REVIEW article
Front. Public Health
Sec. Public Health and Nutrition
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1655750
Modifiable Lifestyle and Metabolic Risk Factors for Colorectal Polyps: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Department of Big Data in Health Sciences, and Center for Clinical Big Data and Statistics, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- 2Zhejiang University School of Medicine Sir Run Run Shaw Hospital Department of Respiratory and Critical Care Medicine, Hangzhou, China
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Objective: To evaluate associations between unhealthy lifestyles, metabolic diseases, and colorectal polyps, with emphasis on subtype-specific effects. Methods: We systematically searched PubMed, Embase, Cochrane Library, and SinoMed (up to July 2024) for studies reporting odds ratios (ORs) of colorectal polyps associated with lifestyle or metabolic factors. Heterogeneity was quantified using I2 statistics, with random-effects models applied as the primary analytical approach. Subgroup analyses were conducted to investigate potential effect modifiers, and meta-regression was performed to explore continuous sources of heterogeneity, while sensitivity analyses and funnel plots evaluated robustness and bias. Results: Alcohol (OR[95%CI]=1.63[1.48 – 1.78]), high-fat diet (OR[95%CI]=1.45[1.33–1.57]), and smoking (OR[95%CI]=1.79[1.69–1.90]) significantly increased polyp risk across subtypes. Smoking showed subtype-and region-specific effects, with the highest risk for sessile serrated lesions (SSLs; OR[95%CI]=3.06[2.41–3.90]) and in the US, South Korea, and Israel. Type 2 diabetes had the strongest metabolic association (OR[95%CI]=2.17[1.82-2.60]), followed by hyperlipidemia (OR[95%CI]=1.50[1.32–1.70]) and hypertension (OR[95%CI]=1.33[1.10–1.61]). Heterogeneity stemmed from pathological classification and geographic variation, with no significant publication bias. Conclusion: Unhealthy lifestyles (alcohol, high-fat diet, smoking) and metabolic diseases (type 2 diabetes, hyperlipidemia, hypertension) independently increase colorectal polyp risk, with smoking demonstrating pronounced subtype and regional variability. These findings can inform the development of risk-stratified screening protocols and targeted public health interventions.
Keywords: colorectal polyps, Pathological types, Meta-analysis, Risk factors, lifestyle
Received: 28 Jun 2025; Accepted: 19 Aug 2025.
Copyright: © 2025 Lei, Cai, Zheng, Li, Deng, Li and Dai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiuyang Li, Department of Big Data in Health Sciences, and Center for Clinical Big Data and Statistics, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.