents.

Cancer survivors are known to be at increased risk for second primary cancers. In addition, immunosuppression and previous cancer treatments such as radiotherapy and systemic chemotherapy are linked with increased risk of both colonic adenomas and adenocarcinomas. We performed a systematic review searching for manuscripts discussing second colon cancers, accelerated polyposis, immunosuppression, radiation, and chemotherapy. We sought to identify a link between immunosuppression and increased risks specific to premalignant polyposis and second colon cancers. We identified multiple studies demonstrating associations between radiotherapy, systemic chemotherapy, and immunosuppression with a higher propensity for second colon adenomas and adenocarcinomas. When compared to the general population, these risks were more profound and the rate at which these second malignancies developed was significantly increased. We believe that timing for colonoscopic surveillance in these patients should be different from the general population in order to identify promptly these rapidly progressive neoplasms. Screening for second malignancies should be considered early after remission of the primary cancer is documented, especially when a prolonged survival or a cure is anticipated. We also recommend consideration be given to increasing the frequency of colonoscopy in these cohorts. Future studies are required in order to establish the optimal time interval for surveillance colonoscopy in these high-risk individuals.

Age as a Predictor of Colonic Adenoma Risk: A Community Study

Introduction: Age is an independent risk factor in developing colon cancer and colonic adenomas. Currently, the starting age of colon cancer screening for an average adult without family history or personal history of higher cancer risk begins at age 50 years. At our institution, we collected 4.5 years of colonoscopy quality data in a systematic fashion. We stratified the prevalence of colonic adenomas by age group, and we found the risk of colonic adenomas appears to increase with age in our community. The highest risk group was for those individuals from 70 to 79 years old. Methods: Since 2010, our group has been systematically collecting colonoscopy quality data. The variables include insertion time, withdraw time, number of adenomas found, number of hyperplastic polyps found, size of the largest adenoma found, indications, age, and gender. The adenoma detection rate (ADR) and descriptive statistics for each variable were computed by age group, where the age groups were defined as < 50 years, 50-59 years, 60-69 years, 70-79 years, and ≥ 80 years. Results: A total of 8384 data entries were collected. Table 1 and Figure 1 compare the prevalence of colonic adenomas across age groups.Figure 1Table 1: Adenoma Detection Rate (ADR) and Descriptive Statistics by Age GroupConclusion: The risk of developing colonic adenomas increases with age. Within our cohort, the ADR for those patients less than 50 years old was as high as 32.2%. The highest risk occurred for the age group 70-79 years, where the ADR was 69.1%. The number of adenomas, average size of the largest adenoma, scope insertion time, and scope withdraw time appeared to increase with age, as well. In selected patients, broadening the age category for colon cancer screening for the younger group may be equally important as the elderly group.

PTU-011 Impact of weight loss after bariatric surgery on adenoma detection rate in colonoscopy: a case control study

<h3>Introduction</h3> Studies have determined that a high Body Mass Index (BMI) is associated with an increased risk of colonic adenoma. There is a paucity of data on the impact of weight loss in morbidly obese populations and its effects on colonic adenoma detection rate (ADR). This study aimed to determine the impact of weight loss after bariatric surgery on the adenoma detection rate on colonoscopy. <h3>Method</h3> After IRB approval a retrospective review of prospectively collected data was performed for patients who underwent bariatric surgery between 2004–2012. Patients who had a colonoscopy after bariatric surgery were identified as cases. Controls included a random sample of patients who had a colonoscopy during the same timeperiod. They were matched by age and gender in 1:4 ratio of case to controls. Patients with poor bowel preparation or Ottawa score &gt;11 were excluded. Patient demographics, baseline BMI and BMI at colonoscopy, weight change, co-morbidities, type of bariatric surgery and presence/absence of adenoma or advanced adenoma (AA) were collected. Adenoma and AA detection rates were analysed by age (&lt;40; 40–49; 50–59; &gt;60 years) and compared between the two groups. AA was defined as tubular adenoma or serrated polyp ≥10 mm in diameter, villous features, high-grade dysplasia. Hyperplastic polyps ≥10 mm were classified as advanced adenoma. <h3>Results</h3> 194 cases and 797 controls were included (females 68%). The mean age of patients was 51.5 years. 62.3% of the patients underwent gastric bypass, 28.5% sleeve gastrectomy and 9.2% gastric band. Average decrease in BMI after bariatric surgery was 13 ± 5.5 kg/m². The median follow-up was 31.6 (2–107) months. The average BMI at the time of colonoscopy of the cases and controls was 32 ± 6 kg/m²and 27.4 ± 5.5 kg/m²respectively. There was no significant difference in adenoma and AA detection rate between groups analysed by age. Among those who underwent bariatric surgery, there was no relation between the occurrence of adenomas and BMI reduction; however the effect of BMI reduction on the occurrence of AA did approach significance. (P = 0.05). The time interval between bariatric surgery and colonoscopy was not related to the incidence of adenoma nor AA. <h3>Conclusion</h3> Despite the differences in BMI between the patients and controls we found no difference in adenoma or advanced adenoma detection. BMI reduction after bariatric surgery did not affect the presence of adenomas but may be associated with a significant decrease in the risk of developing AA. Further studies with large population data might be required to validate these findings. <h3>Disclosure of interest</h3> None Declared.

