Assessment of modifiable risk factors for precancerous colon diseases
https://doi.org/10.51793/OS.2026.29.6.011
Abstract
Background. Precancerous diseases of the colon play a key role in intestinal oncogenesis, as about 80% of colorectal cancers are caused by colon polyps. The prevalence of colorectal epithelial neoplasms ranges from 20% at age 45 to over 50-60% by age 85. Developed countries exhibit higher incidence rates, which are driven by lifestyle factors and national screening programs. Polyps are detected in 20%-53% of screening colonoscopies in adults aged 50 and older. Adenomatous polyps (15-25%) and hyperplastic polyps (up to 30%) represent the most common histological types, the latter being more characteristic of individuals under 50 years of age. Inflammatory polyps are less common and typically occur in patients with inflammatory bowel disease. Genetic predisposition, age, gender, and height are significant determinants of the risk of developing precancerous colon diseases, but these are not modifiable risk factors. When considering the prevention of colorectal polyps, the primary focus should be on modifiable risk factors.
Objective. The aim of this study was to evaluate key risk factors documented in the literature among 199 patients aged 40-75 with precancerous colorectal lesions and 100 apparently healthy controls based on questionnaire data.
Results. A number of endocrine, metabolic, and behavioral factors contribute to the development of polyps and their progression to colorectal cancer. There is a proven link between a history of obesity, hyperglycemia, and type 2 diabetes mellitus and an increased risk of colon polyps. The presence of non-alcoholic (metabolic-associated) fatty liver disease also increases the likelihood of detecting precancerous diseases of the colon, especially with steatohepatitis or cirrhosis of the liver. Well-known risk factors such as smoking and alcohol consumption play an important role in the transformation of a polyp into colorectal cancer. The use of certain medications, primarily broad-spectrum antibiotics and proton pump inhibitors, has also proven its effect on the formation of precancerous colon diseases.
Conclusion. Taken together, these findings highlight the need for systematic screening and the development of preventive strategies, especially in high-risk groups.
About the Authors
N. A. Poptsova
City Polyclinic No. 23; I. I. Mechnikov Northwestern State Medical University
Russian Federation
Russian Federation
Natalya A. Poptsova, gastroenterologist, Head of the Department of Preventive Medicine; assistant of the Department of Propedeutics of Internal Diseases, Gastroenterology and Dietology named after S. M. Ryss, Secondyear Postgraduate Student of the Department of Epidemiology, Parasitology and Disinfectology and Department of Propedeutics of Internal Diseases, Gastroenterology and Dietology named after S. M. Ryss
17 lit. A Kosinova str., Saint Petersburg, 198099
47 Piskarevsky ave., Saint Petersburg, 195067
I. G. Bakulin
I. I. Mechnikov Northwestern State Medical University
Russian Federation
Russian Federation
Igor G. Bakulin, Dr. of Sci. (Med.), Professor, Chief Non-staff Specialist in Internal Medicine of the Ministry of Health of the Russian Federation for the North-Western Federal District, Chief Non-staff Gastroenterologist of the Leningrad Region, Director of the Institute of Therapy, Head of the Department of Propedeutics of Internal Diseases, Gastroenterology and Dietology named after S. M. Ryss
47 Piskarevsky ave., Saint Petersburg, 195067
B. I. Aslanov
I. I. Mechnikov Northwestern State Medical University
Russian Federation
Russian Federation
Batyrbek I. Aslanov, Dr. of Sci. (Med.), Professor, Head of the Department of Epidemiology, Parasitology and Disinfectology
47 Piskarevsky ave., Saint Petersburg, 195067
A. V. Zharkov
I. I. Mechnikov Northwestern State Medical University; Health Committee of the Leningrad region
Russian Federation
Russian Federation
Aleksandr V. Zharkov, Cand. of Sci. (Med.), Associate Professor of the Department of Propedeutics of Internal Diseases, Gastroenterology and Dietology named after S. M. Ryss; Chairman
47 Piskarevsky ave., Saint Petersburg, 195067
6 lit. A Lafonskaya str., Saint Petersburg, 191124
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Review
For citations:
Poptsova N.A., Bakulin I.G., Aslanov B.I., Zharkov A.V. Assessment of modifiable risk factors for precancerous colon diseases. Lechaschi Vrach. 2026;(6):82-88. (In Russ.) https://doi.org/10.51793/OS.2026.29.6.011
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