Risk factors for colorectal neoplasms based on colonoscopy and pathological diagnoses of Chinese citizens: a multicenter, case-control study
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Since observational data in the urban residents are required to better assess the risk factors of colorectal neoplasm occurrence and the effectiveness of colonoscopy screening and surveillance, we conducted a case-control study at multicenters in China to identify patient characteristics and neoplasm features of colorectal adenoma (CRA) and colorectal carcinoma (CRC).
A total of 4089 patients who had undergone a colonoscopy from 19 hospitals were enrolled, of which 1106 had CRA and 466 had CRC. They were compared with controls. The analysis provides features and risk factors of colorectal neoplasm using multivariate logistic regression.
Increasing age, a family history of colorectal cancer or previous cases of colorectal adenoma or hypertension disease, gastrointestinal surgery, regular intake of pickled food (adjusted odds ratio [aOR] 1.42, 95 % confidence interval [CI], 1.048–1.924), consumption of alcohol, and a positive result of fecal occult blood testing (FOBT; aOR 2.509, 95 % CI 1.485–4.237) were associated with an increased risk of CRA. In the CRC group, increasing age, regular intake of pickled foods, and a positive FOBT result were risk factors. In addition, a positive abdominal computed tomography (CT) before a colonoscopy and physical signs of emaciation were also significantly associated with an increasing risk of colorectal carcinoma. Regular intake of vegetables decreased the risk of both CRA and CRC.
Age, pickled foods, and a positive FOBT are risk factors for colorectal neoplasm. Vegetable intake was associated with a decreased risk of CRA and CRC.
KeywordsRisk factors Colonoscopy Diet Colorectal neoplasm
The authors thank the following person and hospitals which recruited patients for this study: Kui Dong, General Hospital of Tianjin Medical University; Jun Li, Peking University Third Hospital; Yuan-Min Zhu, Peking University People’s Hospital; Ping Xu, Songjiang Hospital Affiliated First People’s Hospital, Shanghai Jiao Tong University; Qi Wang, The Second Affiliated Hospital of Shanxi Medical University; Wen-Yuan Bai, The Second Affiliated Hospital of Hebei Medical University; Shu De Li, Second Military Medical University Chang Hai Hospital; Ming-Zhi Xu, Zhong Shan Hospital, Xiamen University; Wei-Chang Chen, The First Affiliated Hospital of Suzhou University; and Cheng Lan, Hainan General Hospital.
We would like to thank Zhi-Zheng Ge, Yun-Jia Zhao, Qing Zheng, Hong Lu, Hong-Yin Zhu, and Lin-Yin Zhu, Ren Ji Hospital, that gave us so much help about the data collection, Yong-Wei He for the data interpretation, and Bing-Shun Wang for the statistical analysis assistance (Department of Statistics, Shanghai Jiao Tong University of Medicine).
This work was supported by grants from the National High-tech R&D program of China (No. 2012AA02A506), The National Key Technology R&D Program (No. 2014BAI09B05) to CYX, and the grant from the National Natural Science Foundation (No. 31271501) to CYX.
Conflict of interest
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