title: Risk and protective factors for development of colorectal polyps and cancer (Bulgarian experience).
abstract: OBJECTIVE
  Colorectal cancer takes third place among all malignancies in the Varna region. The present study aims to determine the typical and distinguishing risk and protective factors for colorectal polyps and cancer formation.
  
  
  METHODS
  166 patients with large bowel polyps and 107 patients with colorectal cancer were questioned, examined endoscopically and histologically. Logistic regression analysis was used to find a possible correlation between alimentary habits, way of life, and risk for colorectal polyps and cancer formation. The latter have been used to define a strategy for their prevention.
  
  
  RESULTS
  Our results showed that fried, preserved, and grilled meat, consumption of animal fats, sugar, and being overweight are positively associated with colorectal polyps. In contrast, consumption of fruit, vegetables, rye- and brown bread, green tea, vegetable food, yoghourt, vegetarian food, fish, lamb, hare, garlic, boiled food, and mineral water, have strong protective effect against large bowel polyps. We have confirmed the role of the well-known risk factors for colorectal cancer, and discovered an association between H. pylori infection, age, villous component in the adenomatous polyps, and family history for any neoplasia and large bowel carcinoma.
  
  
  CONCLUSIONS
  We suggest the following protective factors for CRC: vegetarian food, plant oil, rural life, aspirin intake, legumes, fish, fruit and vegetable consumption. We observe a similarity between the risk factors for colorectal polyps and cancer formation. They act simultaneously and depend on genetic predisposition. A combination of endoscopic treatment and correction of the alimentary factors could be used as a means of cancer prevention.
authors.affiliation: Clinic of Gastroenterology, MHAT "St. Marina", Medical University, Varna, Bulgaria. kotzev@mnet.bg
authors.forename: I
authors.initials: I
authors.lastname: Kotzev
authors.forename: M
authors.initials: M
authors.lastname: Mirchev
authors.forename: B
authors.initials: B
authors.lastname: Manevska
authors.forename: I
authors.initials: I
authors.lastname: Ivanova
authors.forename: M
authors.initials: M
authors.lastname: Kaneva
mesh_terms: D002031:Bulgaria; D003111:Colonic Polyps / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000453:epidemiology*; D012307:Risk Factors