Sessile serrated polyps share risk factors with conventional adenomas
Some of the same modifiable lifestyle factors associated with the risk for developing conventional adenomas are also associated with the risk for sessile serrated polyps, according to a study led by researchers from Vanderbilt University School of Medicine.
Moreover, investigators found that some of these risk factors have even stronger associations with sessile serrated polyps (SSPs), and also identified some unique risk factors associated with SSPs.
“Given the recent identification within the past 1 to 2 decades of SSPs as a [colorectal cancer] precursor, we are still in the infancy of understanding the etiology of these lesions and which risk factors may be associated with these polyps,” they wrote. “In initial models, we newly found that red meat, fat and fiber intakes were associated with SSP risk, and we also confirmed previous findings of associations with cigarette smoking and with NSAID use and a lack of association with alcohol use. After mutual adjustment, these associations remained for red meat intake, cigarette smoking and NSAID use.”
Using data from a colonoscopy-based case-control study performed in Nashville between February 2003 to October 2010, the researchers compared modifiable risk factors for SSPs (n = 214), conventional adenomas (ADs; n = 1,779) and hyperplastic polyps (HPs; n = 560), and used 3,851 patients without polyps as controls.
While cigarette smoking status, duration and intensity were associated with an increased risk for all polyp types, it was more strongly associated with SSPs compared with ADs (OR = 1.74; 95% CI, 1.16-2.62 for current vs. never smokers).
In addition, current regular NSAID use was associated with a lower risk for SSPs (OR = 6.2; 95% CI, 0.62-0.85) and ADs compared with those who never regularly used NSAIDs. Risk reduction was dose-dependent for years of use and when used more than seven times per week for both ADs and SSPs, but was more strongly associated with SSPs when NSAIDs were used for more than 10 years.
Finally, high red meat consumption was strongly associated with an increased risk for SSPs compared with low red meat consumption (OR = 2.59; 95% CI, 1.41-4.74), and this association was stronger for SSPs than for ADs.
“After adjustment for other factors, SSP risk was no longer statistically significant for obesity and fiber, folate and fat intakes, although fiber intake was associated with a borderline statistically significant reduced SSP,” the researchers wrote. “Conversely, several associations persisted after adjustment. Smoking remained strongly associated with risk of all polyps. NSAID use and red meat intake were associated with SSP risk.”
The researchers concluded that preventive efforts for reducing the risk for ADs may also apply to SSPs, but further study is needed to confirm their findings. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.