Kolon polipleri ve diyet ilişkisi

Giriş ve Amaç: Diyet alışkanlıkları ve spesifik besin gruplarının kolon polip gelişimi, histolojisi ve boyutları üzerindeki etkisinin aydınlatılması. Gereç ve Yöntem: 2012-2015 yılları arasında kolonoskopi yapılan 1004 hasta beslenme alışkanlıkları yönünden prospektif olarak değerlendirildi. Hastalar kolon polibi var-yok, kolon polibi olanlar ise hiperplastik-adenomatöz, <1 cm - >1 cm olarak sınıflandırıldı ve gruplar arası diyet alışkanlıklarının farkları incelendi. Bulgular: Çalışmamızda kolon polip gelişmesini; yaş, erkek cinsiyet, kırmızı et ve bulgur tüketimi arttırırken, domates tüketimi azaltmaktadır. Adenomatöz histoloji görülme sıklığını artıran faktörler yaş ve bulgur tüketimi olarak saptanırken; azaltan faktörler ise yumurta ve pirinç tüketimindeki artış olarak saptanmıştır. Kolon polip boyutlarını ise sadece bulgur tüketimindeki artışın etkilediği saptanmıştır. Sonuç: Kolonda polip gelişimi, adenomatöz histoloji varlığı ve 1 cm’den büyük polip gelişimi şeklinde bu üç kolorektal kanser risk faktörünü de artıran tek besin maddesi bulgur olarak saptanmıştır. Bulgurun tüketim şekli, sıklığı ve kolon kanseri saptanan hastaların geçmiş dönemdeki bulgur tüketimleri ayrıntılı sorgulanmalı ve konuyla ilgili daha ayrıntılı çalışmalar yapılmalıdır.

Anahtar Kelimeler:

Kolon polip, diyet, polip boyutu, polip histolojisi, spesifik besin ürünleri

Relationship between colon polyps and diet

Background and Aims: The aim of this study was to identify the effect of dietary habits and specific nutrient groups on colon polyp development, histology, and size. Materials and Methods: Between 2012 and 2015, 1004 patients who underwent colonoscopy were evaluated prospectively for their dietary habits. Patients were classified according to whether or not they had colon polyps. Patients with polyps were classified as hyperplastic-adenomatous, <1 cm –>1 cm and differences in dietary habits among the groups were examined. Results: In our study, colon polyp development decreased by tomato consumption whereas increasing age, male sex, red meat, and bulgur consumption increased development. While factors increasing the incidence of adenomatous histology were determined as age and bulgur consumption, the decrease was observed after an increase in egg and rice consumption. It was concluded that colon polyp diameter is only affected by bulgur consumption. Conclusion: The only nutrient that increases the risk of developing colonic polyps, which are larger than 1 cm in diameter, and have adenomatous histology, is bulgur. The type and frequency of consumption of bulgur should be questioned in detail, and additional studies on this subject that are more comprehensive should be performed.

Keywords:

