Factors that Increase Risk of Colon Polyps

ABSTRACT

Adenomatous polyps are common and factors that increase risk include race, gender, smoking, and obesity. This author summarizes the evidence supporting increased risk with these factors and describes how epidemiological data may be used to tailor screening programs.

KEYWORDS

Polyps - risk factors - epidemiology

REFERENCES

• 1 Parker S L, Tong T, Bolden S, Ingo P A. Cancer statistics, 1997.  CA Cancer J Clin. 1997;  47(1) 5-27
• 2 Winawer S J, Zauber A G, Ho M N et al.. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup.  N Engl J Med. 1993;  329(27) 1977-1981
• 3 Pignone M, Rich M, Teutsch S M, Berg A O, Lohr K N. Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force.  Ann Intern Med. 2002;  137(2) 132-141
• 4 Polite B N, Dignam J J, Olopade O I. Colorectal cancer and race: understanding the differences in outcomes between African Americans and whites.  Med Clin North Am. 2005;  89(4) 771-793
• 5 Coughlin S S, Thompson T. Physician recommendation for colorectal cancer screening by race, ethnicity, and health insurance status among men and women in the United States, 2000.  Health Promot Pract. 2005;  6(4) 369-378
• 6 Peterson N B, Murff H J, Ness R M, Dittus R S. Colorectal cancer screening among men and women in the United States.  J Womens Health (Larchmt). 2007;  16(1) 57-65
• 7 Kelly K M, Dickinson S L, Degraffinreid C R, Tatum C M, Paskett E D. Colorectal cancer screening in 3 racial groups.  Am J Health Behav. 2007;  31(5) 502-513
• 8 Ananthakrishnan A N, Schellhase K G, Sparapani R A, Laud P W, Neuner J M. Disparities in colon cancer screening in the Medicare population.  Arch Intern Med. 2007;  167(3) 258-264
• 9 Schenck A P, Klabunde C N, Davis W W. Racial differences in colorectal cancer test use by Medicare consumers.  Am J Prev Med. 2006;  30(4) 320-326
• 10 Pollack L A, Blackman D K, Wilson K M, Seeff L C, Nadel M R. Colorectal cancer test use among Hispanic and non-Hispanic U.S. populations.  Prev Chronic Dis. 2006;  3(2) A50, 1-11
• 11 Etzioni D A, Ponce N A, Babey S H et al.. A population-based study of colorectal cancer test use: results from the 2001 California Health Interview Survey.  Cancer. 2004;  101(11) 2523-2532
• 12 Wong S T, Gildengorin G, Nguyen T, Mock J. Disparities in colorectal cancer screening rates among Asian Americans and non-Latino whites.  Cancer. 2005;  104(12 Suppl) 2940-2947
• 13 Thornton J G, Morris A M, Thornton J D, Flowers C R, McCashland T M. Racial variation in colorectal polyp and tumor location.  J Natl Med Assoc. 2007;  99(7) 723-728
• 14 Cordice Jr J W, Johnson Jr H. Anatomic distribution of colonic cancers in middle-class black Americans.  J Natl Med Assoc. 1991;  83(8) 730-732
• 15 Nelson R L, Dollear T, Freels S, Persky V. The relation of age, race, and gender to the subsite location of colorectal carcinoma.  Cancer. 1997;  80(2) 193-197
• 16 Francois F, Park J, Bini E J. Colon pathology detected after a positive screening flexible sigmoidoscopy: a prospective study in an ethnically diverse cohort.  Am J Gastroenterol. 2006;  101(4) 823-830
• 17 Johnson Jr H, Margolis I, Wise L. Site-specific distribution of large-bowel adenomatous polyps. Emphasis on ethnic differences.  Dis Colon Rectum. 1988;  31(4) 258-260
• 18 Shavers V L. Racial/ethnic variation in the anatomic subsite location of in situ and invasive cancers of the colon.  J Natl Med Assoc. 2007;  99(7) 733-748
• 19 Agrawal S, Bhupinderjit A, Bhutani M S et al.. Colorectal cancer in African Americans.  Am J Gastroenterol. 2005;  100(3) 515-523 discussion 514
• 20 Theuer C P, Wagner J L, Taylor T H et al.. Racial and ethnic colorectal cancer patterns affect the cost-effectiveness of colorectal cancer screening in the United States.  Gastroenterology. 2001;  120(4) 848-856
• 21 Shaib Y H, Rabaa E, Qaseem T. The site distribution and characteristics of colorectal adenomas in Hispanics: a comparative study.  Am J Gastroenterol. 2002;  97(8) 2100-2102
• 22 Lieberman D. Race, gender, and colorectal cancer screening.  Am J Gastroenterol. 2005;  100(12) 2756-2758
