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Impact of Lifestyle Factors on Colorectal Polyp Detection in the Screening Setting

Hassan, C. M.D.1; Pickhardt, P. J. M.D.2,3; Marmo, R. M.D.4; Choi, J. R. M.D.5

doi: 10.1007/DCR.0b013e3181e10daa
Original Contribution

BACKGROUND: Awareness of risk factors for colorectal neoplasia could address risk reduction strategies in asymptomatic subjects.

METHODS: This is a post hoc analysis of a prospective, cross-sectional study of 1321 asymptomatic adults. All the subjects underwent same-day CT colonography and colonoscopy to determine the prevalence of colorectal neoplasia. The variables examined included body mass index, smoking, alcohol consumption, age, and gender. Univariate and logistic regression analyses were performed for detection of colorectal neoplasia and hyperplastic polyps. Odds ratios with 95% confidence intervals were calculated.

RESULTS: Colorectal adenomas and hyperplastic polyps were detected in 378 (28.6%) and 157 (11.9%) participants, respectively. In both univariate and multivariate analysis, increasing age, male gender, and body mass index ≥25 were significantly associated with the detection of colorectal adenomas, with an odds ratio of 1.22 (95% CI,1.09–1.36), 1.28 (95% CI, 1.06–1.45), and 1.34 (95% CI, 1.02–1.77), respectively. A history of smoking was the only identifiable risk factor for hyperplastic polyps (odds ratio, 1.98; 95% CI, 1.41–2.78).

CONCLUSIONS: Body mass index ≥25, increasing age, and male gender were all associated with an increased likelihood of colorectal adenomas at screening, whereas smoking was strongly associated with hyperplastic polyps.

1Gastroenterology Unit, “Nuovo Regina Margherita” Hospital, Rome, Italy

2Department of Radiology, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin

3Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland

4Division of Gastroenterology, “L. Curto” Hospital, Polla, Sant'Arsenio, Italy

5Walter Reed Army Medical Center, Washington, District of Columbia

Financial Disclosure: Dr Pickhardt is a consultant for Medicsight, Viatronix, and Philips, and he is a Co-founder of VirtuoCTC.

Correspondence: Cesare Hassan, M.D., Gastroenterology Unit, “Nuovo Regina Margherita” Hospital, Via Morosini 30, 00153, Rome, Italy. E-mail:

© The ASCRS 2010