Advanced

Cigarette Smoking and Colorectal Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition Study

Leufkens, Anke M.; Van Duijnhoven, Franzel J. B.; Siersema, Peter D.; Boshuizen, Hendriek C.; Vrieling, Alina; Agudo, Antonio; Gram, Inger T.; Weiderpass, Elisabete; Dahm, Christina and Overvad, Kim, et al. (2011) In Clinical Gastroenterology and Hepatology 9(2). p.137-144
Abstract
BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2741 developed CRC during the follow-up period (mean, 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR, 1.18; 95% CI, 1.06-1.32) and former... (More)
BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2741 developed CRC during the follow-up period (mean, 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR, 1.18; 95% CI, 1.06-1.32) and former cigarette smokers (HR, 1.21; 95% CI, 1.08-1.36), compared with never smokers; the increased risk for current smokers was of borderline significance (HR, 1.13; 95% Cl, 0.98-1.31). When stratified for tumor location, the risk of proximal colon cancer was increased for former (HR, 1.25; 95% CI, 1.04-1.50) and current smokers (HR, 1.31; 95% CI, 1.06-1.64), but the risks for cancers in the distal colon or rectum were not. Subsite analyses showed a nonsignificant difference between the proximal and distal colon (P=.45) for former smokers and a significant difference for current smokers (P=.02). For smokers who had stopped smoking for at least 20 years, the risk of developing colon cancer was similar to that of never smokers. CONCLUSIONS: Ever smokers have an increased risk of colon cancer, which appeared to be more pronounced in the proximal than the distal colon location. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Colorectal Cancer, Tumor Location, Tobacco, Risk Factor
in
Clinical Gastroenterology and Hepatology
volume
9
issue
2
pages
137 - 144
publisher
Elsevier
external identifiers
  • wos:000287550200015
  • scopus:78751696068
ISSN
1542-7714
DOI
10.1016/j.cgh.2010.10.012
language
English
LU publication?
yes
id
f3233d9a-1b54-4088-b1d2-fb4026cc9451 (old id 1876236)
date added to LUP
2011-04-01 12:17:34
date last changed
2017-01-01 03:11:40
@article{f3233d9a-1b54-4088-b1d2-fb4026cc9451,
  abstract     = {BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2741 developed CRC during the follow-up period (mean, 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR, 1.18; 95% CI, 1.06-1.32) and former cigarette smokers (HR, 1.21; 95% CI, 1.08-1.36), compared with never smokers; the increased risk for current smokers was of borderline significance (HR, 1.13; 95% Cl, 0.98-1.31). When stratified for tumor location, the risk of proximal colon cancer was increased for former (HR, 1.25; 95% CI, 1.04-1.50) and current smokers (HR, 1.31; 95% CI, 1.06-1.64), but the risks for cancers in the distal colon or rectum were not. Subsite analyses showed a nonsignificant difference between the proximal and distal colon (P=.45) for former smokers and a significant difference for current smokers (P=.02). For smokers who had stopped smoking for at least 20 years, the risk of developing colon cancer was similar to that of never smokers. CONCLUSIONS: Ever smokers have an increased risk of colon cancer, which appeared to be more pronounced in the proximal than the distal colon location.},
  author       = {Leufkens, Anke M. and Van Duijnhoven, Franzel J. B. and Siersema, Peter D. and Boshuizen, Hendriek C. and Vrieling, Alina and Agudo, Antonio and Gram, Inger T. and Weiderpass, Elisabete and Dahm, Christina and Overvad, Kim and Tjonneland, Anne and Olsen, Anja and Boutron-Ruault, Marie-Christine and Clavel-Chapelon, Francoise and Morois, Sophie and Palli, Domenico and Grioni, Sara and Tumino, Rosario and Sacerdote, Charlotta and Mattiello, Amalia and Herman, Silke and Kaaks, Rudolf and Steffen, Annika and Boeing, Heiner and Trichopoulou, Antonia and Lagiou, Pagona and Trichopoulos, Dimitrios and Peeters, Petra H. and van Gils, Carla H. and van Kranen, Henk and Lund, Eliv and Dumeaux, Vanessa and Engeset, Dagrun and Rodriguez, Laudina and Sanchez, Maria-Jose and Chirlaque, Maria-Dolores and Barricarte, Aurelio and Manjer, Jonas and Almquist, Martin and van Guelpen, Bethany and Hallmans, Goran and Khaw, Kay-Tee and Wareham, Nick and Tsilidis, Konstantinos K. and Straif, Kurt and Leon-Roux, Maria and Vineis, Paul and Norat, Teresa and Riboli, Elio and Bueno-de-Mesquita, H. Bas},
  issn         = {1542-7714},
  keyword      = {Colorectal Cancer,Tumor Location,Tobacco,Risk Factor},
  language     = {eng},
  number       = {2},
  pages        = {137--144},
  publisher    = {Elsevier},
  series       = {Clinical Gastroenterology and Hepatology},
  title        = {Cigarette Smoking and Colorectal Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition Study},
  url          = {http://dx.doi.org/10.1016/j.cgh.2010.10.012},
  volume       = {9},
  year         = {2011},
}