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Background An inverse association between circulating vitamin D and adenoma risk has been reported, but less is known about proximal inflammatory-hyperplastic polyps. Purpose To investigate circulating 25(OH)D3 and risk factors of proximal inflammatory-hyperplastic and adenoma colorectal polyps. Methods From January 2017 to June 2019, consecutive asymptomatic average-risk participants undergoing initial screening colonoscopy. Questionnaires provided information on colorectal polyp risk factors, and plasma samples were assayed for 25-Hydroxyvitamin-D ‒ 25(OH)D3. The colorectal polyps were assessed, and medical history and demographic data were obtained from each patient. Results Of the 220 asymptomatic subjects, the prevalence of proximal inflammatory-hyperplastic polyps and adenoma polyps were 16.8%; 18.1% and 22.2%, respectively. Multivariate analysis revealed that low vitamin D (25(OH)D3 < 18 ng/mL, OR = 3.94; 95% CI: 1.81-9.51) and current/former smoking (OR = 6.85; 95% CI: 2.98-15.70), high body mass index (BMI > 24, OR = 5.32, 95% CI: 2.62-4.71) were independent predictors for proximal inflammatory-hyperplastic colorectal polyps (non-adenoma). Low vitamin D (25(OH)D3 < 18 ng/mL, OR = 7.75; 95% CI: 3.19-18.80) and current/former smoking (OR = 3.75; 95% CI: 1.30-10.81), age over 60 years old (OR = 2.38, 95% CI: 1.02-5.57), were independent predictors for adenoma colorectal polyps. Conclusion Low vitamin D and smoking are common risk factors for both adenomatous and proximal inflammatory hyperplastic polyps. Old age and BMI are additional risk factors for the development of adenomatous and non-adenomatous colorectal polyps. RESUMO Justificativa Uma associação inversa entre a vitamina D circulante e o risco de adenoma foi relatada, mas há pouco conhecimento sobre os pólipos hiperplásico-inflamatórios proximais. Objetivo Investigar os níveis circulantes de 25(OH)D3 e os fatores de risco de pólipos colorretais hiperplásico-inflamatórios e pólipos adenomatosos no colo proximal. Métodos De janeiro de 2017 a junho de 2019, participantes consecutivos, de risco médio, assintomáticos e submetidos à colonoscopia para triagem inicial foram selecionados. Os questionários forneceram informações sobre os fatores de risco para pólipo colorretal, e as amostras de sangue foram analisadas para identificar a concentração plasmática de 25-Hydroxyvitamin-D-25(OH)D3. Os pólipos colorretais foram avaliados e a história médica e os dados demográficos foram obtidos de cada paciente. Resultados Nos 220 indivíduos assintomáticos, a prevalência de pólipos no colo proximal, tanto hiperplásico-inflamatórios quanto adenomatosos, foi de 16.8%, 18.1% e 22.2%, respectivamente. A análise multivariada revelou que nível baixo de vitamina D (25(OH)D3 < 18 ng/mL, OR = 3,94; IC 95%: 1,81-9,51), tabagismo atual/anterior (OR = 6,85; IC 95%: 2,98-15,70) e alto índice de massa corporal (IMC > 24, OR = 5,32, IC 95%: 2,62-4,71) foram preditivos independentes para pólipos colorretais hiperplásico-inflamatórios proximais (não adenomatosos). Nível baixo de vitamina D (25(OH)D3 < 18 ng/mL, OR = 7,75; IC 95%: 3,19-18,80), tabagismo atual/anterior (OR = 3,75; IC 95%: 1,30-10,81) e idade acima de 60 anos (OR = 2,38, IC 95%: 1,02-5,57) foram preditivos independentes para pólipos colorretais adenomatosos. Conclusão Nível baixo de vitamina D e tabagismo são fatores de risco comuns para pólipos tanto adenomatosos quanto hiperplásico-inflamatórios proximais. Idade avançada e IMC são fatores de risco adicionais para o desenvolvimento de pólipos colorretais adenomatosos e não adenomatosos.

International audience; AIM To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological type. METHODS This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer (CRC) screening program; 2979 complete colonoscopies from 18 endoscopists were included. Variability in performance between endoscopists for detection of at least one adenoma (A), one proximal adenoma (PA), one distal adenoma (DA), and one proximal serrated polyp (PSP) was assessed by using multilevel logistic regression models. RESULTS The observed detect ion rates among the 18 endoscopists ranged from 24.6% to 47.6% (mean = 35.7%) for A, from 19.1% to 39.0% (mean = 29.4%) for DA, from 6.0% to 22.9% (mean = 12.4%) for PA, and from 1.3% to 19.3% (mean = 6.9%) for PSP. After adjusting for patient-level variables (sex, age), the interendoscopist detection rates variability achieved a significant level for A, PA, and PSP but not for DA (P = 0.03, P = 0.02, P = 0.02 and P = 0.08, respectively). This heterogeneity, as measured by the variance partition coefficient, was approximately threefold higher for PA (6.6%) compared with A (2.1%), and twofold higher for PSP (12.3%) compared with PA. CONCLUSION These results demonstrate significant interendoscopist variability for proximal polyp particularly for serrated polyps, but not for distal adenoma detection. These findings contribute to explain the decreased effectiveness of complete colonoscopies at preventing proximal CRCs and the need to carefully assess the proximal colon during scope procedure.