SNFGE SNFGE
 
Thématique :
- Cancer colorectal (CCR)
Originalité :
Intermédiaire
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Docteur Jean-Michel ROUILLON
Coup de coeur :
 
 
Gastroenterology
  2016/09  
 
  2016 Sep 14. pii: S0016-5085(16)35028-4  
  doi: 10.1053/j.gastro.2016.09.003  
 
  Lifestyle Risk Factors for Serrated Colorectal Polyps: a Systematic Review and Meta-analysis  
 
  Bailie L, Loughrey MB, Coleman HG  
  http://www.sciencedirect.com/science/article/pii/S0016508516350284  
 
 

Background & Aims

Certain subsets of colorectal serrated polyps (SP) have malignant potential. We performed a systematic review and meta-analysis to investigate the association between modifiable lifestyle factors and risk for SPs.

Methods

We conducted a systematic search of Medline, Embase, and Web of Science, for observational or interventional studies that contained the terms risk or risk factor, and serrated or hyperplastic, and polyps or adenomas, and colorectal (or synonymous terms), published by March 2016. Titles and abstracts of identified articles were independently reviewed by at least 2 reviewers. Adjusted relative risks (RR) and 95% CIs were combined using random effects meta-analyses to assess the risk of SP, when possible.

Results

We identified 43 studies of SP risk associated with 7 different lifestyle factors: smoking, alcohol, body fatness, diet, physical activity, medication and/or hormone replacement therapy. When we compared the highest and lowest categories of exposure, factors we found to significantly increase risk for SP included tobacco smoking (RR, 2.47; 95% CI, 2.12–2.87), alcohol intake (RR, 1.33; 95% CI, 1.17–1.52), body mass index (RR, 1.40; 95% CI, 1.22–1.61), and high intake of fat or meat. Direct associations for smoking and alcohol, but not body fat, tended to be stronger for sessile serrated adenomas/polyps than hyperplastic polyps. In contrast, factors we found to significantly decrease risks for SP included use of non-steroidal anti-inflammatory drugs (RR, 0.77; 95% CI, 0.65–0.92) or aspirin (RR, 0.81; 95% CI, 0.67–0.99), as well as high intake of folate, calcium, or fiber. No significant associations were detected between SP risk and physical activity or hormone replacement therapy.

Conclusions

Several lifestyle factors, most notably smoking and alcohol, are associated with SP risk. These findings enhance our understanding of mechanisms of SP development and indicate that risk of serrated pathway colorectal neoplasms could be reduced with lifestyle changes.

 
Question posée
 
Existe-t-il des facteurs de risque d'apparition de polypes festonnés liés au mode de vie ?
 
Question posée
 
La consommation de tabac, d'alcool, un IMC élevé et une consommation importante de graisses et de viande sont des facteurs de risque. La consommation d'aspirine ou d'AINS, la prise de folates, de calcium et de fibres réduit les risques d'apparition de polypes festonnés.
 
Commentaires

Cette méta-analyse des facteurs de mode vie favorisant les lésions pré-néoplasiques que sont les adénomes festonnés, conforte les grandes lignes des recommandations hygiéno-diététiques concernant la prévention des tumeurs colorectales.

 
www.snfge.org