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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2016; 22(36): 8103-8111
Published online Sep 28, 2016. doi: 10.3748/wjg.v22.i36.8103
How significant is the association between metabolic syndrome and prevalence of colorectal neoplasia?
Stepan Suchanek, Tomas Grega, Ondrej Ngo, Gabriela Vojtechova, Ondrej Majek, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Bohumil Seifert, Ladislav Dusek, Miroslav Zavoral
Stepan Suchanek, Tomas Grega, Gabriela Vojtechova, Petra Minarikova, Nagyija Brogyuk, Bohus Bunganic, Miroslav Zavoral, Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Military University Hospital, CZ 169 02 Prague, Czech Republic
Ondrej Ngo, Ondrej Majek, Ladislav Dusek, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, CZ 602 00 Brno, Czech Republic
Bohumil Seifert, Institute of General Medicine, 1st Faculty of Medicine, Charles University, CZ 128 00 Prague, Czech Republic
Author contributions: Suchanek S, Grega T, Ngo O and Vojtechova G conducted the literature search, analyzed the data and wrote the initial draft of the manuscript; Majek O, Minarikova P and Seifert B revised the manuscript; Brogyuk N and Bunganic B collected the colonoscopy examination data; Dusek L and Zavoral M were responsible for the overall scientific direction.
Supported by Intern Grant Agency of the Czech Ministry of Health (IGA), No. NT 13673-4.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Stepan Suchanek, MD, PhD, Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Military University Hospital, U Vojenske nemocnice 1200, CZ 169 02 Prague, Czech Republic. stepan.suchanek@uvn.cz
Telephone: +420-973208367 Fax: +420-973208367
Received: April 29, 2016
Peer-review started: May 4, 2016
First decision: June 20, 2016
Revised: July 15, 2016
Accepted: August 5, 2016
Article in press: August 5, 2016
Published online: September 28, 2016
Abstract

The incidence and prevalence of metabolic syndrome (MS) and colorectal cancer (CRC) has been rising in developed countries. The association between these two diseases has been widely studied and reported. Less evidence is available about the relationship between MS and CRC precancerous lesions (adenomatous polyps, adenomas). The aim of this paper is to present an overview of our scientific understanding of that topic and its implication in clinical practice. One of the principal goals of current CRC secondary prevention efforts is to detect and remove the precancerous lesions in individuals with an average CRC risk to prevent the development of invasive cancer. MS is not currently considered a high-risk CRC factor and is therefore not included in the guidelines of organized screening programs. However, in light of growing scientific evidence, the approach to patients with MS should be changed. Metabolic risk factors for the development of adenomas and cancers are the same - obesity, impaired glucose tolerance, dyslipidemia, hypertension, cardiovascular diseases and diabetes mellitus type 2. Therefore, the key issue in the near future is the development of a simple scoring system, easy to use in clinical practice, which would identify individuals with high metabolic risk of colorectal neoplasia and would be used for individual CRC secondary prevention strategies. Currently, such scoring systems have been published based on Asian (Asia-Pacific Colorectal Screening Score; APCS) and Polish populations.

Keywords: Metabolic syndrome, Diabetes mellitus type 2, Heart ischemic disease, Colorectal neoplasia

Core tip: This article provides a review of our current understanding of the metabolic risk factors in the development of colorectal neoplasia and the scoring systems that may allow tailored secondary screening strategies. In addition, the preliminary results of a Czech multi-center prospective study investigating the relationship between metabolic syndrome and colorectal neoplasia are provided.