kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2014.14.4.141 kjhp-14-141 Original Article Risk Factors of Colorectal Polyps in Jeju Island UmMira 1 KongMi Hee 1 2 KimHyeon Ju 1 2 NaYeoun Ja 1 Department of Family Medicine, Jeju National University Hospital, Jeju, Korea Department of Family Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea Corresponding author：Hyeon Ju Kim, MD, PhD Department of Family Medicine, Jeju National University Hospital Jeju National University School of Medicine, 15 Aran 13-gil, Jeju 690-767, Korea Tel: +82-64-717-1830, Fax: +82-64-717-1581 E-mail: fmhjukim@hanmail.net 01 2014 20 01 2014 14 4 141 146 26032014 26112014 Copyright © 2014 The Korean Society of Health Promotion and Disease Prevention 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background

The incidence of colorectal polyps have been reported to be increasing in those aged 30–40 years who consume fast food, have low physical activity, and use alcohol and cigarettes. We analyzed the characteristics and risk factors of colorectal polyps in asymptomatic adults in Jeju Island.

 Methods

Data on 1700 individuals who underwent a screening colonoscopy from 1 July, 2010 to 30 June, 2012 were analyzed based on age, gender, body mass index (BMI), blood pressure, blood tests, and behavioral habits including alcohol use, smoking, and exercise.

 Results

The prevalence of colorectal polyps, including adenomatous and hyperplastic, is 43.1% and is higher in males (P<0.001). The prevalence according to age group shows increasing by age (P for trend<0.001). The most common histologic type of polyp is adenomatous in the <50 years and >50 years age groups, 27.3% and 45.3% respectively. And the percentage of adenomatous polyps has shown an increasing trend along with increasing number and size of polyps (P for trend<0.001). BMI, waist circumference (WC), fasting blood sugar, and triglyceride were higher in males with polyps than males in the control group. BMI and WC were higher and HDL-cholesterol was lower in females with polyps. The incidence of colorectal polyps was higher in male and female smokers (P<0.001 and P=0.035 respectively).

 Conclusions

Our results showed that older age, male gender, obesity, and smoking are risk factors for colorectal polyps. The prevalence of colorectal adenomatous polyps is 27.3% in <50 yrs, 33.4% in the 40s. For early detection and treatment, we recommend a screening colonoscopy for those with risk factors.

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General characteristics of subjects

Characteristics Male (n=1,067)
 Pb Female ((n=633)
 Pb
Polypsa (n=543) No (n=524) Polypsc (n=189) No (n=444)
Height, cm 169.11±5.71 170.22±5.87 0.513 155.90±5.15 156.51±5.34 0.294
Weight, kg 73.14±9.86 73.35±9.95 0.030 60.47±8.07 57.45±7.96 <0.001
BMI, kg/m2 25.53±2.85 25.28±2.85 0.033 24.87±3.03 23.46±3.12 <0.001
WC, cm 88.81±7.36 87.76±7.44 0.025 84.39±8.40 80.08±8.38 <0.001
SBP, mmHg 127.00±13.47 126.52±13.48 0.705 121.22±14.68 117.81±14.46 0.426
DBP, mmHg 77.76±9.89 77.59±9.97 0.933 73.46±10.40 71.30±9.38 0.154
FBS, mg/dL 99.92±30.36 92.91±17.50 0.001 93.79±19.68 90.67±19.28 0.249
TC, mg/dL 198.40±35.09 197.45±33.12 0.512 203.92±35.26 197.26±32.30 0.222
TG, mg/dL 141.24±109.41 132.02±79.90 0.019 90.80±50.50 82.92±49.28 0.649
HDL, mg/dL 49.80±12.06 49.83±11.97 0.509 57.27±13.00 61.33±14.32 0.013

Abbreviations: BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBS, fasting blood sugar; TC, total cholesterol; TG, triglyceride; HDL-C, high density lipoprotein-cholesterol. Values are presented as means±SD.

Polyps: containing adenomatous and hyperplastic colorectal polyps.

Calculated by ANCOVA adjusted by age.

Age distribution of colorectal polyps and adenoma

Age, y Polypsa N (%) Pb Adenoma N (%) Pb
20–29 2 (9.1) <0.001 2 (9.1) <0.001
30–39 108 (28.3)   76 (19.9)  
40–49 216 (41.0)   176 (33.4)  
50–59 248 (49.6)   206 (41.2)  
60–69 137 (58.1)   122 (51.7)  
70- 21 (63.6)   20 (60.6)  
Total 732 (43.1)   602 (35.4)  

Values are presented as number (%).

Polyps: containing adenomatous and hyperplastic colorectal polyps.

Calculated by linear by linear association for trend test.

Characteristics of colorectal polyps

Characteristics Number (%)
< 50yr ≥50yr
Pathology 362 (38.9) 438 (57.0)
 Adenomatous 254 (27.3) 348 (45.3)
 Hyperplastic 127 (13.6) 144 (18.7)
 Cancer 1 (0.1) 1 (0.1)
 Carcinoid tumor 3 (0.3) 1 (0.1)
 Non-specific 78 (8.4) 94 (12.2)
Number
 1 192 (53.2) 169 (38.5)
 2 90 (24.9) 123 (15.4)
 3 32 (8.9) 56 (12.8)
 4 20 (5.5) 31 (7.1)
 ≥5 27 (7.5) 60 (13.7)
Size, mm
 < 5.0 99 (27.4) 98 (22.3)
 5.0 – 9.0 218 (60.4) 276 (62.9)
 ≥ 10.0 44 (12.2) 65 (14.8)

Values are presented as number (%).

Multivariate logistic regression analysis of colorectal polyps according to risk factors

  Male
 Female
OR (95% CI) Pa OR (95% CI) Pa
Age, per year 1.073 (1.056–1.091) <0.001 1.063 (1.035–1.353) 0.012
BMI, per 1kg/m2 1.054 (1.002–1.109) 0.042 1.183 (1.035–1.353) 0.014
Smokingb 1.816 (1.349–2.444) <0.001 3.470 (1.088–11.065) 0.035
Alcoholc 1.180 (0.884–1.575) 0.261 0.572 (0.184–1.774) 0.333
Exercised 0.866 (0.631–1.188) 0.372 1.043 (0.461–2.362) 0.920

Abbreviations: OR, odds ratio; CI, confidence interval; BMI, body mass index.

Calculated by multiple logistic regression analysis.

Smoking: current smoker.

Alcohol: use greater than three times per week,

Exercise: over 30min in a day and over three times per week.