Discussion On The Risk And Protective Factors For Progression Of Colorectal Adenomatous Polyps After Polypectomy

Objective：The aim of this study was to investigate the possible risk and protectivefactors for progression of colorectal adenomatous polyps after polypectomy.Methods: We retrospectively studied469patients under surveillance who hadundergone polypectomy for colorectal adenoma (CRA) at Gastroenterology departmentof Renji Hospital, Shanghai and had subsequently undergone at least another twocolonscopes after the adenoma resection during January1,2008to December31,2012.According to the first and last pathological diagnosis, three different models were used toevaluate the progression of the colorectal adenoma, which were good/medium/badprognosis, CRA recurrence/none-recurrence and condition advanced/stabilized.Telephone interviews were made and medical records were consulted for information onpatients’ general characteristics, personal history, medical history, life style and dietpattern. Univariate analysis was first used to estimate the exposure of interest, thenmultiple Logistic regression was applied to evaluate the independent risk and protectivefactors for progression of colorectal adenomatous polyps after polypectomy.Results: Advanced adenomas had a higher recurrence rate than non-advancedadenomas. Multiple Logistic regression showed that age, proximal colon adenoma,multiple adenoma(≥2),urban municipality of residence,family history of CRA, familyhistory of colorectal cancer(CRC),diabetes, high intake of meat, red meat consumption,alcohol intake were significantly associated with a worse prognosis, whilelong-term aspirin administration, beer consumption, sea food consumption were significantlyassociated with a better prognosis；proximal colon adenoma, multiple adenoma(≥2),urbanmunicipality of residence, family history of CRC, hypertension, red meat consumption,cigarette smoking were associated with increased risk of CRA recurrence, while beerconsumption and sea food consumption were associated with decreased risk of CRArecurrence；multiple adenoma(≥2)，family history of CRC，high intake of alcohol, longhistory of drug administration were positively associated with an advanced condition,while suburban municipality of residence, long-term aspirin administration, high intakeof vegetables, coffee consumption were negatively associated with an advancedcondition. Chronic disease of digestive system such as chronic atrophic gastritis and fattyliver were also negatively associated with progression of CRA.Conclusion: This study suggested that age, proximal colon adenoma, multipleadenoma(≥2),urban municipality of residence, cigarette smoking, alcohol consumption,hypertension, diabetes, long history of drug administration, family history of CRA,family history of CRC, high intake of meat, red meat consumption are significant riskfactors for CRA progression, on the other hand, suburban municipality of residence,long-term aspirin administration, high intake of vegetables, beer consumption, sea foodconsumption, coffee consumption may reduce the risk of CRA progression. Objective：The aim of this study was to investigate the possible risk and protectivefactors for progression of colorectal adenomatous polyps after polypectomy.Methods: We retrospectively studied469patients under surveillance who hadundergone polypectomy for colorectal adenoma (CRA) at Gastroenterology departmentof Renji Hospital, Shanghai and had subsequently undergone at least another twocolonscopes after the adenoma resection during January1,2008to December31,2012.According to the first and last pathological diagnosis, three different models were used toevaluate the progression of the colorectal adenoma, which were good/medium/badprognosis, CRA recurrence/non-recurrence and advanced condition/stabilized. Telephoneinterviews were made and medical records were consulted for information on patients’general characteristics, personal history, medical history, life style and diet pattern.Univariate analysis was first used to estimate the exposure of interest, then multipleLogistic regression was applied to evaluate the independent risk and protective factorsfor progression of colorectal adenomatous polyps after polypectomy.Results: Advanced adenomas had a higher recurrence rate than non-advancedadenomas. Multiple Logistic regression showed that age, proximal colon adenoma,multiple adenoma(≥2),urban municipality of residence,family history of CRA, familyhistory of colorectal cancer(CRC),diabetes, high intake of meat, red meat consumption,alcohol intake were significantly associated with a worse prognosis, whilelong-term aspirin administration, beer consumption, sea food consumption were significantlyassociated with a better prognosis；proximal colon adenoma, multiple adenoma(≥2),urbanmunicipality of residence, family history of CRC, hypertension, red meat consumption,cigarette smoking were associated with increased risk of CRA recurrence, while beerconsumption and sea food consumption were associated with decreased risk of CRArecurrence；multiple adenoma(≥2)，family history of CRC，high intake of alcohol, longhistory of drug administration were positively associated with an advanced condition,while suburban municipality of residence, long-term aspirin administration, high intakeof vegetables, coffee consumption were negatively associated with an advancedcondition. Chronic disease of digestive system such as chronic atrophic gastritis and fattyliver were also negatively associated with progression of CRA.Conclusion: This study suggested that age, proximal colon adenoma, multipleadenoma(≥2),urban municipality of residence, cigarette smoking, alcohol consumption,hypertension, diabetes, long history of drug administration, family history of CRA,family history of CRC, high intake of meat, red meat consumption are significant riskfactors for CRA progression, on the other hand, suburban municipality of residence,long-term aspirin administration, high intake of vegetables, beer consumption, sea foodconsumption, coffee consumption may reduce the risk of CRA progression.