Risk Factors for Serrated Polyps of the Colorectum

Abstract

Serrated pathway polyps are a relatively new area of interest in the field of colorectal cancer screening and prevention. Akin to conventional adenomas, some serrated polyps (SPs) have the potential to develop into malignant serrated neoplasms, yet little is known regarding risk factors for these lesions. Early epidemiological studies of hyperplastic polyps (HPs) were performed without knowledge of the serrated pathway, and likely included a mixture of SPs. More recently, studies have specifically evaluated premalignant SPs, such as the sessile serrated adenoma (SSA) or surrogates for these polyps such as large or proximally-located SPs. SPs share some risk factors with conventional adenomas, and have been associated with tobacco use, obesity, and age. Nonsteroidal anti-inflammatory drug (NSAID) use, fiber, folic acid, and calcium have been associated with reduced risk of SPs. Studies focused on SSAs specifically have reported associations with age, female sex, smoking, obesity, diabetes, and possibly diets high in fat, carbohydrates, and calories. Higher education has also been associated with risk of SSAs, while an inverse association between NSAID use and SSAs has been reported. Risk factors for traditional serrated adenomas (TSAs) are largely unknown. Studies are largely limited by varying inclusion criteria, as well as differences in pathological classification schemes. Further epidemiological studies of SPs are needed to aid in risk stratification and screening, and etiological research.

Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp

“…Lifestyle and dietary risk factors are the most common risk factors for development of HP according to epidemiological studies; other risk factors include alcohol consumption, cigarette smoking, obesity, metabolic syndrome, and fiber intake [5, 6]. …”

Effectiveness of flexible sigmoidoscopy screening in men and women and different age groups: pooled analysis of randomised trials

“…Risk factors for adenomas and serrated polyps might differ between men and women and could be important when flexible sigmoidoscopy is considered as a screening tool. 27 Being male is a well established risk factor for adenomas, but the evidence for sex as a risk factor for SSA/P is limited and conflicting. [28][29][30] Some reports have found that being female is an independent risk factor for SSA/P, but others have not confirmed this finding.…”

Lifestyle Risk Factors for Serrated Colorectal Polyps: A Systematic Review and Meta-analysis

“…The role of various modifiable and lifestyle risk factors have been described for colorectal pathologies, most notably for colorectal adenomas [17][18][19][20][21] . To date, only alcohol has been evaluated systematically with regards to SP risk and it was found that moderate and heavy alcohol intake significantly increased SP risk, by 19% and 60%, respectively 22 .…”