BMC Cancer (Oct 2022)

Modifiable lifestyle factors have a larger contribution to colorectal neoplasms than family history

  • Shuyuan Wang,
  • Zhen Yuan,
  • Yuqi Wang,
  • Xuanzhu Zhao,
  • Weifeng Gao,
  • Hongzhou Li,
  • Yuanshun Zhao,
  • Zili Zhang,
  • Shuiqing Liang,
  • Zhaoce Liu,
  • Qinghuai Zhang,
  • Hong Ma,
  • Xipeng Zhang,
  • Wei Cui,
  • Chunze Zhang

DOI
https://doi.org/10.1186/s12885-022-10141-1
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 9

Abstract

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Abstract Background Screening recommendations for colorectal cancer (CRC) are mainly based on family history rather than lifestyle risk factors. We aimed to assess and compare risk factors for colorectal neoplasm (CRN) and evaluate trends in neoplasm detection rates during the three rounds of screening from 2012 to 2020 in Tianjin, China. Methods This study was based on 89,535 first-recorded colonoscopies in Tianjin CRC screening program, 2012–2020. Of these, 45,380 individuals with complete family history and lifestyle factors were included for population attributable fraction (PAF) estimation. Results The overall detection rate of nonadvanced adenomas, advanced adenomas and CRC was 39.3%, 5.9% and 1.5%, respectively. The PAFs of current smoking, alcohol consumption, physical activity, higher BMI and family history of CRC, respectively, were 8.9%, 2.6%, 1.9%, 5.8%, and 1.1% for males with nonadvanced CRN; 12.3%, 7.3%, 4.9%, 7.2%, and 0.8% for males with advanced CRN; 3.4%, 0.4%, 2.1%, 7.8%, and 0.7% for females with nonadvanced CRN; and 4.3%, 0.2%, 8.2%, 8.5%, and -0.6% for females with advanced CRN. The PAFs of selected lifestyle factors were 19.9% for males with nonadvanced CRN, 29.0% for males with advanced CRN, 9.7% for females with nonadvanced CRN and 13.8% for females with advanced CRN. Conclusions Modifiable lifestyle factors, including smoking, alcohol consumption, physical activity and BMI, have a larger contribution to CRN than family history of CRC. Our findings will provide references for developing guidelines of CRC prevention and control in China.

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