Lifestyle Factors Associated With Colorectal Adenomas: Results From a Vietnamese Case-Control Study

Although colorectal cancer (CRC) is the fourth most common cancer in Vietnam, evidence on lifestyle factors associated with colorectal adenomas (CRA) remains limited. We conducted a case-control study to examine lifestyle factors associated with CRA. Conditional logistic regression (CLR) was performed using 845 matched case-control pairs. Structural equation modeling (SEM) and propensity score matching (PSM) analyses were conducted using the full sample of 847 cases and 1201 controls. CLR identified heavy alcohol consumption (OR 1.59, 95% CI: 1.13-2.23), current smoking (OR 1.88, 95% CI: 1.28-2.76), a personal history of colorectal polyps (OR 7.02, 95% CI: 4.02-12.27), and a sibling history of CRC (OR 3.33, 95% CI: 1.23-9.03) as risk factors for overall adenomas. A personal history of colorectal polyps was associated with both advanced and non-advanced adenomas, whereas current smoking and heavy alcohol consumption were associated with advanced but not non-advanced adenomas. SEM and PSM generally corroborated the CLR findings, with heavy alcohol consumption, current smoking, and a personal history of colorectal polyps associated with advanced adenomas. PSM additionally suggested a possible positive association between high meat consumption and advanced adenomas. CLR identified an inverse association between a beverage pattern characterized by coffee, black tea, and fruit juice consumption and adenoma prevalence; however, this finding was not confirmed in PSM. In conclusion, current smoking, heavy alcohol consumption, and a personal history of colorectal polyps were consistently associated with an increased risk of CRA, particularly advanced adenomas. These findings support lifestyle-focused prevention strategies and risk-stratified CRC surveillance in Vietnam.