P2114 - Predictive Factors For Adenoma On First Colonoscopy In True Average-Risk Individuals: Results From An Interim Analysis Of A Prospective Cohort Study

Zakaria El Kouzi, MD¹, Walaa Mahmoud, MD², Mohamad Ali Ibrahim, MD³, Batoul Abdallah, MD³, Jad Saab, BSc³, Kassem Barada, MD³, Fady Daniel, MD¹, Yasser Shaib, MD³, Ala I. Sharara, MD, FACG¹, Noelle El Asmar, MD³, Fadi Mourad, MD^3
1American University of Beirut, Beyrouth, Beyrouth, Lebanon; ²Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY; ³American University of Beirut, Beirut, Beyrouth, Lebanon

Introduction: Risk evaluation and stratification can help optimize colorectal cancer screening. This prospective cross-sectional study aims to evaluate the risk factors of adenoma and advanced neoplasia in individuals presenting for their first screening colonoscopy. This report is an interim analysis of a prospective study that aims to validate our previously-published advanced adenoma risk prediction model (Sharara AI, et al. World J Gastroenterol 2020; 26(37): 5705–5717.) for average-risk individuals at first screening colonoscopy.

Methods: Asymptomatic average-risk individuals who presented for their first screening colonoscopy at the American University of Beirut Medical Center were prospectively recruited from 2022 to 2024. Individuals with history of colon resection, personal history of IBD, family history of NHPCC, CRC or large colon polyps were excluded. Detailed characteristics including demographics, diet, smoking status, and body mass index (BMI) were collected. Demographics and clinical characteristics were compared between subjects with and without adenomas using Chi-squared test. Binary logistic regression analysis was performed to evaluate risk factors for adenoma at first screening colonoscopy.

Results: A total of 329 patients were enrolled (mean age 57.4 ± 6.6 years; female 52.3%; mean BMI 27.3 ± 4.4 kg/M²). The adenoma detection rate was 43.5% [small adenoma (< 1 cm) 30.2%; advanced adenoma 9.7%; invasive cancer 0.6%]. Right-sided serrated lesions were identified in 10.2%. Risk factors for colon adenoma included age, (0.004), male gender (p=0.012), daily red meat consumption (p=0.008), overweight or obesity (p=0.049), hypertension (p=0.035) and smoking (p=0.0001). On multivariate analysis, smoking and meat consumption were the predictor of adenomas (RR 2.5; p=0.002; 95% CI 1.5-3.7 and RR 1.9; p=0.038; 95% CI 1.11-3.5) respectively, with BMI p=0.09 and gender p=0.07 trending towards significance.

Discussion: Smoking, BMI, and red meat consumption are important predictors of colon adenomas in average risk individuals, with smoking being particularly powerful. These preliminary results will need to be validated in the larger prospective study cohort and in other practice settings. Such findings can help in the risk stratification of average-risk individuals considered for colorectal cancer screening strategies.


Disclosures:


Zakaria El Kouzi, MD¹, Walaa Mahmoud, MD², Mohamad Ali Ibrahim, MD³, Batoul Abdallah, MD³, Jad Saab, BSc³, Kassem Barada, MD³, Fady Daniel, MD¹, Yasser Shaib, MD³, Ala I. Sharara, MD, FACG¹, Noelle El Asmar, MD³, Fadi Mourad, MD³. P2114 - Predictive Factors For Adenoma On First Colonoscopy In True Average-Risk Individuals: Results From An Interim Analysis Of A Prospective Cohort Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.