Risk factors for advanced colorectal neoplasms in the proximal colon in 6218 subjects undergoing complete colonoscopy

• Published in: Journal of gastroenterology and hepatology Vol. 34; no. 1; pp. 113 - 119
• Main Authors: Hirai, Hoyee W, Ching, Jessica Y L, Wu, Justin C Y, Sung, Joseph J Y, Chan, Francis K L, Ng, Siew C
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.01.2019
• Subjects: Adenoma - diagnostic imaging; Adenoma - epidemiology; Adenoma - pathology; Age; Age Factors; Anticoagulants; Aspirin; Body mass index; Carcinoma - diagnostic imaging; Carcinoma - epidemiology; Carcinoma - pathology; Case-Control Studies; Colon; Colon, Ascending; Colon, Transverse; Colonic Neoplasms - diagnostic imaging; Colonic Neoplasms - epidemiology; Colonic Neoplasms - pathology; Colonoscopy; Colorectal carcinoma; Coronary artery disease; Cross-Sectional Studies; Diabetes mellitus; Female; Gender; Heart diseases; Hong Kong - epidemiology; Humans; Hypertension; Hypertension - epidemiology; Inflammation; Ischemia; Male; Middle Aged; Migration; proximal lesion; risk factor; Risk Factors; serrated lesion; Sex Factors; Smoking; Smoking - epidemiology; Hong Kong; serrated lesion; risk factor; proximal lesion
• ISSN: 0815-9319; 1440-1746; 1440-1746
• DOI: 10.1111/jgh.14357

Background and Aim Proximal migration of colonic lesion has been observed; however, risk factors of lesions in the proximal colon remain uncertain. This study aimed to investigate risk factors of lesions in the proximal colon. Methods Consecutive subjects with complete colonoscopy were included. The primary outcome was risk factors associated with advanced neoplasm (AN) and serrated lesion in the proximal colon. Age, gender, first‐degree relative (FDR) with colorectal cancer (CRC), smoking, alcohol consumption, body mass index, hypertension, diabetes, ischemic heart disease, and the use of aspirin, non‐steroidal anti‐inflammatory drug, and anticoagulants were fitted into a regression model, with reference to subjects without colonic finding. Results were measured by odds ratio (OR) with 95% confidence interval (CI). Results Among 6218 subjects (mean age 56.65 ± 6.15 years; 46.8% male), 352 (5.7%) had AN; 809 (13.0%) had serrated lesions, and 3648 (58.7%) had no colonic finding. There were 148 (2.4%) and 235 (3.8%) subjects having AN and serrated lesion in the proximal colon. Age ≥ 50 (OR: 13.30; 95% CI: 1.85–95.76), male gender (OR: 1.82; 95% CI: 1.26–2.62), FDR with CRC (OR: 2.12; 95% CI: 1.43–3.15), and hypertension (OR: 1.86; 95% CI: 1.30–2.68) were associated with AN in the proximal colon. Age ≥ 50 (OR: 5.72; 95% CI: 2.10–15.53), male gender (OR: 1.54; 95% CI: 1.15–2.05), and smoking (OR: 1.85; 95% CI: 1.23–2.79) increased risk of serrated lesions in the proximal colon. Conclusion Age ≥ 50 and male gender were associated with both proximally located AN and serrated lesion; FDR with CRC and hypertension increased the risk of proximal AN, while ever smoking increased the risk of proximal serrated lesion. FDR with CRC was not associated with serrated lesion.