Risk Assessment of Folic Acid in Food Supplements

Risk Assessment of Folic Acid in Food Supplements

A cross-sectional study of global DNA methylation and risk of colorectal adenoma.

BackgroundThe methylation of DNA is recognized as a key epigenetic mechanism and evidence for its role in the development of several malignancies is accumulating. We evaluated the relationship between global methylation in DNA derived from normal appearing colon mucosal tissue and blood leukocytes, and colorectal adenoma risk.MethodsPatients, aged 40 to 65, scheduled for a screening colonoscopy were recruited. During the colonoscopy, two pinch biopsies of healthy, normal appearing mucosa were obtained from the descending colon. A fasting blood sample was also collected. The methylation status of LINE-1 (long interspersed nuclear element-1) repetitive sequences, as a surrogate measure of global methylation, was quantified in DNA extracted from normal colon mucosa and blood leukocytes. Statistical analysis of the relationship between global DNA methylation and adenoma risk was conducted on 317 participants, 108 subjects with at least one pathologically confirmed adenoma and 209 subjects with a normal colonoscopy.ResultsA statistically significant inverse relationship was observed between LINE-1 methylation in colon tissue DNA and adenoma risk for males and for both sexes combined for the lowest methylation quartile compared to the highest (adjusted ORs = 2.94 and 2.26 respectively). For blood, although the overall pattern of odds ratio estimates was towards an increase in risk for lower methylation quartiles compared to the highest methylation quartile, there were no statistically significant relationships observed. A moderate correlation was found between LINE-1 methylation levels measured in tissue and blood (Pearson correlation 0.36).ConclusionsWe observed that lower levels of LINE-1 DNA methylation in normal appearing background colon mucosa were associated with increased adenoma risk for males, and for both sexes combined. Though these findings provide some support for a relationship between LINE-1 DNA methylation in colon mucosal tissue and adenoma risk, large prospective cohort studies are needed to confirm results. Until such investigations are done, the clinical usefulness of LINE-1 methylation as a biomarker of increased adenoma risk is uncertain. Regardless, this study contributes to a better understanding of the role of global DNA methylation as an early event in CR carcinogenesis with implications for future etiologic research.

Sa1444 Does Insulin Influence the Risk of Colon Adenomas and Colorectal Cancer? a Multicenter Look At a Minority Population

Epidemiological and experimental studies suggest that type 2 DM is associated with increased risk for Colorectal Cancer (CRC). Hyperinsulinemia, either endogenous or exogenous, has been proposed to increase CRC risk. High levels of insulin induce colonic cell proliferation and reduce apoptosis by increasing the bioavailability of IGF-1. Although a large cohort study found that insulin use was not associated with a substantially increased risk of CRC, more recently it has been suggested that exogenous insulin was associated with increased risk of CRC and colorectal adenomas among patients with type 2 diabetes on insulin therapy compared with noninsulin users, On the other hand, a significant reduction of colorectal cancer risk was observed in insulin-treated patients after adjusting for confounders.

Tu1489 Distinctive Metachronous Adenoma Characteristics Are Observed in Obese Patients

Several authors have assessed the link between obesity and colon adenoma risk. Moreover, it has been reported that obesity could increase the risk of proximal adenoma development, suggesting that obese patients may have a distinctive pattern of adenoma recurrence.

