Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clin Gastroenterol Hepatol. 2019 Jul;17(8):1551-1560.e1. doi: 10.1016/j.cgh.2018.11.034. Epub 2018 Nov 23.
BACKGROUND & AIMS: We investigated the prevalence of sessile serrated polyps (SSPs) and the association between SSP risk and modifiable lifestyle factors in asymptomatic young adults.
We performed a cross-sectional study using a screening colonoscopy database of 13,618 asymptomatic subjects age 30 to 49 years, and 17,999 subjects age 50 to 75 years. We investigated risk factors of SSP by multivariable analyses of clinical data that included cigarette smoking and alcohol consumption.
In subjects age 30 to 49 years, the prevalence of SSP was 2.0% (275 of 13,618 individuals). Of all SSPs, 40.7% (112 of 275 SSPs) were large (≥10 mm). Smoking for 20 or more pack-years was associated with overall SSPs (odds ratio [OR], 1.87; 95% CI, 1.17-2.99) and large SSPs (OR, 3.03; 95% CI, 1.62-5.66). The association between anatomic location and 20 or more pack-years of smoking was stronger for distal SSPs than for proximal SSPs (OR, 2.71; 95% CI, 1.27-5.77 vs OR, 1.60; 95% CI, 1.00-2.54). Cessation of smoking for 5 years or more decreased the risk of SSPs (OR, 0.49; 95% CI, 0.28-0.86) and of large SSPs (OR, 0.23; 95% CI, 0.10-0.54). Alcohol consumption was associated with large SSPs. These findings were similar for subjects age 50 to 75 years.
In an analysis of a screening colonoscopy database, we found that in asymptomatic young adults, smoking and alcohol consumption were associated with any SSPs and large SSPs. Cessation of smoking decreased the risk of SSPs. Therefore, early lifestyle modification may be recommended for primary prevention of SSPs in young adults.
我们调查了无明显症状的年轻成年人中，多发性无蒂锯齿状息肉（SSP）的流行情况，以及 SSP 风险与可改变的生活方式因素之间的关系。
我们使用一项无症状 30 至 49 岁人群筛查结肠镜数据库和一项无症状 50 至 75 岁人群筛查结肠镜数据库进行了一项横断面研究。我们通过包括吸烟和饮酒在内的临床数据分析，调查了 SSP 的危险因素。
在 30 至 49 岁的人群中，SSP 的患病率为 2.0%（13618 人中 275 例）。在所有的 SSP 中，40.7%（275 个 SSP 中的 112 个）为大型（≥10mm）。吸烟 20 包年或以上与所有 SSP（比值比 [OR]，1.87；95%置信区间 [CI]，1.17-2.99）和大型 SSP（OR，3.03；95%CI，1.62-5.66）相关。吸烟 20 包年或以上与远端 SSP 之间的关联比近端 SSP 更强（OR，2.71；95%CI，1.27-5.77 与 OR，1.60；95%CI，1.00-2.54）。戒烟 5 年或以上可降低 SSP（OR，0.49；95%CI，0.28-0.86）和大型 SSP（OR，0.23；95%CI，0.10-0.54）的风险。饮酒与大型 SSP 相关。这些发现对于 50 至 75 岁的人群也相似。
在对筛查结肠镜数据库的分析中，我们发现，在无明显症状的年轻成年人中，吸烟和饮酒与任何 SSP 和大型 SSP 均相关。戒烟可降低 SSP 的风险。因此，对于年轻人，可能需要推荐早期生活方式改变来进行 SSP 的一级预防。
