**4. Risk factors for colorectal polyps according to our data**

Our data find the following risk factors for colorectal polyps: consumption of red meat, meat products, sausages, fat food, high BMI, frequent use of laxatives, beer and alcohol intake, preserved foods, salty foods, grilled or barbecued meat, low physical activity, allergy, bacon, ham, margarine, fried food, preserved meat, sugar, marinated food, tobacco smoking, egg-fried food, working in heavy or petrol industry, presence of autoimmune disease, use of microwave oven, professional exposure to extremely low temperatures, passive smoking and elevated serum glucose level.

We concluded that the most important risk factors for the development of colorectal polyps are diet factors - consumption of sugar products, fried, grilled and preserved food, animal fats and margarine, egg-fried food and obesity. The most important life style and occupational risk factors for the development of colorectal polyps are: chronic alcohol intake, long lasting tobacco smoking, minimal physical activity, occupational exposure to petrol and metals. The chronic alcohol intake includes usage of beer, wine and strong drink. Substantial factors are and presence of autoimmune disease or allergy, frequent use of laxatives and elevated serum glucose level.

Risk and Protective Factors for Development of Colorectal Polyps and Cancer 183

+ + + 0,094

*Factor Intensity Exp. (B)*  Fruit + + + 0,033

Apples + + + 0,122 Vegetables + + + 0,126 Rye bread + + + 0,199 Plumbs + + + 0,244 Raspberries + + + 0,258 Pears + + + 0,268 Rural life + + 0,318 Green tea + + 0,325 Vegetable food + + 0,345 Whole-grain bread + + 0,352 Yoghourt + + 0,367 Green vegetables + + 0,382 Fasting + + 0,385 Fish + + 0,428 Lamb + 0,559 Hares + 0,588 Legumes + 0,595 Garlic + 0,616 Low salt diet + 0,668 Mineral water + 0,895 Table 3. Protective factors for colorectal polyps (0,01 – 0,3 + + +), (0,31 – 0,50 + +),

**6. Risk factors for colorectal cancer according to our data** 

**7. Protective factors for colorectal cancer according to our data** 

One of the most important aims of our study was to establish the risk factors for the CRC epidemic, which is observed now and in Bulgaria. We accomplished this study considering the specific conditions in our country and made comprehensive investigation of the diet habits of all included patients with colorectal polyps and cancer. We estimated and all other possible risk factors. Detailed list of risk factors for development of colorectal cancer is

The major risk factors for CRC are dietary as well: consumption of fat food, red meat and meat diet as a whole, smoked and egg-fried food, sugar and sweets, white bread, obesity. The lifestyle has also a significant effect: long lasting alcohol intake (beer, wine, and spirits), tobacco smoking, minimal physical activity, urban life. We noticed and other risk factors for CRC development: *H. pylori* infection, presence of adenomas, diabetes mellitus, and frequent use of laxatives. Probably, urban life increases the exposition to many of the presented risk factors and therefore it is a specific risk factor for development of CRC.

According to our results consumption of dairy products, fruit, garlic, onions, fish, plant oil, boiled food, vegetables, fowls, legumes and white meat has a strong protective effect for CRC. Low salt diet, fasting, usage of acetylsalicylic acid and rural life also possess protective

Rare consumption of

grilled food

(0,51 – 1,00 +).

presented in Table 4.


Table 2. Risk factors for colorectal polyps (4,01 – 10,00 + + +), (2,01 – 4,00 + +), (1,00 – 2,00 +).

## **5. Protective factors for colorectal polyps according to our data**

According to our results fruits (apples, plumbs, raspberries, and pears), vegetables, rye- and whole-grain bread, green tea, vegetable food consumption, yoghurt, fasting, fish, lamb, hare, garlic, legumes and mineral water have a strong protective effect against large bowel polyps.

The most significant protective factors against colorectal polyps are again diet factors consumption of fruit, vegetables, rye- and whole-grain bread, vegetable food, green tea, yoghurt and fasting. Protective role plays and frequent consumption of fish, lamb and hare. Probably, conditions of rural life are connected with reduction of the risk factors for development of colorectal polyps.

**Factor Intensity Exp. (B)**  Chronic alcohol abuse + + + 9,256 Sugar and sweets + + + 8,917 Fried food + + + 7,258 Preserved food + + + 5,363 Heavy industry workers + + + 5,259 Beer + + + 5,025 Meat delicacy + + + 4,759 Bacon + + + 4,582 Long lasting sausages + + + 4,265 Fat food + + + 4,023 Margarine + + 3,707 Exposure to petrol + + 3,616 Weekly consumption of grilled meal + + 3,093 Presence of autoimmune disease + + 2,958 Strong drink + + 2,919 Low physical activity + + 2,843 Wine + + 2,827 Salty food + + 2,575 Allergy + + 2,566 Grilled meat + + 2,439 Preserved meat + + 2,345 Ham + + 2,241 Smoked food + + 2,144 Frequent use of laxatives + 1,796 Marinated food + 1,658 Preserved food + 1,511 Egg-fried food + 1,448 Tobacco smoking + 1,444 Frequent meat consumption + 1,349 Elevated serum glucose level + 1,115 Years of alcohol consumption) + 1,074 High body mass index (BMI) + 1,047 Years of smoking + 1,030 Table 2. Risk factors for colorectal polyps (4,01 – 10,00 + + +), (2,01 – 4,00 + +),

**5. Protective factors for colorectal polyps according to our data** 

According to our results fruits (apples, plumbs, raspberries, and pears), vegetables, rye- and whole-grain bread, green tea, vegetable food consumption, yoghurt, fasting, fish, lamb, hare, garlic, legumes and mineral water have a strong protective effect against large bowel

The most significant protective factors against colorectal polyps are again diet factors consumption of fruit, vegetables, rye- and whole-grain bread, vegetable food, green tea, yoghurt and fasting. Protective role plays and frequent consumption of fish, lamb and hare. Probably, conditions of rural life are connected with reduction of the risk factors for

(1,00 – 2,00 +).

polyps.

development of colorectal polyps.


Table 3. Protective factors for colorectal polyps (0,01 – 0,3 + + +), (0,31 – 0,50 + +), (0,51 – 1,00 +).
