The Association between Red Meat Consumption and Advanced Colorectal Adenomas in a Population Undergoing a Screening-Related Colonoscopy in Alberta, Canada.

The association between red meat consumption and colorectal cancer has been rigorously examined. However, a more comprehensive understanding of how the intake of unprocessed red meat contributes to the development of early precancerous colorectal lesions, such as advanced colorectal adenomas (ACRAs), requires further investigation. We examined the associations between different types of red meat intake and ACRAs in a sample population of 1083 individuals aged ≥ 50 years undergoing an initial screening colonoscopy in Calgary, Alberta, Canada. Associations between grams per day of total, processed, and unprocessed red meat from diet history questionnaires and ACRAs were evaluated with multivariable logistic regression models. We also applied cubic spline models fitted with three knots (10th, 50th, and 90th percentiles) to identify potential nonlinear associations. We did not observe a meaningful association between unprocessed red meat intake and the presence of ACRAs. In contrast, for every 10 g/d increase in total and processed meat intake, we observed an increase in the odds of ACRAs at the screening colonoscopy (adjusted odds ratio (OR) = 1.05, 95% [CI = 1.01-1.09], p = 0.04) and (adjusted OR = 1.11, 95% [CI = 1.02-1.20], p = 0.02), respectively. This study highlights the importance of differentiating between types of red meat consumption in the context of dietary risks associated with ACRAs.

Analysis of the Current Status and Factors Influencing Compliance with Colonoscopic Monitoring After Endoscopic Surgery for Advanced Colorectal Adenoma.

Background: Advanced colorectal adenomas are at a risk of malignant transformation following endoscopic resection, and colonoscopic monitoring interval after polypectomy have been widely used. This study aims to investigate the prevailing state of compliance with postoperative colonoscopic surveillance among patients with advanced colorectal adenomas and its' influencing factors at Affiliated Hospital of Jiangnan University between November 2020 and April 2021. Methods: A retrospective analysis was conducted on patients who underwent endoscopic treatment for ACA at Affiliated Hospital of Jiangnan University from November 2020 to April 2021. Compliance with postoperative colonoscopic surveillance was assessed based on established guidelines. Factors such as sociodemographic features, medical histories, and health beliefs were analyzed to determine their influence on compliance. Univariate analysis, survival analysis, and multi-factor Cox regression analysis were used for statistical evaluation. Results: A total of 511 patients were included in the study. The compliance rate was found to be 43.2%. The univariate analysis indicated that factors such as gender, education level, work status, type of health insurance, place of residence, marital status, type of consultation, presence of gastrointestinal symptoms, number of polyps, and the maximum diameter of polyps significantly affected compliance. Multi-factor Cox regression analysis revealed that female gender, absence of gastrointestinal symptoms, outpatient endoscopic treatment, and solitary polyps were independent factors influencing compliance. Reasons for poor compliance included underestimating the severity of the disease, fear of colonoscopy, and procedural complexities. Conclusion: Patients with advanced colorectal adenomas had poor compliance with postoperative colonoscopy monitoring. Tailored health education programs should be designed, targeting women, outpatients undergoing endoscopic procedures, and patients with solitary polyps to enhance their compliance with colonoscopy monitoring.

Strong associations of a healthy lifestyle with all stages of colorectal carcinogenesis: Results from a large cohort of participants of screening colonoscopy.

The risk of developing colorectal cancer (CRC) is associated with a wide range of dietary and lifestyle factors. The individual contribution of single modifiable factors, such as alcohol consumption, physical activity, smoking, body mass index (BMI) or dietary components, to the development of CRC has been investigated extensively, but evidence on their combined effect at various stages of colorectal carcinogenesis is sparse. The aim of our study was to analyze the association of a healthy lifestyle pattern with prevalence of early and advanced colorectal neoplasms. A total of 13,600 participants of screening colonoscopy in Saarland/Germany (mean age 62.9 years) who were enrolled in the KolosSal study (Effektivität der Früherkennungs-Koloskopie: eine Saarland-weite Studie) from 2005 until 2013 were included in this cross-sectional analysis. Dietary and lifestyle data were collected and colonoscopy results were extracted from physicians' reports. The association of an a priori defined healthy lifestyle score-including dietary intake, alcohol consumption, physical activity, smoking and BMI-with early and advanced colorectal neoplasms was assessed by multiple logistic regression analyses with comprehensive adjustment for potential confounders. Strong inverse dose-response relationships were observed between an overall healthier lifestyle pattern and presence of advanced colorectal neoplasms, nonadvanced adenomas and hyperplastic polyps (p value <0.0001 in all cases), with adjusted odds ratios (95% CI) for the highest compared to the lowest category of the healthy lifestyle score of 0.41 (0.30-0.56), 0.42 (0.33-0.54) and 0.39 (0.29-0.54) respectively. A healthy lifestyle is strongly associated with lower risk of all stages of colorectal neoplasms.

Incidence and distribution of advanced colorectal adenomas in patients undergoing colonoscopy for screening, surveillance, and symptoms.

