title: Lifestyle and lifestyle-related comorbidities independently associated with colorectal adenoma recurrence in elderly Chinese people.
abstract: OBJECTIVE
  The purpose of this study was to determine the lifestyle and lifestyle-related comorbidities independently associated with colorectal adenoma (CRA) recurrence in elderly Chinese people.
  
  
  METHODS
  During the 5-year follow-up after the initial colonoscopy, participants aged >60 years with the diagnosis and removal of CRA underwent a complete surveillance colonoscopy, and 152 participants with CRA recurrence plus 152 participants free of recurrence were included in this analysis.
  
  
  RESULTS
  Participants with CRA recurrence were more likely to consume less vegetables and fruits, and more red meats compared with the control group (P<0.05 for all). Lifestyle-related comorbidities, including hypertension and nonalcoholic fatty liver disease (NAFLD), were more common in participants with CRA recurrence than in the control group (P<0.05 for all). In the multivariate analysis, pack-years of smoking were independently associated with an increased CRA recurrence (odds ratio [OR]: 1.03; P<0.05). Eating less vegetables (OR: 099; P<0.05) and fruits (OR: 0.98; P<0.05) was identified as a statistically independent factor influencing CRA recurrence, as was eating more red meats (OR: 1.01; P<0.05). Hypertension was also found to be a factor independently associated with an increased CRA recurrence (OR: 2.44; P<0.05). NAFLD had an independent association, with an increased CRA recurrence (OR: 3.43; P<0.05).
  
  
  CONCLUSIONS
  Smoking cigarettes, high consumption of red meats, low intake of fruits and vegetables, and the presence of hypertension and NAFLD were independently associated with an increased CRA recurrence in elderly Chinese people. This conclusion helps elderly Chinese people to make effective behavioral changes, such as smoking cessation, substitution of fruits and vegetables for red meats, and timely treatment of hypertension and NAFLD, to reduce CRA recurrence and colorectal cancer risk.
authors.affiliation: Department of Gastroenterology, Peking University Third Hospital, Beijing, People's Republic of China.
authors.forename: Adake
authors.initials: A
authors.lastname: Saiken
authors.affiliation: Department of Gastroenterology, Peking University Third Hospital, Beijing, People's Republic of China.
authors.forename: Fang
authors.initials: F
authors.lastname: Gu
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000368:Aged; D002681:China; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000601:surgery*; D015897:Comorbidity; D004032:Diet; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology*; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking
keywords: colorectal adenoma recurrence; elderly Chinese; lifestyle; lifestyle-related comorbidities