Results of screening in Lublin Province, Poland, for colorectal cancer and neoplastic polyps - the role of environmental factors
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Department of Gastroenterology, Medical University of Lublin, Poland
Department of Clinical Pathomorphology, Medical University of Lublin, Poland
Halina Cichoż-Lach   

Department of Gastroenterology, Medical University of Lublin, Poland
Ann Agric Environ Med. 2017;24(1):108–112
Screening colonoscopy is a recommended tool, and the most sensitive and cost-effective method for reducing the incidence of colorectal cancer (CRC).

The purpose of the study was to present the results of a 5-year screening for early detection of CRC carried out among the population of the central-eastern regions of Poland, primarily in Lublin Province.

Material and Methods:
Screening colonoscopy was conducted in a group of 1,009 patients – 636 women and 373 men, aged 40–65 years.

Neoplastic polyps were found in 275 patients, advanced adenomas in 49 patients and adenocarcinoma in 13. 70.55% of neoplastic polyps was located in the distal colon, 18.9% in the proximal part and 10.55% in both regions, advanced adenomas in 79.59%, 8.16% and 12.25%, respectively. Adenocarcinoma was located in the proximal colon in 2 cases and in the distal region in 11 cases. Neoplastic polyps and advanced adenomas occurred significantly more frequently in smokers than in non-smokers. Neoplastic polyps were found statistically more frequent in males than in females, among the overweight and obese patients, than in subjects with normal BMI, and more frequently in the group of urban, compared to rural patients. However, the frequency of advanced adenomas and CRC was not statistically different in those groups. The incidence of CRC was statistically more frequent in males than in females. Smoking and male gender were significant risk factors for developing neoplastic polyps. Male gender seemed to predispose to CRC. Obesity was found to favour advanced adenomas.

Ferlay J, Autier P, Biniol P, Heanue M, Colombet M, Boyle P. Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol. 2007; 18(3): 581–592.
Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. Ca Cancer J Clin. 2010; 60(5): 277–300.
the State Register of Carcinomas in Poland
Garborg K, Holme Ø, Løberg M, Kalager M, Adami HO, Bretthauer M. Current status of screening for colorectal cancer. Ann Oncol. 2013; 24(8): 1963–1972.
Young PE, Womeldorph CM. Colonoscopy for colorectal cancer screening. J Cancer. 2013; 4(3): 217–226.
Katicic M, Antoljak N, Kujundżic M, Stamenic W, Stoko-Poljak D, et al. Results of National Colorectal Cancer Screening Program in Croatia. World J Gastroenterol. 2012; 18(32): 4300–4307.
Zavoral M, Suchanek S, Zavada F, Dusek L, Muzik J, Seifert B, et al. Colorectal cancer screening in Europe. World J Gastroenterol. 2009; 15(47): 5907–5915.
West NJ, Boustiere C, Fischbach W, Parente F, Leicester RJ. Colorectal cancer screening in Europe: differences in approach; similar barriers to overcome. Int J Colorectal Dis. 2009; 24(7): 731–740.
Pox C, Schmiegel W, Classen M. Current status of screening colonoscopy in Europe and in the United States. Endoscopy. 2007; 39(2): 168–173.
Reguła J, Rupiński M, Kraszewska E, Polkowski M, Pachlewski J, Orłowska J, et al. Colonoscopy in colorectal cancer screening for detection of advanced neoplasia. N Eng J Med. 2006; 355(18): 1863–1872.
Kotowski B, Kamiński MF, Rupiński M, Kraszewska E, Pachlewski L, Orłowska J, et al. Colonoscopy quality indicators in the National Colorectal Cancer Screening Program in Poland [in Polish]. Gastroenterol Klin. 2009; 1(1): 45–53.
Świątkowski M, Meder A, Sobczyński L, Koza J, Szamocka M, Brudny J. The screening program for the early colorectal cancer detection performer at the Gastroenterology Departament of Nicolas Copernicus Universisty in Toruń Collegium Medium in Bydgoszcz in 2000–2009. Gastroenterol Pol. 2010; 17(6): 410–415.
Morini S, Hassan C, Zullo A, Lorenzetti R, de Mathaeis M, Stella F, et al. Detection of colonie polyps according to insertion/withdrawal phases of colonoscopy. Int J Colorectal Dis. 2009; 24(5): 527–530.
Botteri E, Iodice S, Bagnardi V, Raimondi S, Lowenfels AB, Maisonneuve P. Smoking and colorectal cancer. A meta-analysis. JAMA. 2008; 300(23): 2765–2778.
Ning Y, Wang L, Giovannucci EL. A quantitative analysis of body mass index and colorectal cancer: findings from 56 observational studies. Obes Rev. 2010; 11(1): 19–30.
Aleksandrova K, Nimptsch K, Pischon T. Influence of obesity and related metabolic alterations on colorectal cancer risk. Curr Nutr Rep. 2013; 291): 1–9.
Hong S, Cai Q, Chen D, Zhu W, Huang W, Li Z. Abdominal obesity and the risk of colorectal adenoma: a meta-analysis of observational studies. Eur J Cancer Prev. 2012; 21(6): 523–531.
Yun KE, Chang Y, Jung HS, Kim CW, Kwon MJ, Park SK, et al. Impact of body mass index on the risk of colorectal adenoma in a metabolically healthy population. Cancer Res. 2013; 73(13): 4020–4027.
Larsson SC, Wolk A. Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr. 2007; 86(3): 556–565.
Bardou M, Barkun AN, Martel M. Obesity and colorectal cancer. Gut. 2013; 62(6): 933–947.
Guffey CR, Fan D, Singh UP, Murphy EA. Linking obesity to colorectal cancer: recent insights into plausible biological mechanisms. Curr Opin Clin Nutr Metab Care. 2013 Jun 10. [Epub ahead of print]. doi: 10.1097/MCO.0b013e328362d10b.
An W, Bai Y, Deng SX, Gao J, Ben QW, Cai QC, et al. Adiponectin levels in patients with colorectal cancer and adenoma: a meta-analysis. Eur J Cancer Prev. 2012; 21(2): 126–33.
Burnett-Hartman AN, Passarelli MN, Adams SV, Upton MP, Zhu LC, Potter JD, et al. Differences in epidemiologic risk factors for colorectal adenomas and serrated polyps by lesion severity and anatomical site. Am J Epidemiol. 2013; 177(7): 625–637.
Perše M. Oxidative stress in the pathogenesis of colorectal cancer: cause or consequence? Biomed Res Int. 2013; 2013: 725710. doi: 10.1155/2013/725710.
Taylor DP, Burt RW, Williams MS, Haug PJ, Cannon-Albright LA. Population-based family history-specific risks for colorectal cancer: a constellation approach. Gastroenterology. 2010; 138(3): 877–85.