Patients had a lower risk for advanced neoplasia with cereal fiber intake (greater than 4.2 grams/.15 ounces a day), vitamin D intake of greater than 645 IU/d, and daily use of nonsteroidal anti-inflammatory drugs (NSAIDs, 34 percent lower risk). Marginal factors included physical activity, daily multivitamin use, and intake of calcium and fat derived from red meat. No association was found for body mass index, prior cholecystectomy, or serum cholesterol level. Risk variables were similar to those for patients with no polyps, except that past and current smoking were associated with an increased risk of polyps.

" ... it is prudent to recommend that patients stop smoking, reduce alcohol intake, and exercise regularly as part of general preventive health measures," the authors write. "Consuming vitamin D plus a calcium supplement or regular dairy products represents a low-risk strategy that may benefit patients. The benefit of a daily multivitamin is uncertain and requires further study but is associated with very low risk to patients. The strong association with family history of colorectal cancer reinforces existing recommendations to offer screening with colonoscopy. The potential protective effect of NSAIDs must be carefully balanced against the risks. Further study is needed to determine if risk factors at baseline colonoscopy are predictive of future incidence or recurrence of advanced neoplasia." (JAMA. 2003;290:2959-2967. Available post-embargo at jama.com)

'"/>

Contact: Pat Forsyth
503-402-2975
JAMA and Archives Journals
9-Dec-2003