PURPOSE: The aim of the study was to determine the frequency and distribution of advanced colorectal adenomas (ACAs) in Chinese population. METHODS: The patients who were referred to receive a colonoscopy were divided into three subgroups of screening, surveillance, and symptomatic, and then they were selected based on their indications. The symptomatic subgroup was further broken down into the alarm and non-alarm categories. The location and morphology of all colorectal lesions were both investigated and recorded. RESULTS: There were significantly more patients with ACAs in the symptomatic subgroup compared to the screening or surveillance subgroup (11.0% vs 4.1%, P<0.001; 11.0% vs 4.6%, P=0.006). No differences were found in the ACA frequency between the alarm and non-alarm categories (11.7% vs 9.7%, P=0.056). One observation was that in the symptomatic subgroup, distal lesions were more likely to contain ACAs than proximal ones (OR 1.50, 95% CI 1.05-2.15, P=0.024). It was also noted that nonpolypoid lesions had significantly higher amounts of ACAs in the symptomatic subgroup (OR 2.09, 95% CI 1.48-2.94, P<0.001) than the other groups. CONCLUSION: The incidence of ACAs was higher in patients undergoing a colonoscopy due to their symptoms, compared to the incidence in those who underwent the procedure for screening or surveillance purposes. Additionally, more attention should be focused on distal and nonpolypoid lesions to improve the detection rate of ACAs.

Bayesian and frequentist analysis of an Austrian genome-wide association study of colorectal cancer and advanced adenomas.

Most genome-wide association studies (GWAS) were analyzed using single marker tests in combination with stringent correction procedures for multiple testing. Thus, a substantial proportion of associated single nucleotide polymorphisms (SNPs) remained undetected and may account for missing heritability in complex traits. Model selection procedures present a powerful alternative to identify associated SNPs in high-dimensional settings. In this GWAS including 1060 colorectal cancer cases, 689 cases of advanced colorectal adenomas and 4367 controls we pursued a dual approach to investigate genome-wide associations with disease risk applying both, single marker analysis and model selection based on the modified Bayesian information criterion, mBIC2, implemented in the software package MOSGWA. For different case-control comparisons, we report models including between 1-14 candidate SNPs. A genome-wide significant association of rs17659990 (P=5.43×10-9, DOCK3, chromosome 3p21.2) with colorectal cancer risk was observed. Furthermore, 56 SNPs known to influence susceptibility to colorectal cancer and advanced adenoma were tested in a hypothesis-driven approach and several of them were found to be relevant in our Austrian cohort. After correction for multiple testing (α=8.9×10-4), the most significant associations were observed for SNPs rs10505477 (P=6.08×10-4) and rs6983267 (P=7.35×10-4) of CASC8, rs3802842 (P=8.98×10-5, COLCA1,2), and rs12953717 (P=4.64×10-4, SMAD7). All previously unreported SNPs demand replication in additional samples. Reanalysis of existing GWAS datasets using model selection as tool to detect SNPs associated with a complex trait may present a promising resource to identify further genetic risk variants not only for colorectal cancer.

Adenomas avanzados en 3700 Colonoscopías / Advanced adenoma in 3700 colonoscopies

Objetivos: Determinar la prevalencia, distribución y características de los pólipos colorectales, con especial atención en los adenomas avanzados, en los pacientes adultos sometidos a colonoscopía en un Centro Endoscópico de Lima. Material y métodos : Estudio prospectivo de un año de duración. Se registraron datos demográficos, indicaciones y hallazgos de cada colonoscopía. La histología de cada lesión fue analizada por separado. Resultados : Se realizaron 3,701 colonoscopías en 3,690 pacientes; 1,492 (40.4%) tuvieron pólipo se ingresaron al estudio. 997 (27%) tuvieron adenomas y 495 (13.4%) pólipos no adenomatosos. Los adenomas predominaron en todo el colon y los hiperplásicos en el recto. El 78% de los adenomas y el 84% de los adenomas avanzados fueron detectados en mayores de 50 años. En 203 pacientes (5.5%) se encontraron un total de 260 adenomas avanzados; 62 (24%) tenían displasia de alto grado y 12 (4.5%) carcinoma temprano; también se hallaron 37 lesiones planas (14%) y 26 adenomas aserrados (10%). La historia previa de adenomas o cáncer colorectal (46/203 vs. 63/495; p < 0.01), así como la presencia de 3 o más adenomas en la colonoscopía (67/203 vs. 121/794; p < 0.01) fueron factores de riesgo significativamente relacionados con el hallazgo de adenomas avanzados. Conclusiones : Los adenomas son los pólipos colónicos más frecuentes en nuestra población y aproximadamente un 20% de ellos pueden ser avanzados, sobre todo en personas mayores de 50 años.

Objectives: To determine the prevalence of colon polyps, distribution in the colon, as well as their histological characteristics, with special mention on advanced adenomas, in an adult population at an endoscopy center in Lima. Material and Methods: One year long prospective study. We obtained the demographic data, reason for procedure, and endoscopic findings of each colonoscopy. Each polyp was studied separately and its histological findings recorded. Results : 3,701 colonoscopies were done in 3,690 patients; 1,492 (40,4%) had polyps and were included in the study. 997 (27%) had adenomatous polyps and 495 (13.4%) non adenomatous polyps. Adenomatous polyps were found throughout the colon, with a predominance of hyperplasic polypsin the rectum. 78% of the adenomatous polyps and 84% of the advanced adenomas were found in patients older than 50 years old. A total of 260 advanced adenomas were found in 203 patients (5.5%). In the advanced adenomas group, we found 62 lesions (24%) with high grade dysplasia and 12 (4.5%) with early carcinoma; as well as 37 flat lesions (14%) and 26 serrated adenomas (10%). In this group of patients, significant risk factors were: prior history of adenomas or colorectal cancer (46/203 vs. 63/495; p < 0.01), and multiple adenomatous polyps found during colonoscopy (67/203vs. 121/794; p < 0.01). Conclusions: Adenomatous polyps were the most frequently found polyps in our study; approximately 20% were advanced lesions, especially in patients older than 50 years old.