Risk Factors Associated with Adenomas or Serrated Polyps in Patients who Underwent Screening Colonoscopy

Colorectal polyps, including adenomas and serrated adenomas, are recognized as premalignant lesions responsible of a significant proportion of colorectal cancer, via the traditional adenoma-carcinoma sequence and the serrated neoplasia pathway. This study aimed to search for potential risk factors of these lesions.

Demographic and clinical characteristics of consecutive subjects with positive fecal immunological test who underwent colonoscopy, as a part of regional screening program (first round), were collected. In detail, age, gender, current smoking habit, presence of blood hypertension, diabetes, hyperlipaemia, and diverticulosis were considered as potential risk factors. Data were analysed at both univariate and multivariate analysis.

Data of 1,499 (707 males; mean age: 62.2 ± 7.1 years) subjects were collected. At least an adenomas or serrated polyp were detected in 533 (35.5%) and 47 (3.1%) subjects, respectively. At multivariable logistic regression analysis, smoking habit (OR=1.6, 95%CI: 1.3-2.1), diverticulosis (OR=1.5, 95%CI: 1.01-1.6), male gender (OR=1.4, 95%CI: 1.1-1.9), and age (OR=1.02, 95%CI: 1.01-1.04) were significant risk factors for adenomas, whilst smoking was the lone independent risk factor for serrated lesions (OR=2.3; 95%CI: 1.2-4.5).

In our study population, adenomas were associated with male gender, age, smoking and diverticula, whilst serrated polyp only with smoking habit. Other considered factors were not associated. Smoking avoiding or cessation could impact colon polyp development.