Risk factors for colorectal cancer in patients with multiple serrated polyps: A cross-sectional case series from genetics clinics

Buchanan, Daniel D., Sweet, Kevin, Drini, Musa, Jenkins, Mark A., Win, Aung Ko, English, Dallas R., Walsh, Michael D., Clendenning, Mark, McKeone, Diane M., Walters, Rhiannon J., Roberts, Aedan, Pearson, Sally-Ann, Pavluk, Erika, Hopper, John L., Gattas, Michael R., Goldblatt, Jack, George, Jill, Suthers, Graeme K., Phillips, Kerry D., Woodall, Sonja, Arnold, Julie, Tucker, Kathy, Muir, Amanda, Field, Michael, Greening, Sian, Gallinger, Steven, Perrier, Renee, Baron, John A., Potter, John D., Haile, Robert, Frankel, Wendy, de la Chapelle, Albert, Macrae, Finlay, Rosty, Christophe, Walker, Neal I., Parry, Susan and Young, Joanne P. (2010) Risk factors for colorectal cancer in patients with multiple serrated polyps: A cross-sectional case series from genetics clinics. PLoS One, 5 7: e11636-1-e11636-7. doi:10.1371/journal.pone.0011636

Author Buchanan, Daniel D.
Sweet, Kevin
Drini, Musa
Jenkins, Mark A.
Win, Aung Ko
English, Dallas R.
Walsh, Michael D.
Clendenning, Mark
McKeone, Diane M.
Walters, Rhiannon J.
Roberts, Aedan
Pearson, Sally-Ann
Pavluk, Erika
Hopper, John L.
Gattas, Michael R.
Goldblatt, Jack
George, Jill
Suthers, Graeme K.
Phillips, Kerry D.
Woodall, Sonja
Arnold, Julie
Tucker, Kathy
Muir, Amanda
Field, Michael
Greening, Sian
Gallinger, Steven
Perrier, Renee
Baron, John A.
Potter, John D.
Haile, Robert
Frankel, Wendy
de la Chapelle, Albert
Macrae, Finlay
Rosty, Christophe
Walker, Neal I.
Parry, Susan
Young, Joanne P.
Title Risk factors for colorectal cancer in patients with multiple serrated polyps: A cross-sectional case series from genetics clinics
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2010-07-16
Sub-type Article (original research)
DOI 10.1371/journal.pone.0011636
Open Access Status DOI
Volume 5
Issue 7
Start page e11636-1
End page e11636-7
Total pages 7
Editor Damian Pattinson
Place of publication San Francisco, CA, U.S.A.
Publisher Public Library of Science (PLoS)
Collection year 2011
Language eng
Formatted abstract
Background Patients with multiple serrated polyps are at an increased risk for developing colorectal cancer (CRC). Recent reports have linked cigarette smoking with the subset of CRC that develops from serrated polyps. The aim of this work therefore was to investigate the association between smoking and the risk of CRC in high-risk genetics clinic patients presenting with multiple serrated polyps.

Methods and Findings We identified 151 Caucasian individuals with multiple serrated polyps including at least 5 outside the rectum, and classified patients into non-smokers, current or former smokers at the time of initial diagnosis of polyposis. Cases were individuals with multiple serrated polyps who presented with CRC. Controls were individuals with multiple serrated polyps and no CRC. Multivariate logistic regression was performed to estimate associations between smoking and CRC with adjustment for age at first presentation, sex and co-existing traditional adenomas, a feature that has been consistently linked with CRC risk in patients with multiple serrated polyps. CRC was present in 56 (37%) individuals at presentation. Patients with at least one adenoma were 4 times more likely to present with CRC compared with patients without adenomas (OR = 4.09; 95%CI 1.27 to 13.14; P = 0.02). For females, the odds of CRC decreased by 90% in current smokers as compared to never smokers (OR = 0.10; 95%CI 0.02 to 0.47; P = 0.004) after adjusting for age and adenomas. For males, there was no relationship between current smoking and CRC. There was no statistical evidence of an association between former smoking and CRC for both sexes.

Conclusion A decreased odds for CRC was identified in females with multiple serrated polyps who currently smoke, independent of age and the presence of a traditional adenoma. Investigations into the biological basis for these observations could lead to non-smoking-related therapies being developed to decrease the risk of CRC and colectomy in these patients.
Copyright: © 2010 Buchanan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keyword Island methylator phenotype
Adenoma-carcinoma sequence
Hyperplastic polyposis
BRAF mutations
Microsatellite instability
Tobacco smoking
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published under "Research Article: Smoking Paradox in HPS".

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 33 times in Thomson Reuters Web of Science Article | Citations
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Created: Sun, 01 Aug 2010, 00:01:58 EST