Obesity Is Associated with an Increased Prevalence of Advanced Adenomatous Colon Polyps in a Male Veteran Population
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Obesity has been associated with an increased risk for colonic adenomatous polyps (APs) and colorectal cancers, but the influence of obesity on the development of advanced APs is not clear. The purpose of this study is to determine the influence of obesity on the prevalence of advanced APs in a male veteran population. We performed a retrospective study of patients (n = 2,903) with histologically confirmed APs on an index colonoscopy. APs were evaluated for advanced features (size ≥1 cm in diameter and/or a villous component and/or high grade dysplasia). Patients were categorized as: normal weight (BMI >18.5 and <25), overweight (BMI ≥25 and <30), and obese (BMI ≥30). An association between clinical factors and advanced APs was sought by Kruskal–Wallis test and Pearson Chi-square. Multiple logistic regression analysis was used to determine independent predictors for advanced APs. We identified 2,903 male patients with APs (mean age 64 + 1.1(SE) years; 770 (27%) normal weight, 1,029 (35%) overweight, 1,104 (38%) obese. By univariate analysis, obese patients had a greater prevalence of advanced APs than the overweight and normal weight patients (28 vs. 23 vs. 24%, p = 0.025). Multiple logistic regression analysis confirmed the association of obesity and advanced APs (OR = 1.01, CI = 1–1.02, p = 0.04). For every one-unit increase in BMI above 30, there was a corresponding 1% increase in the frequency of finding advanced APs. Obesity in male veteran patients is associated with the finding of advanced APs on colonoscopy. We speculate that obesity may increase the risk for CRC by promoting the development of advanced APs.
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- Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96. doi:10.3322/CA.2007.0010. CrossRef
- Kronborg O, Fenger C. Prognostic evaluation of planned follow-up in patients with colorectal adenomas. An interim report. Int J Colorectal Dis. 1987;2:203–207. doi:10.1007/BF01649506. CrossRef
- Thiis-Evensen E, Hoff GS, Sauar J, Langmark F, Majak BM, Vatn MH. Population-based surveillance by colonoscopy: effect on the incidence of colorectal cancer. Telemark polyp study I. Scand J Gastroenterol. 1999;34:414–420. doi:10.1080/003655299750026443. CrossRef
- Atkin WS, Morson BC, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med. 1992;326:658–662.
- Giovannucci E, Colditz GA, Stampfer MJ, Willett WC. Physical activity, obesity, and risk of colorectal adenoma in women (United States). Cancer Causes Control. 1996;7:253–263. doi:10.1007/BF00051301. CrossRef
- Boutron-Ruault MC, Senesse P, Meance S, Belghiti C, Faivre J. Energy intake, body mass index, physical activity, and the colorectal adenoma-carcinoma sequence. Nutr Cancer. 2001;39:50–57. doi:10.1207/S15327914nc391_7. CrossRef
- Kim SE, Shim KN, Jung SA, Yoo K, Moon IH. An association between obesity and the prevalence of colonic adenoma according to age and gender. J Gastroenterol. 2007;42:616–623. doi:10.1007/s00535-007-2074-4. CrossRef
- Bird CL, Frankl HD, Lee ER, Haile RW. Obesity, weight gain, large weight changes, and adenomatous polyps of the left colon and rectum. Am J Epidemiol. 1998;147:670–680.
- Stemmermann GN, Heilbrun LK, Nomura AM. Association of diet and other factors with adenomatous polyps of the large bowel: a prospective autopsy study. Am J Clin Nutr. 1988;47:312–317.
- Wallace K, Baron JA, Karagas MR, et al. The association of physical activity and body mass index with the risk of large bowel polyps. Cancer Epidemiol Biomarkers Prev. 2005;14:2082–2086. doi:10.1158/1055-9965.EPI-04-0757. CrossRef
- Renehan AG, Zwahlen M, Minder C, O’Dwyer ST, Shalet SM, Egger M. Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis. Lancet. 2004;363:1346–1353. doi:10.1016/S0140-6736(04)16044-3. CrossRef
- Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The national polyp study workgroup. N Engl J Med. 1993;329:1977–1981. doi:10.1056/NEJM199312303292701. CrossRef
- Neugut AI, Lee WC, Garbowski GC, et al. Obesity and colorectal adenomatous polyps. J Natl Cancer Inst. 1991;83:359–361. doi:10.1093/jnci/83.5.359. CrossRef
- Jacobs ET, Martinez ME, Alberts DS, et al. Association between body size and colorectal adenoma recurrence. Clin Gastroenterol Hepatol. 2007;5:982–990. doi:10.1016/j.cgh.2007.03.022. CrossRef
- Almendingen K, Hofstad B, Vatn MH. 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;96:2238–2246. doi:10.1111/j.1572-0241.2001.03942.x. CrossRef
- Tran TT, Medline A, Bruce WR. Insulin promotion of colon tumors in rats. Cancer Epidemiol Biomarkers Prev. 1996;5:1013–1015.
