title: Role of life events in the presence of colon polyps among African Americans.
abstract: BACKGROUND
  African Americans have disproportionately higher incidence and death rates of colorectal cancer among all ethnic groups in the United States. Several lifestyle factors (e.g. diet, physical activity and alcohol intake) have been suggested as risk factors for colorectal cancer. Stressful life events have also been identified as risk factors for colorectal cancer. The association between stressful life events and colon polyps, which are precursors of colorectal cancer, has yet to be determined.
  
  
  METHODS
  In this cross-sectional study, 110 participants were recruited from a colon cancer screening program at Howard University Hospital. Participants completed an 82-item Life Events Questionnaire (Norbeck 1984), assessing major events that have occurred in the participants' life within the past 12 months. Participants also reported whether the event had a positive or negative impact. Three scores were derived (total, positive, and negative).
  
  
  RESULTS
  Total life events scores were higher (Median [M] = 29 and Interquartile range [IQR] = 18-43) in patients with one or more polyps compared to patients without polyps (M, IQR = 21,13-38; P = 0.029). Total, positive or negative Life Events scores did not differ significantly between normal and adenoma patients. Total, negative and positive Life Events scores did not differ between patients who underwent diagnostic colonoscopy (symptomatic) and patients who underwent colonoscopy for colon cancer screening (asymptomatic) and patients for surveillance colonoscopies due to a personal history of colon polyps. Linear regression analysis indicated that male gender is associated with 9.0 unit lower total Life Events score (P = 0.025).
  
  
  CONCLUSIONS
  This study suggests that patients who experienced total life events may be at higher risk of having colon polyps and adenomas which indicates an association between stress and the development of colorectal polyps.
authors.forename: Hassan
authors.initials: H
authors.lastname: Ashktorab
authors.forename: Hassan
authors.initials: H
authors.lastname: Hassanzadeh Namin
authors.forename: Teletia
authors.initials: T
authors.lastname: Taylor
authors.forename: Carla
authors.initials: C
authors.lastname: Williams
authors.forename: Hassan
authors.initials: H
authors.lastname: Brim
authors.forename: Thomas
authors.initials: T
authors.lastname: Mellman
authors.forename: Babak
authors.initials: B
authors.lastname: Shokrani
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Holt
authors.forename: Adeyinka O
authors.initials: AO
authors.lastname: Laiyemo
authors.forename: Mehdi
authors.initials: M
authors.lastname: Nouraie
mesh_terms: D000236:Adenoma / Q000453:epidemiology / Q000208:ethnology*; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D003111:Colonic Polyps / Q000453:epidemiology / Q000208:ethnology*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000208:ethnology*; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires