Citation: | CHENG Rui, GONG Rui, JIANG Wei, ZHANG Shutian. Clinicopathological Characteristics of Middle-Aged and Elderly Patients with Colorectal Polyps and Risk Factors of Adenomatous Polyps[J]. Cancer Research on Prevention and Treatment, 2025, 52(1): 19-24. DOI: 10.3971/j.issn.1000-8578.2025.24.0746 |
To determine the risk factors related to the occurrence of colorectal adenomatous polyps and provide a basis for early screening, diagnosis, and treatment of colorectal cancer.
A total of 1 527 cases of colorectal polyps detected by colonoscopy were selected as the research subjects. Data on sociodemographic information, lifestyle and dietary habits, clinical history, laboratory tests, and endoscopic characteristics were collected. The patients were divided into adenoma and non-adenoma groups based on the pathological type. Multivariate logistic regression analysis was conducted to explore the influence of the above factors on the occurrence of colorectal adenoma.
Old age (OR: 1.024, 95%CI: 1.001-1.048, P=0.044), high body mass index (OR: 1.046, 95%CI: 1.008-1.087, P=0.020), and a history of smoking (OR: 1.493, 95%CI: 1.035-2.158, P=0.032) were independent risk factors for the occurrence of colorectal adenoma. Patients with better cognitive function had a lower risk of developing colorectal adenoma than those with poorer cognitive function (OR: 0.929, 95%CI: 0.871-0.984, P=0.017). Polyps located in the rectum (OR: 0.396, 95%CI: 0.229-0.677, P=0.001) and those of flat type (OR: 0.531, 95%CI: 0.342-0.810, P=0.004) or laterally spreading type (OR: 0.306, 95%CI: 0.135-0.698, P=0.005) were more likely to be non-adenomatous polyps. The possibility of adenomatous pathological changes increased significantly with an increase in polyp size (OR: 1.063, 95%CI: 1.035-1.095, P<0.001).
Old age, high body mass index, smoking history, and large polyp diameters are related with a high risk of adenoma in the patients with colorectal polyps. Patients who have satisfactory cognitive function, polyps located in the rectum and polyps of flat type or laterally spreading type are likely to have non-adenoma.
Competing interests: The authors declare that they have no competing interests.
[1] |
Arnold M, Abnet CC, Neale RE, et al. Global Burden of 5 Major Types of Gastrointestinal Cancer[J]. Gastroenterology, 2020, 159(1): 335-349. e15.
|
[2] |
Markowitz SD, Bertagnolli MM. Molecular origins of cancer: Molecular basis of colorectal cancer[J]. N Engl J Med, 2009, 361(25): 2449-2460. doi: 10.1056/NEJMra0804588
|
[3] |
Li X, Hu M, Wang Z, et al. Prevalence of diverse colorectal polyps and risk factors for colorectal carcinoma in situ and neoplastic polyps[J]. J Transl Med, 2024, 22(1): 361. doi: 10.1186/s12967-024-05111-z
|
[4] |
Leigard E, Hertzberg D, Konrad D, et al. Increasing perioperative age and comorbidity: a 16-year cohort study at two University hospital sites in Sweden[J]. Int J Surg, 2024, 110(7): 4124-4131.
|
[5] |
Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer[J]. Gastroenterology, 2012, 143(3): 844-857. doi: 10.1053/j.gastro.2012.06.001
|
[6] |
Siripongpreeda B, Mahidol C, Dusitanond N, et al. High prevalence of advanced colorectal neoplasia in the Thai population: a prospective screening colonoscopy of 1, 404 cases[J]. BMC gastroenterol, 2016, 16(1): 101. doi: 10.1186/s12876-016-0526-0
|
[7] |
Rex DK. Colonoscopy: a review of its yield for cancers and adenomas by indication[J]. Am J Gastroenterol, 1995, 90(3): 353-365.
|
[8] |
Williams AR, Balasooriya BA, Day DW. Polyps and cancer of the large bowel: a necropsy study in Liverpool[J]. Gut, 1982, 23(10): 835-842. doi: 10.1136/gut.23.10.835
|
[9] |
Pendergrass CJ, Edelstein DL, Hylind LM, et al. Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study[J]. Clin Gastroenterol Hepatol, 2008, 6(9): 1011-1015. doi: 10.1016/j.cgh.2008.03.022
|
[10] |
Wolf AMD, Fontham ETH, Church TR, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society[J]. CA Cancer J Clin, 2018, 68(4): 250-281. doi: 10.3322/caac.21457
|
[11] |
Im JP, Kim D, Chung SJ, et al. Visceral obesity as a risk factor for colorectal adenoma occurrence in surveillance colonoscopy[J]. Gastrointest Endosc, 2018, 88(1): 119-127. e4.
|
[12] |
Colussi D, Fabbri M, Zagari RM, et al. Lifestyle factors and risk for colorectal polyps and cancer at index colonoscopy in a FIT-positive screening population[J]. United European Gastroenterol J, 2018, 6(6): 935-942. doi: 10.1177/2050640618764711
|
[13] |
He S, Berndt SI, Kunzmann AT, et al. Weight Change and Incident Distal Colorectal Adenoma Risk in the PLCO Cancer Screening Trial[J]. JNCI Cancer Spectr, 2022, 6(1): pkab098. doi: 10.1093/jncics/pkab098
|
[14] |
Øines M, Helsingen LM, Bretthauer M, et al. Epidemiology and risk factors of colorectal polyps[J]. Best Pract Res Clin Gastroenterol, 2017, 31(4): 419-424. doi: 10.1016/j.bpg.2017.06.004
|
[15] |
Shin A, Hong CW, Sohn DK, et al. Associations of cigarette smoking and alcohol consumption with advanced or multiple colorectal adenoma risks: a colonoscopy-based case-control study in Korea[J]. Am J Epidemiol, 2011, 174(5): 552-562. doi: 10.1093/aje/kwr098
|
[16] |
Paun BC, Kukuruga D, Jin Z, et al. Relation between normal rectal methylation, smoking status, and the presence or absence of colorectal adenomas[J]. Cancer, 2010, 116(19): 4495-4501. doi: 10.1002/cncr.25348
|
[17] |
Fu Z, Shrubsole MJ, Li G, et al. Interaction of cigarette smoking and carcinogen-metabolizing polymorphisms in the risk of colorectal polyps[J]. Carcinogenesis, 2013, 34(4): 779-786. doi: 10.1093/carcin/bgs410
|
[18] |
Gao Y, Hayes RB, Huang WY, et al. DNA repair gene polymorphisms and tobacco smoking in the risk for colorectal adenomas[J]. Carcinogenesis, 2011, 32(6): 882-887. doi: 10.1093/carcin/bgr071
|
[19] |
Yu JH, Bigler J, Whitton J, et al. Mismatch repair polymorphisms and colorectal polyps: hMLH1-93G>A variant modifies risk associated with smoking[J]. Am J Gastroenterol, 2006, 101(6): 1313-1319. doi: 10.1111/j.1572-0241.2006.00551.x
|
[20] |
Huang WY, Berndt SI, Kang D, et al. Nucleotide excision repair gene polymorphisms and risk of advanced colorectal adenoma: XPC polymorphisms modify smoking-related risk[J]. Cancer Epidemiol Biomarkers Prev, 2006, 15(2): 306-311. doi: 10.1158/1055-9965.EPI-05-0751
|
[21] |
Zhu JZ, Wang YM, Zhou QY, et al. Systematic review with meta-analysis: alcohol consumption and the risk of colorectal adenoma[J]. Aliment Pharmacol Ther, 2014, 40(4): 325-337. doi: 10.1111/apt.12841
|
[22] |
Ma C, Li Y, Mei Z, et al. Association Between Bowel Movement Pattern and Cognitive Function: Prospective Cohort Study and a Metagenomic Analysis of the Gut Microbiome[J]. Neurology, 2023, 101(20): e2014-e2025.
|
[23] |
Khatibzadeh N, Ziaee SA, Rahbar N, et al. The indirect role of site distribution in high-grade dysplasia in adenomatous colorectal polyps[J]. J Cancer Res Ther, 2005, 1(4): 204-207. doi: 10.4103/0973-1482.19587
|
[24] |
Nusko G, Mansmann U, Altendorf-Hofmann A, et al. Risk of invasive carcinoma in colorectal adenomas assessed by size and site[J]. Int J Colorectal Dis, 1997, 12(5): 267-271. doi: 10.1007/s003840050103
|
[25] |
Fenoglio CM, Kaye GI, Pascal RR, et al. Defining the precursor tissue of ordinary large bowel carcinoma: implications for cancer prevention[J]. Pathol Annu, 1977, 12 Pt 1: 87-116.
|
[26] |
雷甜甜, 刘家欢, 黄虹玉, 等. 进展期结直肠腺瘤及高危腺瘤的危险因素分析[J]. 中华胃肠内镜电子杂志, 2021, 8(2): 61-67. [Lei TT, Liu JH, Huang HY, et al. Analysis of risk factors for advanced colorectal adenoma and high-risk adenoma[J]. Zhonghua Wei Chang Nei Jing Dian Zi Za Zhi, 2021, 8(2): 61-67.] doi: 10.3877/cma.j.issn.2095-7157.2021.02.004
Lei TT, Liu JH, Huang HY, et al. Analysis of risk factors for advanced colorectal adenoma and high-risk adenoma[J]. Zhonghua Wei Chang Nei Jing Dian Zi Za Zhi, 2021, 8(2): 61-67. doi: 10.3877/cma.j.issn.2095-7157.2021.02.004
|
[27] |
Naravadi V, Gupta N, Early D, et al. Prevalence of advanced histological features and synchronous neoplasia in patients with flat adenomas[J]. Gastrointest Endosc, 2016, 83(4): 795-799. doi: 10.1016/j.gie.2015.08.040
|
[28] |
Bafandeh Y, Khoshbaten M, Eftekhar Sadat AT, et al. Clinical predictors of colorectal polyps and carcinoma in a low prevalence region: results of a colonoscopy based study[J]. World J Gastroenterol, 2008, 14(10): 1534-1538. doi: 10.3748/wjg.14.1534
|
[29] |
Ashktorab H, Paydar M, Yazdi S, et al. BMI and the risk of colorectal adenoma in African-Americans[J]. Obesity (Silver Spring), 2014, 22(5): 1387-1391. doi: 10.1002/oby.20702
|
[30] |
Nouraie M, Hosseinkhah F, Brim H, et al. Clinicopathological features of colon polyps from African-Americans[J]. Dig Dis Sci, 2010, 55(5): 1442-1449. doi: 10.1007/s10620-010-1133-5
|
[1] | ZHOU Hairong, WANG Weiwei, LUO Pengfei, HONG Xin. Trend of Colorectal Cancer Burden in China from 1990 to 2019[J]. Cancer Research on Prevention and Treatment, 2024, 51(2): 115-120. DOI: 10.3971/j.issn.1000-8578.2024.23.0883 |
[2] | LIN Hao, HU Ting, WANG Chaoyang, ZHANG Haibao, JU Jiahua, YU Yongjiang. Application of Clinical Prediction Models for Postoperative Complications of Colorectal Cancer[J]. Cancer Research on Prevention and Treatment, 2023, 50(9): 908-912. DOI: 10.3971/j.issn.1000-8578.2023.23.0293 |
[3] | GAO Jingru, LI Jiaxin, QIAO Youlin, ZHANG Xi, ZHANG Shaokai, XU Huifang, HUA Yunqi, HAO Jinqi, FU Ying, SHI Zhengyang, YU Yanqin, SHI Jihai. Cognition of Colorectal Cancer-related Knowledge and Influencing Factors of Patients with Middle- and Advanced-stage Colorectal Cancer in Inner Mongolia[J]. Cancer Research on Prevention and Treatment, 2023, 50(6): 603-608. DOI: 10.3971/j.issn.1000-8578.2023.22.1248 |
[4] | ZHONG Haojie, LUO Wenhui, LIU Yongjia, LIN Da, XUE Lanfeng, CHEN Yu. Progress in Follow-up of High-risk Factors After Endoscopic Resection of Colorectal Tumors[J]. Cancer Research on Prevention and Treatment, 2019, 46(4): 371-375. DOI: 10.3971/j.issn.1000-8578.2019.18.1406 |
[5] | ZHANG Yachen, LIANG Di, JIN Jing, LI Daojuan, LIU Congmin, GAO Zhaoyu, HE Yutong. Research Progress on Risk Factors for Lung Cancer in Nonsmokers[J]. Cancer Research on Prevention and Treatment, 2017, 44(7): 501-505. DOI: 10.3971/j.issn.1000-8578.2017.16.1627 |
[6] | JIANG Meihua, LIU Baoying, WU Chuancheng, GUO Saixiong, LI Dan, ZHOU Yan, LI Hongtu. 1:2 Matched Case-control Investigation on Risk Factors of Gastric Cancer in Xianyou County[J]. Cancer Research on Prevention and Treatment, 2016, 43(10): 898-902. DOI: 10.3971/j.issn.1000-8578.2016.10.014 |
[7] | PENG Xian-e, JIANG Ying-ying, SHI Xi-shun, ZHENG Xiao-yian, XIAO Jing-rong, LIN Xu. Case-control Study on Risk Factors of Colorectal Cancer in Fujian Province[J]. Cancer Research on Prevention and Treatment, 2009, 36(09): 794-796. DOI: 10.3971/j.issn.1000-8578.2009.09.023 |
[8] | ZHAO Jun-shi, HUANG Min-zhu, WU Xin-yin, HE Xiao-wei. A Case-control Study on Risk Factors of Colonic Cancer[J]. Cancer Research on Prevention and Treatment, 2008, 35(07): 524-526. DOI: 10.3971/j.issn.1000-8578.1486 |
[9] | ZHU Zhao-yang, ZHANG Zhi-feng, LI Chang-feng, WAN Jun, DUAN Ji-jun. Analysis on Risk Factors of Lung Cancer in the City Zone of Wuhan[J]. Cancer Research on Prevention and Treatment, 2007, 34(08): 633-635. DOI: 10.3971/j.issn.1000-8578.2351 |
[10] | ZENG Zhuan-ping, CHEN Feng, LIU Bin, HUANG Man-ni, ZHANG Xun, PAN Qin-jing, ZHAO Fang-hui, RONG Shou-de, QIAO You-lin. Analysis of Risk Factors for Cervical Cancer in Yangcheng County[J]. Cancer Research on Prevention and Treatment, 2004, 31(03): 178-181. DOI: 10.3971/j.issn.1000-8578.1020 |
Tables(2)