Risk Factors of Colorectal Polyps in Jeju Island

Article information

Korean J Health Promot. 2014;14(4):141-146

Publication date (electronic) : 2014 January 20

doi : https://doi.org/10.15384/kjhp.2014.14.4.141

Mira Um ¹, Mi Hee Kong ¹^,², Hyeon Ju Kim ¹^,²^,, Yeoun Ja Na ¹

¹Department of Family Medicine, Jeju National University Hospital, Jeju, Korea

²Department 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

Received 2014 March 26; Accepted 2014 November 26.

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.

Keywords: Colorectal polyp; Prevalence; Risk factors

Table 1.

General characteristics of subjects

Table 2.

Age distribution of colorectal polyps and adenoma

Table 3.

Characteristics of colorectal polyps

Table 4.

Multivariate logistic regression analysis of colorectal polyps according to risk factors

References

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Article information Continued

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Table 1.

General characteristics of subjects

Characteristics	Male (n=1,067)		P^b	Female ((n=633)		P^b
Characteristics	Polyps^a (n=543)	No (n=524)	P^b	Polypsc (n=189)	No (n=444)	P^b
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.

Table 2.

Age distribution of colorectal polyps and adenoma

Age, y	Polyps^a N (%)	P_b	Adenoma N (%)	P^b
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.

Table 3.

Characteristics of colorectal polyps

Characteristics	Number (%)
Characteristics	< 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 (%).

Table 4.

Multivariate logistic regression analysis of colorectal polyps according to risk factors

	Male		Female
	OR (95% CI)	P^a	OR (95% CI)	P^a
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
Smoking^b	1.816 (1.349–2.444)	<0.001	3.470 (1.088–11.065)	0.035
Alcohol^c	1.180 (0.884–1.575)	0.261	0.572 (0.184–1.774)	0.333
Exercise^d	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.