AIM:To determine the real association between serumlipid levels and colonic polyp formation.METHODS:We performed a large scale retrospectivestudy to analyze the correlation between the incidence ofcolorectal adenoma or carcinoma and the fasting serumlevels of total cholesterol(TC)and triglycerides(TG)inpatients who underwent total colonoscopy for screeningfor colon cancer.RESULTS:Both levels were significantly elevated inpatients with adenomas as compared with patientswithout any neoplastic lesion(TC 207.6+29.5 vs 199.5±34.3,n=4883,p<0.001;TG 135.0±82.2 vs 108.7±71.5,n=4874,p<0.001).The difference was significantin patients with tubular adenoma but not in those withvillous or serrated adenoma.Multiple logistic regressionanalysis including age and sex revealed that TG was anindependent correlation factor in male(p<0.01),butnot in female patients.The level of TG in patients withinvasive carcinoma did not show a significant elevationfrom that in patients with adenoma.These findingssuggest that hypertriglyceridemia is an independent riskfactor for colonic adenoma in men.CONCLUSION:Although a high level of serumtriglyceride does not appear to be mechanically involvedin the development of carcinoma,reduction of serum TGand intensive surveillance with total colonoscopy mayhave benefit in men with hypertriglyceridemia. AIM: To determine the real association between serumlipid levels and colonic polyp formation. METHODS: We performed a large scale retrospective study to analyze the correlation between the incidence ofcolorectal adenoma or carcinoma and the fasting serum levels of total cholesterol (TC) and triglycerides (TG) inpatients who underwent total colonoscopy for screening for colon cancer .RESULTS: Both levels were significantly elevated inpatients with adenomas as compared with patientswithout any neoplastic lesion (TC 207.6 + 29.5 vs 199.5 ± 34.3, n = 4883, p <0.001; TG 135.0 ± 82.2 vs 108.7 ± 71.5, n = 4874, p <0.001). The difference was significantin patients with tubular adenoma but not in those withvillous or serrated adenoma. Multiple logistic regression analysis including age and sex revealed that TG was anindependent correlation factor in male (p <0.01) , butnot in female patients. The level of TG in patients withinvasive carcinoma did not show a significant elevation from that in patients with adenoma.These findingssugg est that hypertriglyceridemia is an independent risk factor for colonic adenoma in men. CONCLUSION: Although a high level of serum triglyceride does not appear to be mechanically involved in the development of carcinoma, reduction of serum TG and intensive surveillance with total colonoscopy mayhave benefit in men with hypertriglyceridemia.