Predictors of advanced colorectal neoplasia at initial and surveillance colonoscopy after positive screening immunochemical faecal occult blood test

Edoardo Botteri, Cristiano Crosta, Vincenzo Bagnardi, Darina Tamayo, Angelica Maria Sonzogni, Giuseppe De Roberto, Annalisa de Leone, Albert Lowenfels, Patrick Maisonneuve

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Characteristics such as gender and lifestyle are not taken in account in colorectal cancer screening and surveillance recommendations. Aims: To identify factors associated with advanced neoplasia at initial and surveillance colonoscopy. Methods: In this observational study, 750 individuals with positive faecal occult blood test, aged 50-74 years, underwent a first screening colonoscopy in 2007-2009. We collected anthropometric data as well as data on physical activity, smoking and drinking habits, fruit and vegetable consumption and low-dose aspirin use through a questionnaire. Results: At initial colonoscopy advanced neoplasia (n = 399, 53.2%) was positively associated with age, male gender, smoking and alcohol drinking, and inversely associated with physical activity, fruit and vegetables consumption and long-term use of aspirin. These 7 factors were used to calculate a risk score, ranging from 0 (no unfavourable characteristics) to 7 (all unfavourable characteristics present), which was significantly associated with advanced neoplasia (odds ratio 1.55 for one point increase, P <0.01). Among the 372 adenoma patients who returned for follow-up surveillance colonoscopy, the score remained associated with advanced neoplasia (odds ratio 1.28 for one point increase, P = 0.01). Conclusion: Besides age and gender, modifiable factors such as lifestyle and aspirin use were associated with the risk of advanced neoplasia at initial and surveillance colonoscopy.

Original languageEnglish
Pages (from-to)321-326
Number of pages6
JournalDigestive and Liver Disease
Volume48
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

Keywords

  • Colonoscopy
  • Colorectal cancer
  • Lifestyle
  • Screening

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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