Higher BMI Is Associated with Increased Detection of Adenomatous Polyps During Colonoscopy
Notice bibliographique
Résumé
Purpose: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer death in the United States. Obesity is a growing national concern; one in two Americans is overweight and one in three is obese. Recent data suggests that obesity is an independent risk factor for adenomas as well as for CRC. The purpose of our study is to characterize the relationship between BMI and the detection of colonic adenomas. Methods: Between March and July 2011 we prospectively enrolled 430 patients into the study. Participants completed a questionnaire before colonoscopy, and self-reported height and weight were used to calculate body mass index (BMI). Polyp detection rate (PDR) was calculated during colonoscopy and adenoma detection rate (ADR) was calculated after histologic review of each polyp. Adenomatous polyps included tubular adenoma, tubulovillous adenoma, villous adenoma and serrated sessile adenoma. BMI was categorized into 4 groups: <25 kg/m2, 25-29 kg/m2, 30-34 kg/m2 and ≥35 kg/m2. Pearson's Chi-square or Kendall's tau-b tests were used to identify factors associated with detection of polyps and adenomas. Multiple logistic regression analysis was performed to determine independent predictors for polyp and adenoma detection. Results: The mean age was 60.4 (24-84) and 211 (49.1%) participants were male. The mean BMI was 26.0 (15.4-53.4), including 45.1% below 25 kg/m2, 38.4% from 25-29 kg/m2, 10.5% from 30-34 kg/m2 and 6.0% ≥35 kg/m2. 87.3% of the bowel preps were excellent or good (total Ottawa score 4 or less). The overall PDR was 57.4% and the ADR was 44%. 35.5% of all adenomas were in the right colon (cecum and ascending colon). In a univariate analysis, age, gender and BMI were all significantly associated with PDR (p=0.001 for all). BMI was significantly associated with adenoma detection in the entire colon (p=0.003) and in the right colon only (p=0.009). After adjusting for age, gender, history of colonoscopy, type of bowel prep, quality of bowel prep (Ottawa score), race, BMI, and comorbidities, BMI remained independently associated with adenoma detection in the entire colon (p=0.032) and in the right colon (p=0.045). In a subset analysis, participants with BMI 30-34 mg/m2 had an odds ratio for adenoma detection in the right colon of 3.03 compared to participants with a BMI <25 kg/m2 (95% CI 1.33-6.90, p=0.008). Conclusion: Higher BMI was independently associated with detection of more adenomatous polyps in both the entire colon and in the right colon after multiple adjustments, including for age, gender, race, and quality of bowel preparation. This finding underscores the importance of aggressive colorectal cancer screening as the population of the United States becomes increasingly overweight and obese.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».