How significant is the association between metabolic syndrome and prevalence of colorectal neoplasia?
The incidence and prevalence of metabolic syndrome (MS) and colorectal cancer (CRC) has been rising in developed countries. The association between these two diseases has been widely studied and reported. Less evidence is available about the relationship between MS and CRC precancerous lesions (adenomatous polyps, adenomas). The aim of this paper is to present an overview of our scientific understanding of that topic and its implication in clinical practice. One of the principal goals of current CRC secondary prevention efforts is to detect and remove the precancerous lesions in individuals with an average CRC risk to prevent the development of invasive cancer. MS is not currently considered a high-risk CRC factor and is therefore not included in the guidelines of organized screening programs. However, in light of growing scientific evidence, the approach to patients with MS should be changed. Metabolic risk factors for the development of adenomas and cancers are the same - obesity, impaired glucose tolerance, dyslipidemia, hypertension, cardiovascular diseases and diabetes mellitus type 2. Therefore, the key issue in the near future is the development of a simple scoring system, easy to use in clinical practice, which would identify individuals with high metabolic risk of colorectal neoplasia and would be used for individual CRC secondary prevention strategies. Currently, such scoring systems have been published based on Asian (Asia-Pacific Colorectal Screening Score; APCS) and Polish populations.
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Stepan
S
Suchanek
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Tomas
T
Grega
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Ondrej
O
Ngo
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Gabriela
G
Vojtechova
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Ondrej
O
Majek
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Petra
P
Minarikova
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Nagyija
N
Brogyuk
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Bohus
B
Bunganic
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Bohumil
B
Seifert
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Ladislav
L
Dusek
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1 Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic.
Miroslav
M
Zavoral
D000236:Adenoma / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D018153:Czech Republic; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000150:complications; D009361:Neoplasm Invasiveness; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D055502:Secondary Prevention; D012720:Severity of Illness Index
Colorectal neoplasia; Diabetes mellitus type 2; Heart ischemic disease; Metabolic syndrome
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