Open AccessLifestyle factors and risk for colorectal polyps and cancer at index colonoscopy in a FIT‐positive screening population
Author(s) -
Colussi Dora,
Fabbri Margherita,
Zagari Rocco Maurizio,
Montale Amedeo,
Bazzoli Franco,
Ricciardiello Luigi
Publication year - 2018
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640618764711
Subject(s) - medicine , colonoscopy , odds ratio , colorectal cancer , confidence interval , population , logistic regression , epidemiology , gastroenterology , body mass index , cancer , environmental health
Background Many countries have adopted the fecal immunochemical test (FIT) as the primary colorectal cancer (CRC) screening tool; however, its accuracy is limited. Epidemiological studies have shown that obesity and type 2 diabetes increase risk for the disease. Objective The objective of this article is to evaluate the association of colorectal polyps and cancer with comorbidities and lifestyle factors in a population that is part of a FIT‐based CRC screening program. Methods Between 2005 and 2013, we analyzed 3894 FIT + patients who underwent total colonoscopy. The impact of lifestyle factors on polyps and cancer was assessed using individuals with a negative colonoscopy as the control group. A multivariate logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results We collected data from 3894 FIT + patients. Obesity (OR 1.29; 95% CI 1.05–1.60) and smoking (OR 1.45; 95% CI 1.24–1.71) were significantly associated with high‐risk adenomas. Smoking and heavy alcohol drinking were both independently associated with high risk of CRC (OR 1.50; 95% CI 1.10–2.04 and OR 2.29; 95% CI 1.15–4.58) and colon cancer alone (OR 1.43; 95% CI 1.01–2.02 and OR 3.09; 95% CI 1.53–6.23). Positivity to first round of FIT was associated with high‐risk adenomas (OR 1.47; CI 95% 1.26–1.71) and CRC (OR 1.74; 95% CI 1.29–2.36). No associations were found for diabetes. Conclusion In our FIT + population, lifestyle factors are significantly associated with the risk of carrying high‐risk adenomas and CRC. In the future, studies could be aimed at finding better screening strategies through the development of clinical algorithms based on lifestyle changes/comorbidities.