Association between lifestyle and dietary preference factors and conventional adenomas and serrated polyps

Jue Xu; Peihan Chi; Kang Qin; Biao Li; Zhongxue Cheng; Zhecong Yu; Caixia Jiang; Yunxian Yu

doi:10.3389/fnut.2023.1269629

Association between lifestyle and dietary preference factors and conventional adenomas and serrated polyps

Front Nutr. 2024 Jan 10:10:1269629. doi: 10.3389/fnut.2023.1269629. eCollection 2023.

Authors

Jue Xu^#¹, Peihan Chi^#², Kang Qin¹, Biao Li¹, Zhongxue Cheng¹, Zhecong Yu¹, Caixia Jiang¹, Yunxian Yu²

Affiliations

¹ HangZhou Center for Disease Control and Prevention, Hangzhou, China.
² Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China.

^# Contributed equally.

Abstract

Introduction: Both conventional adenoma (AD) and serrated polyp (SP) were known precursor lesions of colorectal cancer (CRC). Modifiable lifestyle factors were significantly associated with CRC risk, but whether these factors were related to the risk of different precursors of CRC needed to be clarified. This study aimed to evaluate the risks of AD and SP caused by lifestyle factors and compare the risk differences between AD and SP.

Methods: The study population was from the CRC screening cohort in Hangzhou, China. A total of 458,457 eligible individuals volunteered to undergo initial screening including the fecal immunochemical test (FIT) and the CRC risk assessment. Finally, 13,993 participants who had undergone colonoscopy tests and had been diagnosed at designated hospitals were selected in this study. All participants were required to fill out a questionnaire during the initial screening for collecting their information. The generalized estimate equation (GEE) model was used to assess the association between lifestyle factors/dietary preferences and AD/SP.

Results: The body mass index (BMI) and smoking were positively associated with the risks of only SP (BMI: OR = 1.50, 95%CI: 1.23-1.84; smoking: OR = 1.29, 95%CI: 1.07-1.55), only AD (BMI: OR = 1.53, 95%CI: 1.28-1.82; OR = 1.24, 95%CI: 1.11-1.39), and synchronous SP and AD (BMI: OR = 1.97, 95%CI: 1.40-2.75; smoking: OR = 1.53, 95%CI: 1.27-1.85). In the case-group comparison, smoking was more strongly associated with the risk of synchronous SP and AD than only AD. Alcohol drinking was positively associated with the risk of AD (OR = 1.28, 95%CI: 1.14-1.44), but no statistically significant difference was observed in risks in the case-group comparison. Furthermore, whole-grain intake was associated with a decreased risk of only AD (OR = 0.78, 95%CI: 0.65-0.93). However, white meat intake was positively associated with risks of only SP when compared with AD cases (OR = 1.60, 95%CI: 1.15-2.23).

Conclusion: The current study identified common risk factors such as BMI and smoking as well as different risks of certain factors (e.g., alcohol drinking and whole-grain intake) for SP and AD. However, there were still some factors, especially diet-related factors, that have not been fully elucidated in their association with the two lesions. Further research is needed in future to confirm and develop prevention strategies for different lesions.

Keywords: colorectal cancer; conventional adenomas; diet; modifiable lifestyle factors; serrated polyps.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The authors acknowledge the financial support from the Chinese National Natural Science Foundation (81973055), the National Key Research and Development Program of China (Grant No. 2022YFC2703505 and 2021YFC2701901), Major research and development projects of the Zhejiang Science and Technology Department (Grant No. 2018C03010), Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province (Grant No. 2020E10004), and Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang (Grant No. 2019R01007).