The association of lifestyle and dietary factors with the risk for serrated polyps of the colorectum.
Some serrated polyps of the colorectum are likely preinvasive lesions, evolving through a newly recognized serrated pathway to colorectal cancer. To assess possible risk and protective factors for serrated polyps and particularly to explore differences in risk factors between polyps in the right and left colorectum, we pooled data from three large multicenter chemoprevention trials. A serrated polyp was defined broadly as any serrated lesion (hyperplastic, sessile serrated adenoma, "traditional" serrated adenoma, mixed adenoma) diagnosed during each trial's main treatment period of approximately 3 to 4 years. Using generalized linear regression, we computed risk ratios and 95% confidence intervals as measures of the association between risk for serrated polyps and demographic, lifestyle, and dietary variables. Of the 2,830 subjects that completed at least one follow-up exam after randomization, 675 (23.9%) had at least one left-sided serrated polyp and 261 (9.2%) had at least one right-sided lesion. In the left colorectum, obesity, cigarette smoking, dietary fat, total energy intake, and red meat intake were associated with an increased risk for serrated polyps. In the right colon, aspirin treatment was associated with a reduced risk and family history of polyps and folate treatment were associated with an increased risk for serrated polyps. Our results suggest that several common lifestyle and dietary variables are associated with risk for serrated polyps, and some of these may differ for the right and left colorectum.
Wallace
Kristin
K
Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hamsphire, USA.
Grau
Maria V
MV
Ahnen
Dennis
D
Snover
Dale C
DC
Robertson
Douglas J
DJ
Mahnke
Daus
D
Gui
Jiang
J
Barry
Elizabeth L
EL
Summers
Robert W
RW
McKeown-Eyssen
Gail
G
Haile
Robert W
RW
Baron
John A
JA
D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D015992:Body Mass Index; D002118:Calcium / Q000627:therapeutic use; D003111:Colonic Polyps / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D004032:Diet; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011230:Precancerous Conditions / Q000209:etiology / Q000473:pathology; D044469:Racial Groups; D016032:Randomized Controlled Trials as Topic; D012002:Rectal Diseases / Q000209:etiology* / Q000473:pathology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000975:Antioxidants; D001241:Aspirin; D002118:Calcium