Association of Laboratory data on Lifestyle-related Factors with the Risk of Colorectal Adenoma and Cancer: A Retrospective Cohort Study with Long-term Follow-up Total Colonoscopy

Abstract

AIM: Lifestyle-related factors, in particular hyperglycemia, have been positively related to the risk of colorectal adenoma or cancer in most, but not all, studies. METHODS: We conducted a retrospective cohort study using data from 611 individuals who had at least 10-year follow-up with total colonoscopy for colorectal adenoma or cancer. Blood glucose, cholesterol, triglycerides, and uric acid as “lifestyle-related factors” were measured in all patients at their first TCS. RESULTS: By Kaplan-Meier analysis, comparing the cumulative incidence of colorectal adenoma or cancer, the rate in cases with a blood glucose level of 110 mg/dL or more was significantly higher than in cases with less than 110 mg/dL (p=0.013 by the log-rank test, glucose<110 vs. glucose 110-125, p=0.014, glucose<110 vs. glucose ≥126). Cox’s proportional hazards model showed that a high level of blood glucose (110 mg/dL or more) was more strongly associated with an increased risk of adenoma or cancer relative to that in cases with a level of less than 110 mg/dL [hazard ratio (HR), 1.65; 95% CI, 1.33-1.94]. There was no significant difference in the cumulative incidence of adenoma or cancer according to the levels of cholesterol, triglycerides, or uric acid. Moreover, this relationship was also found in patients of older age (>50 years) and in the adenoma and cancer groups (HR, 1.4, 95% CI, 1.09–1.71; HR, 1.3, 95% CI, 0.98–1.63). CONCLUSION: Our results suggest that hyperglycemia increases the risk of colorectal adenoma or cancer in Japanese adults as determined by long-term follow-up with total colonoscopy.