Certain subsets of colorectal serrated polyps have malignant potential.
Dr Helen Coleman and colleagues from Northern Ireland performed a systematic review and meta-analysis to investigate the association between modifiable lifestyle factors and risk for serrated polyps.
The team 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, published by 2016.
Titles and abstracts of identified articles were independently reviewed by at least 2 reviewers.
|There were direct associations for smoking and alcohol tended to be stronger for sessile serrated polyps|
The researchers identified 43 studies of serrated polyps risk associated with 7 different lifestyle factors, including smoking, alcohol, body fatness, diet, physical activity, medication, and hormone-replacement therapy.
When the team compared the highest and lowest categories of exposure, factors found to significantly increase risk for serrated polyps included tobacco smoking, alcohol intake, body mass index, and high intake of fat or meat.
The research team found that 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 the researchers found to significantly decrease risks for serrated polyps included use of nonsteroidal anti-inflammatory drugs or aspirin, as well as high intake of folate, calcium, or fiber.
The researchers detected no significant associations between serrated polyp risk, and physical activity or hormone replacement therapy.
Dr Coleman's team comments, "Several lifestyle factors, most notably smoking and alcohol, are associated with serrated polyps risk."
"These findings enhance our understanding of mechanisms of serrated polyp development, and indicate that risk of serrated pathway colorectal neoplasms could be reduced with lifestyle changes."