The comparison of the clinical manifestations and risk factors of colorectal cancer and adenomas: results from a colonoscopy-based study in southern Chinese
- First Online:
- 212 Downloads
Background and aims
Colorectal cancer (CRC) is one of the most common gastrointestinal tumors in the world. This study aimed to compare the clinical manifestations and risk factors of CRC and adenomas in native patients of Guangzhou.
Patients who underwent colonoscopy for the first time at Nanfang Hospital between July 2008 and July 2009 were recruited. Data on demographic information, main clinical manifestations, results of endoscopies and pathology, and possible risk factors of colorectal tumor were collected. Chi-square test and logistic regression were used to compare the clinical characteristics and risk factors for CRC and adenomas.
Hematochezia and body weight loss were more frequent in proximal and distal CRC groups, respectively (P ≤ 0.05). Older age [odds ratio (OR), 1.079; 95% confidence interval (CI), 1.065–1.093], smoking status (OR, 1.712; 95% CI, 1.158–2.531), BMI = 18.5–24.9 and ≥ 25.0 (OR, 2.384; 95% CI, 1.250–4.549; OR, 2.162; 95% CI, 1.044–4.478, respectively) were significant risk factors for advanced adenoma, while female (OR, 0.638; 95% CI, 0.429–0.949) and using aspirin (OR, 0.188; 95% CI, 0.042–0.845) were significant protective factors. Hyperlipemia (OR, 0.109; 95% CI, 0.013–0.886) was identified as a protective factor for proximal CRC. Smoking (OR, 1.717; 95% CI, 1.093–2.696), drinking (OR, 1.817; 95% CI, 1.145–2.883), DM history (OR, 2.204; 95% CI, 1.044–4.652) were identified as independent risk factors for distal CRC, and using aspirin (OR, 0.190; 95% CI, 0.043–0.840) was a protective factor. Drinking (OR, 3.288; 95% CI, 1.546–6.994; OR, 1.862; 95% CI, 1.037–3.343, respectively) was an independent risk factor for both poorly to moderately differentiated CRC and well-differentiated CRC. Besides, DM (OR, 3.761; 95% CI, 1.615–8.762) and hypertension (OR, 0.384; 95% CI, 0.178–0.828) were identified as independent risk factor and protective factor for well-differentiated CRC, respectively.
Hematochezia and body weight loss were representative manifestations for distal and proximal CRC, respectively. For southern Chinese the most important influential factors for colorectal tumor are age, smoking, drinking, nutritional state, DM, hypertension, and the use of aspirin.
KeywordsColorectal cancer Adenomas Clinical manifestations Risk factors Protective factors
- 11.Lieberman DA, Weiss DG, Harford WV, Ahnen DJ, Provenzale D, Sontag SJ, Schnell TG, Chejfec G, Campbell DR, Kidao J, Bond JH, Nelson DB, Triadafilopoulos G, Ramirez FC, Collins JF, Johnston TK, McQuaid KR, Garewal H, Sampliner RE, Esquivel R, Robertson D (2007) Five-year colon surveillance after screening colonoscopy. Gastroenterology 133:1077–1085CrossRefPubMedGoogle Scholar
- 21.Sandler RS, Halabi S, Baron JA, Budinger S, Paskett E, Keresztes R, Petrelli N, Pipas JM, Karp DD, Loprinzi CL, Steinbach G, Schilsky R (2003) A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. N Engl J Med 348:883–890CrossRefPubMedGoogle Scholar
- 46.Chan AO, Jim MH, Lam KF, Morris JS, Siu DC, Tong T, Ng FH, Wong SY, Hui WM, Chan CK, Lai KC, Cheung TK, Chan P, Wong G, Yuen MF, Lau YK, Lee S, Szeto ML, Wong BC, Lam SK (2007) Prevalence of colorectal neoplasm among patients with newly diagnosed coronary artery disease. JAMA 298:1412–1419CrossRefPubMedGoogle Scholar
- 52.Bingham SA, Day NE, Luben R, Ferrari P, Slimani N, Norat T, Clavel-Chapelon F, Kesse E, Nieters A, Boeing H, Tjonneland A, Overvad K, Martinez C, Dorronsoro M, Gonzalez CA, Key TJ, Trichopoulou A, Naska A, Vineis P, Tumino R, Krogh V, Bueno-de-Mesquita HB, Peeters PH, Berglund G, Hallmans G, Lund E, Skeie G, Kaaks R, Riboli E (2003) Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet 361:1496–1501CrossRefPubMedGoogle Scholar