Duodenal Adenomas Coincide with Colorectal Neoplasia

Small case series have alluded to an association between sporadic duodenal adenomas and colorectal neoplasia. The strength of the association remains uncertain. This case-control study was designed to test this association in a large national pathology database. This study, performed at Miraca Life Sciences, a specialized pathology laboratory that receives gastrointestinal biopsy specimens from outpatient centers throughout the US, included all subjects who underwent a bidirectional endoscopy with biopsy results from both procedures between January 2008 and December 2011. The association between duodenal and colonic neoplasms was investigated using odds ratios (OR) and their 95 % confidence intervals (CIs) derived from univariate and multivariate analyses. There were 203,277 patients who underwent bidirectional procedures within the study period (mean age 58 years, 58 % females). Duodenal adenomas were present in 537 patients (median age 65 years, 51 % females; OR for male sex 1.34, 95 % CI 1.13-1.59). Hyperplastic colon polyps were present in 30,205 and colon adenomas in 85,801 patients. Hyperplastic polyps were more common in patients with duodenal adenomas (1.45, 1.07-1.95). Patients with duodenal adenomas also had a significantly greater prevalence of all types of colonic adenomas (2.65, 2.16-3.25), particularly of advanced adenomas (4.30, 3.24-5.70) and colorectal cancer (3.13, 1.38-7.12). Duodenal adenomas were associated with an equally increased risk for left and right colon adenomas. Patients with duodenal adenomas harbor an increased risk for any type of colonic neoplasm. This association may provide new insights into the general mechanisms underlying mucosal proliferation in the gastrointestinal tract.

BMI and the risk of colorectal adenoma in African-Americans.

ObjectivesObesity is associated with the activation of the molecular pathways that increase the risk of colorectal cancer. Increasing body mass index may accelerate the development of adenomatous polyps, the antecedent lesion of colorectal cancer. The aim of this study was to assess the BMI effect on the risk of colonic polyp and adenoma in African American.Design and MethodsWe examined the records of 923 patients who underwent colonoscopy. Demographic and clinical data were collected before colonoscopy. Polyp and adenoma diagnosis were confirmed by pathology examinations.ResultsOverall, 43% of the patients were male, median age was 57 years and 77% had BMI≥25.0 kg/m2. The frequency of colorectal polyps and adenomas were 61% and 35%, respectively. BMI≥25.0 (OR=1.61, 95%CI=1.14-2.26), smoking (OR=1.61, 95%CI=1.15-2.26) and history of colon polyps (OR=1.64, 95%CI=1.09-2.47) were associated with higher risk of colon polyp. BMI≥25.0 (OR=1.81, 95%CI=1.24-2.62), age (OR=1.04, 95%CI=1.02-2.05 for each year), male gender (OR=1.38, 95%CI=1.02-1.86), and smoking (OR=1.73, 95%CI=1.23-2.42) were associated with higher risk of colon adenoma.ConclusionMale and overweight African Americans are at higher risk of colorectal adenoma. The findings of this study could be applied for risk stratification and modifying the colorectal cancer prevention including screening guideline in African Americans.

Type 2 Diabetes and the Risk of Colorectal Adenomas: Black Women's Health Study

Evidence for the association of type 2 diabetes mellitus (DM) with colorectal neoplasms is contradictory, and African Americans have been underrepresented in the studies published to date. In a nested case-control study (1995-2009), we examined DM and insulin therapy as risk factors for colorectal adenomas in African American women enrolled in the ongoing Black Women's Health Study. From women reporting ever having undergone a gastrointestinal endoscopy, 917 cases of colorectal adenoma were compared with 2,751 controls without a colorectal polyp, matched on age and follow-up time. Cases were verified by medical record review. We used multivariable logistic regression analyses that included DM exposures and selected confounders. There were no overall associations between DM and adenoma risk or between insulin use and adenoma risk. However, DM without insulin use was inversely associated with risk of colon adenomas (odds ratio (OR) = 0.71, 95% confidence interval (CI): 0.52, 0.97) but not rectal adenomas. DM was inversely associated with adenoma risk in women older than 55 years (OR = 0.64, 95% CI: 0.44, 0.91) but not in women 55 years or younger (OR = 1.24, 95% CI: 0.81, 1.89). Future research should attempt to replicate the unexpected inverse association of DM with colon adenoma risk among older African American women.