• 23 Leung W K, Ho K Y, Kim W H et al.. Colorectal neoplasia in Asia: a multicenter colonoscopy survey in symptomatic patients.  Gastrointest Endosc. 2006;  64(5) 751-759
• 24 Lieberman D A, Prindiville S, Weiss D G, Willett W. VA Cooperative Study Group 380 . Risk factors for advanced colonic neoplasia and hyperplastic polyps in asymptomatic individuals.  JAMA. 2003;  290(22) 2959-2967
• 25 Soon M S, Kozarek R A, Ayub K et al.. Screening colonoscopy in Chinese and Western patients: a comparative study.  Am J Gastroenterol. 2005;  100(12) 2749-2755
• 26 Kupfer S S, McCaffrey S, Kim K E. Racial and gender disparities in hereditary colorectal cancer risk assessment: the role of family history.  J Cancer Educ. 2006;  21(1 Suppl) S32-S36
• 27 Lieberman D A, Holub J, Eisen G, Kraemer D, Morris C D. Prevalence of polyps greater than 9 mm in a consortium of diverse clinical practice settings in the United States.  Clin Gastroenterol Hepatol. 2005;  3(8) 798-805
• 28 Betes M, Muñoz-Navas M A, Duque J M et al.. Use of colonoscopy as a primary screening test for colorectal cancer in average risk people.  Am J Gastroenterol. 2003;  98(12) 2648-2654
• 29 Schoenfeld P, Cash B, Flood A et al.. Colonoscopic screening of average-risk women for colorectal neoplasia.  N Engl J Med. 2005;  352(20) 2061-2068
• 30 Giovannucci E. An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer.  Cancer Epidemiol Biomarkers Prev. 2001;  10(7) 725-731
• 31 Monnet E, Allemand H, Farina H, Carayon P. Cigarette smoking and the risk of colorectal adenoma in men.  Scand J Gastroenterol. 1991;  26(7) 758-762
• 32 Nagata C, Shimizu H, Kametani M et al.. Cigarette smoking, alcohol use, and colorectal adenoma in Japanese men and women.  Dis Colon Rectum. 1999;  42(3) 337-342
• 33 Zahm S H, Cocco P, Blair A. Tobacco smoking as a risk factor for colon polyps.  Am J Public Health. 1991;  81(7) 846-849
• 34 Terry M B, Neugut A I. Cigarette smoking and the colorectal adenoma-carcinoma sequence: a hypothesis to explain the paradox.  Am J Epidemiol. 1998;  147(10) 903-910
• 35 Giovannucci E, Colditz G A, Stampfer M J et al.. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. women.  J Natl Cancer Inst. 1994;  86(3) 192-199
• 36 Reid M E, Marshall J R, Roe D et al.. Smoking exposure as a risk factor for prevalent and recurrent colorectal adenomas.  Cancer Epidemiol Biomarkers Prev. 2003;  12(10) 1006-1011
• 37 Longnecker M P, Chen M J, Probst-Hensch NM, et al.. Alcohol and smoking in relation to the prevalence of adenomatous colorectal polyps detected at sigmoidoscopy.  Epidemiology. 1996;  7(3) 275-280
• 38 Kikendall J W, Bowen P E, Burgess M B et al.. Cigarettes and alcohol as independent risk factors for colonic adenomas.  Gastroenterology. 1989;  97(3) 660-664
• 39 Jacobson J S, Neugut A I, Murray T et al.. Cigarette smoking and other behavioral risk factors for recurrence of colorectal adenomatous polyps (New York City, NY, USA).  Cancer Causes Control. 1994;  5(3) 215-220
• 40 Hoff G, Vatn M H, Larsen S. Relationship between tobacco smoking and colorectal polyps.  Scand J Gastroenterol. 1987;  22(1) 13-16
• 41 Rosen A B, Schneider E C. Colorectal cancer screening disparities related to obesity and gender.  J Gen Intern Med. 2004;  19(4) 332-338
• 42 Botteri E, Iodice S, Raimondi S, Maisonneuve P, Lowenfels A B. Cigarette smoking and adenomatous polyps: a meta-analysis.  Gastroenterology. 2008;  134(2) 388-395
• 43 James W P. The epidemiology of obesity: the size of the problem.  J Intern Med. 2008;  263(4) 336-352
• 44 Renehan A G, Tyson M, Egger M, Heller R F, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.  Lancet. 2008;  371(9612) 569-578
• 45 Parkin D M, Muir C S. Cancer Incidence in five continents. Comparability and quality of data.  IARC Sci Publ. 1992;  (120) 45-173
• 46 Neugut A I, Lee W C, Garbowski G C et al.. Obesity and colorectal adenomatous polyps.  J Natl Cancer Inst. 1991;  83(5) 359-361
• 47 Bayerdorffer E, Mannes G A, Ochsenkühn T et al.. Increased risk of ‘high-risk’ colorectal adenomas in overweight men.  Gastroenterology. 1993;  104(1) 137-144
• 48 Kono S, Hunda K, Hayabuchi H et al.. Obesity, weight gain and risk of colon adenomas in Japanese men.  Jpn J Cancer Res. 1999;  90(8) 805-811