- Wu X, Fan Z, Masui H, Rosen N, Mendelsohn J. Apoptosis induced by an anti-epidermal growth factor receptor monoclonal antibody in a human colorectal carcinoma cell line and its delay by insulin. J Clin Invest. 1995;95:1897–1905. doi:10.1172/JCI117871. CrossRef
- Corpet DE, Jacquinet C, Peiffer G, Tache S. Insulin injections promote the growth of aberrant crypt foci in the colon of rats. Nutr Cancer. 1997;27:316–320. CrossRef
- Koenuma M, Yamori T, Tsuruo T. Insulin and insulin-like growth factor 1 stimulate proliferation of metastatic variants of colon carcinoma 26. Jpn J Cancer Res. 1989;80:51–58.
- Renehan AG, Painter JE, Atkin WS, Potten CS, Shalet SM, O’Dwyer ST. High-risk colorectal adenomas and serum insulin-like growth factors. Br J Surg. 2001;88:107–113. doi:10.1046/j.1365-2168.2001.01645.x. CrossRef
- Sandhu MS, Dunger DB, Giovannucci EL. Insulin, insulin-like growth factor-I (IGF-I), IGF binding proteins, their biologic interactions, and colorectal cancer. J Natl Cancer Inst. 2002;94:972–980.
- Schoen RE, Weissfeld JL, Kuller LH, et al. Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps. Gastroenterology. 2005;129:464–475.
- Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr. 2001;131:3109S–3120S.
- Wu AH, Paganini-Hill A, Ross RK, Henderson BE. Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study. Br J Cancer. 1987;55:687–694.
- Rosenberg L, Palmer JR, Zauber AG, Warshauer ME, Stolley PD, Shapiro S. A hypothesis: nonsteroidal anti-inflammatory drugs reduce the incidence of large-bowel cancer. J Natl Cancer Inst. 1991;83:355–358. doi:10.1093/jnci/83.5.355. CrossRef
- Sandler RS, Halabi S, Baron JA, et al. A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. N Engl J Med. 2003;348:883–890. doi:10.1056/NEJMoa021633. CrossRef
- Thun MJ, Namboodiri MM, Heath CW Jr. Aspirin use and reduced risk of fatal colon cancer. N Engl J Med. 1991;325:1593–1596.
- Baron JA, Cole BF, Sandler RS, et al. A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med. 2003;348:891–899. doi:10.1056/NEJMoa021735. CrossRef
- Pahl HL. Activators and target genes of Rel/NF-kappaB transcription factors. Oncogene. 1999;18:6853–6866. doi:10.1038/sj.onc.1203239. CrossRef
- Narisawa T, Morotomi M, Fukaura Y, Hasebe M, Ito M, Aizawa R. Chemoprevention by pravastatin, a 3-hydroxy-3-methylglutaryl-coenzyme a reductase inhibitor, of N-methyl-N-nitrosourea-induced colon carcinogenesis in F344 rats. Jpn J Cancer Res. 1996;87:798–804.
- Poynter JN, Gruber SB, Higgins PD, et al. Statins and the risk of colorectal cancer. N Engl J Med. 2005;352:2184–2192. doi:10.1056/NEJMoa043792. CrossRef
- Jakobisiak M, Golab J. Potential antitumor effects of statins. Int J Oncol. 2003;23:1055–1069. (Review).
- Omata F, Brown WR, Tokuda Y, et al. Modifiable risk factors for colorectal neoplasms and hyperplastic polyps. Intern Med. 2009;48:123–128. doi:10.2169/internalmedicine.48.1562. CrossRef
About this Article
- Obesity Is Associated with an Increased Prevalence of Advanced Adenomatous Colon Polyps in a Male Veteran Population
Digestive Diseases and Sciences
Volume 54, Issue 7 , pp 1560-1564
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- Adenomatous polyps
- Advanced adenomatous polyps
- Body mass index
- Industry Sectors
- Author Affiliations
- 1. Department of Internal Medicine, Dallas Veterans Affairs Medical Center, 4500 S. Lancaster Road (111B1), Dallas, TX, 75216, USA
- 2. University of Texas Southwestern Medical School, Dallas, TX, USA
- 3. The Dallas Veterans Affairs Research Corporation, Dallas, TX, USA