RECURRENT ADENOMATOUS POLYPS AND BODY-MASS INDEX

Interest in risk factors for the recurrence of adenomatous polyps deri ves from the use of recurrent adenomas as surrogate end points in long itudinal studies of invasive colorectal cancer, In this case-control s tudy, the effect of increased body mass index (BMI) on the risk of rec urrent adenomas was investigated, Subjects consisted of patients seen at three colonoscopy practices in New York City, all of whom had a pre vious history of adenomas, On index colonoscopy, recurrent cases had a n adenoma, whereas controls were normal, Men and women were analyzed s eparately, with different logistic models developed using backward eli mination from a full model containing the covariates age at diagnosis, age-at-highest-weight, pack-years of smoking, activity level, energy intake, and fat and fiber intake, Men in the upper quartiles of BMI we re found to be at greater risk of recurrent adenomas. In a model which controlled for age at diagnosis, age-at-highest-weight, activity leve l, pack-years of smoking and kilocalories, the estimated odds ratios w ere 2.2, 1.9 and 1.9 respectively for the second, third and fourth qua rtiles compared to the first quartile. Only the estimate for the secon d quartile was found to be statistically significant, No effect was ob served for women, even in a model which controlled for age at diagnosi s, age-at-highest-weight, pack-years and total fat, Obesity may play a role in adenoma recurrence, Confirmation of this finding would have i mportant implications for possible prevention strategies in the future .