Abstract
BACKGROUND: Precancerous serrated polyps (SPs) are significant precursor lesions of colorectal cancer (CRC), whose development is associated with lifestyle and dietary preferences. However, the relationship between lifestyle, dietary preferences with precancerous SPs remains underexplored in regionally specific cohorts. This study aimed to investigate the risk associations between lifestyle and dietary preferences and precancerous SPs in a hospital-based cohort from Guangzhou, China. METHODS: We conducted a hospital-based case-control study between 2021 and 2023 in Guangzhou, China, including 62 patients with histologically confirmed precancerous SP and 1247 controls. Before colonoscopy, participants completed validated questionnaires assessing demographic characteristics, lifestyle factors, and dietary preferences. Relative risk (RR) and 95% confidence interval (CI) for precancerous SPs were estimated using multivariable modified Poisson regression models. RESULTS: Smoking was significantly associated with precancerous SP risk (RR 4.85, 95% CI: 2.64-8.89), with a dose-response relationship for smoking duration and daily cigarette consumption (P-trend < 0.001). Beer preference (RR 2.68, 95% CI: 1.31-5.49), frequent red meat (RR 7.32, 95% CI: 1.03-52.13), and freshwater fish consumption (RR 2.01, 95% CI: 1.08-3.75) were positively associations with precancerous SP risk. Conversely, daily water intake of 2-4 cups (RR 0.21, 95% CI: 0.07-0.63) or 4-8 cups (RR 0.27, 95% CI: 0.10-0.75), and chili peppers consumption (RR 0.47, 95% CI: 0.24-0.94) were significantly inversely. CONCLUSION: This study highlights the critical role of lifestyle and dietary factors in precancerous SP, suggesting that regional prevention strategies targeting lifestyle and dietary modifications may help alleviate the CRC burden.