• 49 Shinchi K, Kono S, Honjo S et al.. Obesity and adenomatous polyps of the sigmoid colon.  Jpn J Cancer Res. 1994;  85(5) 479-484
• 50 Bird C L, Frankl H D, Lee E R, Haile R W. Obesity, weight gain, large weight changes, and adenomatous polyps of the left colon and rectum.  Am J Epidemiol. 1998;  147(7) 670-680
• 51 Anderson J C, Messina C R, Dakhllalah F et al.. Body mass index: a marker for significant colorectal neoplasia in a screening population.  J Clin Gastroenterol. 2007;  41(3) 285-290
• 52 Almendingen K, Hofstad B, Vatn M H. Does high body fatness increase the risk of presence and growth of colorectal adenomas followed up in situ for 3 years?.  Am J Gastroenterol. 2001;  96(7) 2238-2246
• 53 Larsen I K, Grotmol T, Almendingen K, Hoff G. Lifestyle as a predictor for colonic neoplasia in asymptomatic individuals.  BMC Gastroenterol. 2006;  6 5
• 54 Gunter M J, Leitzmann M F. Obesity and colorectal cancer: epidemiology, mechanisms and candidate genes.  J Nutr Biochem. 2006;  17(3) 145-156
• 55 Moore L L, Bradlee M L, Singer M R et al.. BMI and waist circumference as predictors of lifetime colon cancer risk in Framingham Study adults.  Int J Obes Relat Metab Disord. 2004;  28(4) 559-567
• 56 Giovannucci E, Ascherio A, Rimm E B et al.. Physical activity, obesity, and risk for colon cancer and adenoma in men.  Ann Intern Med. 1995;  122(5) 327-334
• 57 Kim S E, Shim K N, Jung S A, Yoo K, Moon I H. An association between obesity and the prevalence of colonic adenoma according to age and gender.  J Gastroenterol. 2007;  42(8) 616-623
• 58 Terry P D, Miller A B, Rohan T E. Obesity and colorectal cancer risk in women.  Gut. 2002;  51(2) 191-194
• 59 Murff H J, Shrubsole M J, Smalley W E et al.. The interaction of age and hormone replacement therapy on colon adenoma risk.  Cancer Detect Prev. 2007;  31(2) 161-165
• 60 Wallace K, Baron J A, Karagas M R et al.. The association of physical activity and body mass index with the risk of large bowel polyps.  Cancer Epidemiol Biomarkers Prev. 2005;  14(9) 2082-2086
• 61 Little B B, Malina R M. Familial similarity in body size in an isolated Zapotec-speaking community in the valley of Oaxaca, southern Mexico: estimated genetic and environmental effects.  Ann Hum Biol. 2005;  32(4) 513-524
• 62 Michels K B, Giovannucci E, Chan A T et al.. Fruit and vegetable consumption and colorectal adenomas in the Nurses' Health Study.  Cancer Res. 2006;  66(7) 3942-3953
• 63 Tripkovic I, Tripkovic A, Ivanisevic Z, Capkun V, Zekan L. Insulin increase in colon cancerogenesis: a case-control study.  Arch Med Res. 2004;  35(3) 215-219
• 64 Tripkovic I, Tripkovic A, Strnad M, Capkun V, Zekan L. Role of insulin-like growth factor-1 in colon cancerogenesis: a case-control study.  Arch Med Res. 2007;  38(5) 519-525
• 65 Kim J H, Lim Y J, Kim Y-H et al.. Is metabolic syndrome a risk factor for colorectal adenoma?.  Cancer Epidemiol Biomarkers Prev. 2007;  16(8) 1543-1546
• 66 Yoshida I, Suzuki A, Vallée M et al.. Serum insulin levels and the prevalence of adenomatous and hyperplastic polyps in the proximal colon.  Clin Gastroenterol Hepatol. 2006;  4(10) 1225-1231
• 67 Schoen R E, Weissfeld J L, Kuller L H et al.. Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps.  Gastroenterology. 2005;  129(2) 464-475
• 68 Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence.  J Nutr. 2001;  131(11 Suppl) 3109S-3120S
• 69 Davies M, Gupta S, Goldspink G, Winslet M. Int J Colorectal Dis. 2006;  21(3) 201-208
• 70 Kaczka A, Kumor A, Pietruczuk M, Małecka-Panas E. [Serum concentration of insulin, C-peptide and insulin-like growth factor I in patients with colon adenomas and colorectal cancer].  Pol Merkur Lekarski. 2007;  22(131) 373-375
• 71 Draper H H, Bettger W J. Role of nutrients in the cause and prevention of oxygen radical pathology.  Adv Exp Med Biol. 1994;  366 269-289
• 72 Mohanty P, Ghanim H, Hamouda W et al.. Both lipid and protein intakes stimulate increased generation of reactive oxygen species by polymorphonuclear leukocytes and mononuclear cells.  Am J Clin Nutr. 2002;  75(4) 767-772
• 73 Grimble R F. Inflammatory status and insulin resistance.  Curr Opin Clin Nutr Metab Care. 2002;  5(5) 551-559