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Background : Folate deficiency may predispose to the initiation of colorectal cancer. Moderate to high alcohol consumption may lead to cellular folate deficiency. We studied to know whether the development of rectosigmoid adenoma is associated with plasma homocysteine concentration in the heavy alcohol drinkers. Methods : Heavy alcohol drinkers (n=533) among apparently healthy men who participated in a periodic health examination program were investigated retrospectively. All subjects in this study underwent sigmoidoscopy and measurement of plasma homocysteine concentration. Adjustment in these analyses were made for age as well as for other diseases such as diabetes, hyperlipidemia, fatty liver and hypertension, family history, drug history, obesity (body mass index), and cigarette smoking. Results : Subjects with high homocysteine concentration and old age were more likely to have rectosigmoid adenomas than low homocysteine level and young age respectively. An increase in 1μg/L of homocysteine concentration resulted in the increased relative risk of 1.070 (95 percent CI, 1.009 -1.136). There was no significant association between the risk of adenoma and other variables such as cigarette smoking, obesity, diabetes, hyperlipidemia, fatty liver, hypertension, family history and drug history. Conclusion : High plasma homocysteine concentration was associated with the increased risk of rectosigmoid adenoma in heavy alcohol drinkers.

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