S748 Obesity and Precancerous Colonic Polyps: A Gender-Stratified Retrospective Analysis From a Community Hospital

Introduction: Colorectal diseases, including colorectal cancer (CRC), remain major contributors to global morbidity and mortality. Most CRCs arise through the adenoma to carcinoma sequence, and early detection of precancerous polyps (PPs) via colonoscopy significantly reduces progression to malignancy. While current screening guidelines focus on age and family history, emerging evidence suggests that metabolic comorbidities, particularly obesity, may influence PP development. This study examined associations between body mass index (BMI), hypertension (HTN), diabetes mellitus (DM), and PPs, stratified by gender, in a community-based population. Methods: This retrospective cohort study included 341 adults (151 men and 190 women) who underwent colonoscopy at Landmark Medical Center from 2023 to 2025. Demographics, BMI, family history of CRC, and polyp presence were collected from electronic medical records. BMI was classified as normal (15–24.9), overweight (25–29.9), or obese (≥30). Chi-square analysis assessed associations between comorbidities and PPs, stratified by gender. Statistical significance was set at P < 0.05. Results: Patients were predominantly aged 46–75 years (54.5%), and 14.7% had a family history of CRC. Among men, obesity was significantly associated with PPs (χ² = 16.96, P = 0.0003), with 35 observed cases in obese men versus 23.14 expected. No significant associations were found between PP prevalence and HTN or DM in either gender. In women, BMI did not significantly correlate with PP presence (χ² = 3.53, P = 0.17), although a trend toward increased prevalence with rising BMI was noted. Conclusion: This study identified obesity as an independent predictor of precancerous colonic polyps in males, even in the absence of a family history of CRC. These findings suggest a potential gender-specific role of BMI in colorectal neoplasia, possibly mediated by hormonal, behavioral, or microbiome-related mechanisms. In contrast, BMI was not a significant predictor in females, highlighting the need for sex-stratified research. These results support the inclusion of BMI in personalized CRC risk assessments, particularly for male patients, and advocate for further investigation into sex-specific screening thresholds.