The Effects of Vitamin D and Smoking Status on the Risk of Colonic Adenomas: A Retrospective Study in an Ethnically Diverse Community

The Effects of Vitamin D and Smoking Status on the Risk of Colonic Adenomas: A Retrospective Study in an Ethnically Diverse Community

Risk of colorectal polyps in patients with sporadic gastric polyps: A case-control study

To assess the risk of colonic polyps, adenomas and advanced neoplastic lesions (ANL) in patients with sporadic gastric polyps, especially those with fundic gland polyps (FGP). Clinical records of patients who had performed an upper and a lower digestive endoscopy between September 2007 and August 2008 were retrospectively analyzed. A case-control study was carried out, calling patients with gastric polyps as "cases" and patients without gastric polyps as "controls". The risk of colonic polyps, adenomas and ANL (villous component ≥ 25%, size ≥ 10 mm, or high grade dysplasia) was assessed [odds ratio (OR) and its corresponding 95%CI]. Two hundred and forty seven patients were analyzed: 78 with gastric polyps (cases) and 169 without gastric polyps (controls). Among the cases, the majority of gastric polyps were FGP (80%, CI: 69-88) and hyperplastic (20%, CI: 12-31); 25% had colonic polyps (25% hyperplastic and 68% adenomas, from which 45% were ANL). Among the controls, 20% had colonic polyps (31% hyperplastic and 63% adenomas, from which 41% were ANL). The patients with sporadic FGP had an OR of 1.56 (CI: 0.80-3.04) for colonic polyps, an OR of 1.78 (CI: 0.82-3.84) for colonic adenomas, and an OR of 0.80 (CI: 0.21-2.98) for ANL. Similar results were found in patients with gastric polyps in general. The results of this study did not show more risk of colorectal adenomas or ANL neither in patients with sporadic gastric polyps nor in those with FGP.

No Association between Circulating Levels and Genetic Variants of IL-6 and TNF-α and Colon Adenoma

BackgroundInterleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α), two important inflammatory cytokines, have been inconsistently associated with risk of colon neoplasia in epidemiological studies. However, research to date has not adequately assessed whether race-specific differences may exist in associations between biomarkers and genetic variants of these cytokines and colorectal adenoma - the precursor lesions of colorectal cancer. We sought to determine whether circulating levels of IL-6 and TNF-α, or genetic polymorphisms in IL-6and TNF-α were associated with colon adenoma and if so, whether that association differed by race.MethodsWe analyzed the associations of circulating levels and single nucleotide polymorphisms (SNPs) of IL-6 and TNF-α with risk of colon adenomas in a colonoscopy -based case-control study of 401 incident adenoma cases and 1,050 controls. We used multivariate unconditional logistic regression models to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for levels or genotypes (log additive models) of IL-6 and TNF-α.ResultsCompared to the bottom tertile of IL-6, the adjusted ORs were 1.06 (0.75 - 1.44) and 1.01 (0.72 - 1.40), respectively for the 2nd and 3rd tertiles (Ptrend = 0.10); the corresponding ORs for TNF-α were: 0.85 (0.63 - 1.15) and 1.01 (0.75 - 1.36), respectively (Ptrend = 0.39). Race-stratified analyses did not reveal any significant associations. There were also no statistically significant associations between IL-6 and TNF-α SNPs and colon adenoma.ConclusionsOur results do not support pre-diagnostic levels of IL-6, TNF-α or their genetic variants as significant risk factors for the development of colon adenoma.

Gallstones Are Associated with Colonic Adenoma: A Meta‐analysis

Increased levels of secondary bile acids after gallstone disease and cholecystectomy are believed to increase the risk of colorectal cancer. It remains unclear whether there is a similar risk of developing adenomas. The aim of this meta-analysis was to determine the risk of developing colonic adenomas following gallstone disease or cholecystectomy. The study was based on a systematic search of PubMed, MEDLINE, EMBASE, and Current Contents (1950-2012). Selection criteria were developed to sort for studies exploring the relationship between cholelithiasis, cholecystectomy, and colonic adenoma in an adult population. A random-effects model was used to generate pooled odds ratios (OR) and 95 % confidence intervals (CI). Publication bias and heterogeneity were assessed. Of the 1,276 studies identified, 14 were suitable for final analysis. There were 253,059 subjects in total, 42,543 of whom were diagnosed with colonic adenoma, and 28,281 of whom had gallstones or underwent cholecystectomy. There was a significant risk of developing colonic adenoma if gallstones were present (OR = 2.26; 95 % CI = 1.83-2.81). A risk was also seen with cholecystectomy (OR = 1.15; 95 % CI = 1.04-1.26), but this risk was negated when only adjusted odds were selected (OR = 1.01; 95 % CI = 0.91-1.12). No publication bias and only low levels of heterogeneity existed. Gallstones increase the risk of colonic adenoma. No association exists with cholecystectomy.