title: Predictors of advanced colorectal neoplasia at initial and surveillance colonoscopy after positive screening immunochemical faecal occult blood test.
abstract: BACKGROUND
  Characteristics such as gender and lifestyle are not taken in account in colorectal cancer screening and surveillance recommendations.
  
  
  OBJECTIVE
  To identify factors associated with advanced neoplasia at initial and surveillance colonoscopy.
  
  
  METHODS
  In this observational study, 750 individuals with positive faecal occult blood test, aged 50-74 years, underwent a first screening colonoscopy in 2007-2009. We collected anthropometric data as well as data on physical activity, smoking and drinking habits, fruit and vegetable consumption and low-dose aspirin use through a questionnaire.
  
  
  RESULTS
  At initial colonoscopy advanced neoplasia (n=399, 53.2%) was positively associated with age, male gender, smoking and alcohol drinking, and inversely associated with physical activity, fruit and vegetables consumption and long-term use of aspirin. These 7 factors were used to calculate a risk score, ranging from 0 (no unfavourable characteristics) to 7 (all unfavourable characteristics present), which was significantly associated with advanced neoplasia (odds ratio 1.55 for one point increase, P<0.01). Among the 372 adenoma patients who returned for follow-up surveillance colonoscopy, the score remained associated with advanced neoplasia (odds ratio 1.28 for one point increase, P=0.01).
  
  
  CONCLUSIONS
  Besides age and gender, modifiable factors such as lifestyle and aspirin use were associated with the risk of advanced neoplasia at initial and surveillance colonoscopy.
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. Electronic address: edoardo.botteri@ieo.it.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Botteri
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Milan, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Crosta
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy; Department of Statistics and Quantitative Methods, Unit of Biostatistics, Epidemiology and Public Health, University of Milan-Bicocca, Milan, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bagnardi
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Milan, Italy.
authors.forename: Darina
authors.initials: D
authors.lastname: Tamayo
authors.affiliation: Division of Pathology, European Institute of Oncology, Milan, Italy.
authors.forename: Angelica Maria
authors.initials: AM
authors.lastname: Sonzogni
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Roberto
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Milan, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: de Leone
authors.affiliation: Department of Surgery, New York Medical College, Valhalla, New York, United States.
authors.forename: Albert
authors.initials: A
authors.lastname: Lowenfels
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D004032:Diet / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer; D015444:Exercise; D005260:Female; D005638:Fruit; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D065840:Protective Factors; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D014675:Vegetables
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: Colonoscopy; Colorectal cancer; Lifestyle; Screening