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By Anthony J. Brown, MD Tuesday, December 9, 2003 NEW YORK (Reuters Health) - US researchers have identified several risk factors for the polyps that become colon cancer. Many of the risk factors can be eliminated through lifestyle changes, such as quitting smoking and taking vitamins. "Our study is unique because it involved (people without symptoms) who had completed colonoscopy and because it was large enough to look at a wide variety of purported risk factors," lead author Dr. David A. Lieberman, from the Portland VA Medical Center in Oregon, told Reuters Health. The study focused on 329 subjects found to have advanced polyps on colonoscopy and 1441 subjects with no polyps. At the time of colonoscopy, the subjects were between 50 and 75 years of age and had no colon symptoms. The new findings are published in the Journal of the American Medical Association. Having a close family member with colon cancer, smoking, and moderate to heavy alcohol use were all tied to an increased risk of polyps. Conversely, eating foods high in cereal fiber, taking vitamin D supplements, and using drugs like aspirin seemed to protect against polyps. "Smoking emerged as a stronger risk factor than we might have expected based on previous studies," Lieberman noted. "On the protective side, vitamin D emerged as a strong" factor against polyps, he added. "This supports a report earlier this month showing that vitamin D and calcium may work together to lower the cancer risk." Increased physical activity, multivitamin use, calcium intake, and decreased intake of red meat had a marginal beneficial effect on polyp risk. Body weight, prior gallbladder removal, and cholesterol level were not linked to the risk. "Although our study doesn't prove that modifying these risk factors will lower the colon cancer risk, it does provide a roadmap for very simple lifestyle changes that could have a beneficial effect," Lieberman said. "The other take-home message, which is consistent with previous reports, is that people with a family history of colon cancer really need to discuss screening with their healthcare provider," he added. SOURCE: Journal of the American Medical Association, December 10, 2003.
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