Colon polyp, diet, polyp size, polyp histology, specific nutritional products,

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1) Longo DL. Approach to the patient with cancer. In: Fauci AS, Braunwald E, Kasper DL, eds. Harrison’s Principles of Internal Medicine. 17th ed. New York: McGraw-Hill Professional; 2008.
2) Neri E, Giusti P, Battolla L, et al. Colorectal cancer: role of CT colonography in preoperative evaluation after incomplete colonoscopy. Radiology 2002;223:615-9.
3) Schor S, Behar S, Modan B, et al. Disposition of presumed coronary patients from an emergency room: a follow-up study. JAMA 1976;236:941-3.
4) Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer 1975;15:617-31.
5) Kono S, Ahn Y. Vegetables, cereals and colon cancer mortality: long-term trend in Japan. Eur J Cancer Prev 2000;9:363-5.
6) Neugut AI, Garbowski G, Lee WC, et al. Dietary risk factors for the incidence and recurrence and recurrence of colorectal adenomatous polyps. Ann Internal Med 1993;118:91-5.
7) Witte JS, Longnecker M, Bird CL, et al. Relation of vegetable, fruit and grain consumption to colorectal adenomatous polyps. Am J Epidemiol 1996;144:1015-25.
8) MacLennan R, Macrae F, Bain C, et al; Australian Polyp Prevention Project. Randomized trial of intake of fat, fiber, and beta carotene to prevent colorectal adenomas. J Natl Cancer Inst 1995;87:1760-6.
9) Hofstad B, Almendingen K, Vatn M, et al. Growth and recurrence of colorectal polyps: a double-blind 3-year intervention with calcium and antioxidants. Digestion 1998;59:148-56.
10) [No authors listed] Guidelines on diet, nutrition, and cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. The American Cancer Society 1996 Advisory Committee on Diet, Nutrition, and Cancer Prevention. CA Cancer J Clin 1996;46:325-41.
11) Glade MJ. Food, nutrition, and the prevention of cancer: a global perspective. American Institute for Cancer Research/World Cancer Research Fund, American Institute for Cancer Research, 1997. Nutrition 1999;15:523-6.
12) Austin GL, Adair LS, Galanko JA, et al. A diet high in fruits and low in meats reduces the risk of colorectal adenomas. J Nutr 2007;137:999-1004.
13) Butler TL, Fraser GE, Beeson WL, et al. Cohort profile: the Adventist health study-2 (AHS-2). Int J Epidemiol 2008;37:260-5.
14) Shinya H, Wolff WI. Morphology, anatomic distribution and cancer potential of colonic polyps. Ann Surg 1979;190:679-83.
15) Lanza E, Hartman T, Albert PS, et al. High dry bean intake and reduced risk of advanced colorectal adenoma recurrence among participants in the polyp prevention trial. J Nutr 2006;136:1896-903.
16) Edwards BK, Ward E, Kohler BA, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 2010;116:544-73.
17) O'brien MJ, Winawer SJ, Zauber AG, et al; National Polyp Study Workgroup. Flat adenomas in the National Polyp Study: is there increased risk for high-grade dysplasia initially or during surveillance? Clin Gastroenterol Hepatol 2004;2:905-11.
18) Leggett BA1, Devereaux B, Biden K, et al. Hyperplastic polyposis: Association with colorectal cancer. Am J Pathol 2001;25:177-84.
19) DeCosse JJ, Miller HH, Lesser ML. Effect of wheat fiber and vitamin-C and vitamin-E on rectal polyps in patients with familial adenomatous polyposis. J Natl Cancer Inst 1989;81:1290-7.
20) Tantamango YM, Knutsen SF, Beeson WL, et al. Foods and food groups associated with the incidence of colorectal polyps: the Adventist Health Study. Nutr Cancer 2011;63:565-72.
20) Witte JS, Longnecker MP, Bird CL, et al. Relation of vegetable, fruit, and grain consumption to colorectal adenomatous polyps. Am J Epidemiol 1996;144:1015-25.
21) Neugut AI, Garbowski GC, Lee WC, et al. Dietary risk factors for the incidence and recurrence of colorectal adenomatous polyps: a case-control study. Ann Intern Med 1993;118:91-5.
22) Lanza E, Yu B, Murphy G, et al; Polyp Prevention Trial Study Group. The polyp prevention trial continued follow-up study: no effect of a low-fat, high-fiber, high-fruit, and -vegetable diet on adenoma recurrence eight years after randomization. Cancer Epidemiol Biomarkers Prev 2007;16:1745-52.
23) Erhardt JG, Kreichgauer HP, Meisner C, et al. Alcohol, cigarette smoking, dietary factors and the risk of colorectal adenomas and hyperplastic polyps–a case control study. Eur J Nutr 2002;41:35-43
24) Giovannucci E, Stampfer MJ, Colditz G, et al. Relationship of diet to risk of colorectal adenoma in men. J Natl Cancer Inst 1992;84:91-8
25) Kono S, Imanishi K, Shinchi K, Yanai F. Relationship of diet to small and large adenomas of the sigmoid colon. Jpn J Cancer Res 1993;84:13-9.
26) Ferlitsch M, Reinhart K, Pramhas S, et al. Sex-specific prevalence of adenomas, advanced adenomas, and colorectal cancer in individuals undergoing screening colonoscopy. JAMA 2011;306:1352-8.