P0300 - The Effect of Tobacco Smoking on the Burden of Advanced Neoplasia in Patients With Colon Polyps

Panagiotis G.. Doukas, MD¹, Sotirios G.. Doukas, MD, PhD¹, Paris Charilaou, MD², Louisa Recinos-Arenas, MD¹, Arkady Broder, MD, FACG¹
1Saint Peter's University Hospital / Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; 2Wake Forest Universtiy, Charlotte, NC

Introduction: Smoking is a known risk factor for colorectal cancer (CRC). We aimed to evaluate its impact on advanced neoplasia (AdvN) burden in patients with at least one colonoscopy-detected polyp.

Methods: We retrospectively queried our institution’s endoscopy database, including procedures with at least one non-inflammatory polyp. AdvN was defined as at least 3 tubular/sessile serrated adenomas, size of ≥10mm (including hyperplastic polyps), and/or villous features on histology. Smoking exposure was defined as low (never smoker, or former smoker with >30 years abstinence or quit < age 40); moderate (active smoker with < 20 pack-years [PY], or former smoker with < 10 years abstinence and < 20 PY); high (current smoker with ≥20 PY, or former smoker with < 10 years abstinence and ≥20 PY). Multivariable logistic regression was adjusted by indication, previous colonoscopy, and age and clustered by endoscopists to assess the risk of AdvN presence.

Results: We extracted data from 838 colonoscopies. Compared to “low-exposure” females: “low-exposure” male smokers carry 71% increased risk (Odds ratio [OR] 1.71, 95% CI 1.19-2.44, p=0.003), without difference in risk between moderate-exposure male smokers (p=0.44); “high-exposure” female smokers carry 27% increased risk (OR 1.27, 95%CI 1.001-1.61, p=0.048); and “high-exposure” male smokers carry 2-fold risk (OR 2.03, 95%CI 1.02-4.03, p=0.043), for AdvN. AdvN risk increased by 3.8% per year above age 50 when adjusting for first vs. non-first colonoscopy.

Discussion: Tobacco smoking independently increases the AdvN risk in patients with colonoscopy-detected polyps, suggesting increased vigilance for AdvN in “moderate-exposure” male smokers and “high-exposure” female smokers.

Disclosures:
Panagiotis Doukas indicated no relevant financial relationships.
Sotirios Doukas indicated no relevant financial relationships.
Paris Charilaou indicated no relevant financial relationships.
Louisa Recinos-Arenas indicated no relevant financial relationships.
Arkady Broder indicated no relevant financial relationships.

Panagiotis G.. Doukas, MD¹, Sotirios G.. Doukas, MD, PhD¹, Paris Charilaou, MD², Louisa Recinos-Arenas, MD¹, Arkady Broder, MD, FACG¹. P0300 - The Effect of Tobacco Smoking on the Burden of Advanced Neoplasia in Patients With Colon Polyps, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.