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Multiple behavioral factors are associated with occurrence of large, flat colorectal polyps

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Abstract

Purpose

The prevalence of advanced dysplasia and synchronous lesions is particularly high in patients with large, flat colorectal polyps. However, the impact of lifestyle on the development of such polyps is poorly investigated. Hence, this study aims to identify associations between behavioral factors and the occurrence of large, flat colorectal polyps.

Methods

Behavioral factors were retrospectively analyzed in patients with large, flat polyps and control patients with at most one diminutive polyp. Information on lifestyle factors, comorbidities, and demographic parameters were determined by a structured, self-administered questionnaire.

Results

Questionnaires of 350 patients with large, flat polyps and 489 control patients were included in the analysis. Most large, flat colorectal polyps contained adenoma with low-grade neoplasia and were located in the right colon. Multivariate analysis showed that advanced age (per 1-year increase—OR 1.09, CI 1.07–1.11, p < 0.0001), frequent cigarette smoking (OR 2.04, CI 1.25–3.32, p = 0.0041), daily consumption of red meat (OR 3.61, CI 1.00–12.96, p = 0.0492), and frequent bowel movements (OR 1.62, CI 1.13–2.33, p = 0.0093) were independent risk factors for occurrence of large, flat colorectal polyps. In contrast, frequent intake of cereals (OR 0.62, CI 0.44–0.88, p = 0.0074) was associated with a reduced risk.

Conclusion

Multiple behavioral factors modulate the risk for developing large, flat colorectal polyps. This knowledge can be used to improve prevention of colorectal cancer.

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Authors and Affiliations

  1. Division of Signaling and Functional Genomics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany

    Tianzuo Zhan & Johannes Betge

  2. Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Universitätsmedizin Mannheim, Theodor-Kutzer Ufer 1–3, D-68167, Mannheim, Germany

    Tianzuo Zhan, Felix Hahn, Asmé Bilge, Johannes Betge, Matthias P. Ebert & Sebastian Belle

  3. Division of Biostatistics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany

    Thomas Hielscher

  4. Heilig Geist Hospital, Rodensteinstraße 94, 64625, Bensheim, Germany

    Jürgen Grüger

  5. Praxis Dr. Knapp und Kollegen, Mathildenstraße 30, 64625, Bensheim, Germany

    Jürgen Grüger

  6. Gastroenterologische Schwerpunktpraxis, Lameystr. 2, 68165, Mannheim, Germany

    Jürgen Weers

  7. Institute of Pathology, Medical Faculty Mannheim, Heidelberg University, Universitätsmedizin Mannheim, Theodor-Kutzer Ufer 1–3, D-68167, Mannheim, Germany

    Timo Gaiser

  8. Central Interdisciplinary Endoscopy Unit, Medical Faculty Mannheim, Heidelberg University, Universitätsmedizin Mannheim, Theodor-Kutzer Ufer 1–3, D-68167, Mannheim, Germany

    Georg Kähler

Authors
  1. Tianzuo Zhan
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  2. Felix Hahn
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  3. Thomas Hielscher
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  4. Asmé Bilge
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  5. Jürgen Grüger
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  6. Jürgen Weers
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  7. Johannes Betge
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  8. Timo Gaiser
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  9. Georg Kähler
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  10. Matthias P. Ebert
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  11. Sebastian Belle
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Corresponding authors

Correspondence to Tianzuo Zhan or Sebastian Belle.

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The authors declare that they have no competing interests.

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None.

Ethical approval

This study is approved by the local board of ethics (Medizinische Ethikkommission II, Heidelberg University, identifier 2013-557N-MA).

Additional information

T.Z. and F.H. contributed equally to this work.

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Zhan, T., Hahn, F., Hielscher, T. et al. Multiple behavioral factors are associated with occurrence of large, flat colorectal polyps. Int J Colorectal Dis 32, 575–582 (2017). https://doi.org/10.1007/s00384-016-2717-0

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