Main Article Content

Hye Young Lee
Hye Kyung Song
Yong Hwan Kim


colon polyp, fitness, odds ratio, physical activity


Background and objectives
Colon polyps are precursor lesions for colon cancer and are associated with a range of risk factors, including smoking, alcohol, obesity, a high-calorie diet, inactivity, and low levels of fitness. The purpose of this study was to analyze the prevalence of colon polyps in relation to age, cardiopulmonary fitness and exercise frequency, intensity, and duration (or continuous time).
Materials and methods
This study involved asymptomatic males who underwent a colonoscopy and cardiac exercise stress test. Participants were divided by age (30–49 years [young adults – YA], 50–59 years [middle-aged – MID], and 60+ years [elderly – ELD]). Participants completed an exercise questionnaire that assessed the frequency, intensity, and duration of exercise. Cardiopulmonary fitness was measured with a gas analyzer using a treadmill and the Bruce protocol. Polyps were classified according to their number (≥3) and size (≥0.6 cm), and logistic regression was performed to determine odds ratios (OR). Statistical significance was set at p<0.05.
The incidence of colon polyps was 40.1%, 56.2%, and 68.9% in the YA, MID, and ELD groups, respectively. In the YA group, the OR for the presence of polyps decreased to 0.854 and 0.687 in the G3 and G4 (highest fitness) groups, respectively. Although there was no difference in the presence of polyps in the MID group based on cardiopulmonary fitness, there were differences based on exercise intensity and frequency. The OR for the presence of polyps in subjects from the YA group who exercised frequently was 0.743, while those in the MID group had an OR of 0.787; these ORs represented a 21.3–25.7% lower risk than participants who did not exercise (p<0.05).
Higher cardiopulmonary fitness, along with increased exercise frequency, intensity, and duration, could lower the prevalence of polyps in younger and middle-aged participants, although exercise did not affect the prevalence of polyps in older participants.


Download data is not yet available.
Abstract 248 | PDF Downloads 101 HTML Downloads 25 XML Downloads 2


