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Smokeless tobacco (snus) use and colorectal cancer incidence and survival : Results from nine pooled cohorts

Araghi, Marzieh; Galanti, Maria Rosaria; Lundberg, Michael; Liu, Zhiwei; Ye, Weimin; Lager, Anton; Engström, Gunnar LU ; Manjer, Jonas LU ; Alfredsson, Lars and Knutsson, Anders, et al. (2017) In Scandinavian Journal of Public Health 45(8). p.741-748
Abstract

Aims: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association. Methods: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During 7,135,504 person-years of observation, 4170 men... (More)

Aims: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association. Methods: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis. Conclusions: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention.

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publication status
published
subject
keywords
Colorectal cancer, incidence; survival, snus
in
Scandinavian Journal of Public Health
volume
45
issue
8
pages
8 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85038388344
  • wos:000418185200002
ISSN
1403-4948
DOI
10.1177/1403494817714191
language
English
LU publication?
yes
id
56164159-0476-4d62-932c-0dfaf3791bba
date added to LUP
2018-01-10 16:12:25
date last changed
2018-01-16 13:29:34
@article{56164159-0476-4d62-932c-0dfaf3791bba,
  abstract     = {<p>Aims: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association. Methods: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis. Conclusions: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention.</p>},
  author       = {Araghi, Marzieh and Galanti, Maria Rosaria and Lundberg, Michael and Liu, Zhiwei and Ye, Weimin and Lager, Anton and Engström, Gunnar and Manjer, Jonas and Alfredsson, Lars and Knutsson, Anders and Norberg, Margareta and Palmqvist, Richard and Gylling, Björn and Wennberg, Patrik and Lagerros, Ylva trolle and Bellocco, Rino and Pedersen, Nancy L. and Östergren, Per Olof and Magnusson, Cecilia},
  issn         = {1403-4948},
  keyword      = {Colorectal cancer,incidence; survival,snus},
  language     = {eng},
  month        = {12},
  number       = {8},
  pages        = {741--748},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Public Health},
  title        = {Smokeless tobacco (snus) use and colorectal cancer incidence and survival : Results from nine pooled cohorts},
  url          = {http://dx.doi.org/10.1177/1403494817714191},
  volume       = {45},
  year         = {2017},
}