1. Bray F, Møller B. Predicting the future burden of cancer. Nat Rev Canc. 2006;6:63.
2. Center MM, Jemal A, Smith RA, et al. Worldwide variations in colorectal cancer. CA Cancer J Clin 2009;59:366–78.
3. Jung K-W, Won Y-J, Oh C-M, et al. Cancer statistics in Korea: Incidence, mortality, survival, and prevalence in 2014. Canc Res Treat 2017;49:292.
4. Ransohoff DF. Colon cancer screening in 2005: Status and challenges. Gastroenterology 2005; 128:1685–95.
5. Im Shim J, Kim Y, Han MA, et al. Results of colorectal cancer screening of the national cancer screening program in Korea, 2008. Canc Res Treat 2010;42:191.
6. Vogelstein B, Fearon ER, Hamilton SR, et al. Genetic alterations during colorectal-tumor development. N Eng J Med 1988;319:525–32.
7. Gopalswamy N, Shenoy VN, Choudhry U, et al. Is in vivo measurement of size of polyps during colonoscopy accurate? Gastrointest Endos 1997; 46:497–502.
8. Wu L, Li Y, Li Z, et al. Diagnostic accuracy of narrow-band imaging for the differentiation of neoplastic from non-neoplastic colorectal polyps: A meta-analysis. Colorectal Dis 2013;15:3–11.
9. Zahm SH, Cocco P, Blair A. Tobacco smoking as a risk factor for colon polyps. Am J Publ Health 1991;81:846–49.
10. Lee WC, Neugut AI, Garbowski GC, et al. Cigarettes, alcohol, coffee, and caffeine as risk factors for colorectal adenomatous polyps. Ann Epidemiol 1993;3:239–44.
11. Todoroki I, Kono S, Shinchi K, et al. Relationship of cigarette smoking, alcohol use, and dietary habits with sigmoid colon adenomas. Ann Epidemiol 1995;5:478–83.
12. Longnecker MP, Chen M-J, Probst-Hensch NM, et al. Alcohol and smoking in relation to the prevalence of adenomatous colorectal polyps detected at sigmoidoscopy. Epidemiol 1996:275–80.
13. Sanchez NF, Stierman B, Saab S, et al. Physical activity reduces risk for colon polyps in a multiethnic colorectal cancer screening population. BMC Res Notes 2012;5:312.
14. ACSM. ACSM's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins, Philadelphia; 2013.
15. Wolin KY, Yan Y, Colditz GA. Physical activity and risk of colon adenoma: A meta-analysis. Br J Canc 2011;104:882.
16. Ulrich CM, Kampman E, Bigler J, et al. Lack of association between the C677T MTHFR polymorphism and colorectal hyperplastic polyps. Cancer Epidemiol Biomarkers Prev 2000;9:427–33.
17. Haggar FA, Boushey RP. Colorectal cancer epidemiology: Incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg 2009;22:191–97.
18. Rosenberg L, Boggs D, Wise LA, et al. A follow-up study of physical activity and incidence of colorectal polyps in African-American women. Cancer Epidemiol Biomarkers Prev 2006;15:1438–42.
19. Wallace K, Baron JA, Karagas MR, et al. The association of physical activity and body mass index with the risk of large bowel polyps. Cancer Epidemiol Biomarkers Prev 2005;14:2082–86.
20. Setty P, Padmanabha B, Doddamani B. Correlation between obesity and cardio respiratory fitness. Int J Med Sci Public Health 2013;2:300–04.
21. MacIntosh BJ, Swardfager W, Crane DE, et al. Cardiopulmonary fitness correlates with regional cerebral grey matter perfusion and density in men  with coronary artery disease. PLoS One 2014;9:e91251.
22. McCullough PA, Franklin BA, Leifer E, et al. Impact of reduced kidney function on cardiopulmonary fitness in patients with systolic heart failure. Am J Nephrol 2010;32:226–33.
23. Meseeha M, Attia M, Dulebohn S, et al. Colon Polyps. StatPearls, Treasure Island; 2018.
24. Klein JL, Okcu M, Preisegger KH, et al. Distribution, size and shape of colorectal adenomas as determined by a colonoscopist with a high lesion detection rate: Influence of age, sex and colonoscopy indication. United Eur Gastroenterol J 2016;4:438–48.
25. Schoefl R, Ziachehabi A, Wewalka F. Small colorectal polyps. Dig Dis 2015;33:38–41.
26. Watabe H, Yamaji Y, Okamoto M, et al. Risk assessment for delayed hemorrhagic complication of colonic polypectomy: Polyp-related factors and patient-related factors. Gastrointes Endos 2006;64:73–78.
27. Strong JP, Reif A, Correa P, et al. The epidemiology of colorectal polyps. Prevalence in New Orleans and international comparisons. Cancer 1977;39:2258–64.
28. Lee GE, Park HS, Yun KE, et al. Association between BMI and metabolic syndrome and adenomatous colonic polyps in Korean men. Obesity 2008;16:1434–39.
29. Ashktorab H, Paydar M, Yazdi S, et al. BMI and the risk of colorectal adenoma in African-Americans. Obesity 2014;22:1387–91.
30. Lee BI, Hong SP, Kim SE, et al. Korean guidelines for colorectal cancer screening and polyp detection. J Korean Soc Radiol 2012; 66:385–406.
31. Fletcher G, Ades P, Kligfield P, et al. Exercise standards for testing and training: A scientific statement from the American Heart Association. Circulation 2013;128:873–934.
32. Dishman RK, Heath GW, Lee I-M. Physical activity epidemiology. Human Kinetics, Champaign; 2018.
33. Wolin KY, Yan Y, Colditz GA, et al. Physical activity and colon cancer prevention: A meta-analysis. Br J Canc 2009;100:611.
34. Kahn HS, Tatham LM, Thun MJ, et al. Risk factors for self-reported colon polyps. J Gen Intern Med 1998;13:303–10.
35. Howley ET, Bassett DR, Welch HG. Criteria for maximal oxygen uptake: Review and commentary. Med Sci Sports Exerc 1995;27: 1292–92.
36. Enright PL. The six-minute walk test. Respir Care 2003;48:783–85.
37. Stringhini S, Sabia S, Shipley M, et al. Association of socioeconomic position with health behaviors and mortality. JAMA 2010;303: 1159–66.