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Cigarette smoking and colorectal cancer: long-term, subsite-specific risks in a cohort study of postmenopausal women.
Clin Gastroenterol Hepatol. 2003 May; 1(3):202-10.CG

Abstract

BACKGROUND & AIMS

Cigarette smoking is a putative risk factor for colorectal cancer (CRC). However, long-term CRC risk estimates among female smokers remain limited and inconsistent. The goal of this prospective study was to assess cigarette smoking and CRC risk, overall and by anatomic subsite, among postmenopausal women.

METHODS

Data were drawn from a large population-based cohort (n = 41836) of randomly selected women, age 55-69 years at baseline (Iowa Women's Health Study). Cigarette smoking and other CRC risk factors were characterized at baseline (1986). Incident (n = 869) and fatal (n = 249) CRC cases were identified through December 31, 1999. CRC risks were estimated using Cox proportional hazards regression models.

RESULTS

Compared with never smokers, ever smokers had slightly increased risks for both incident (relative risk [RR], 1.17; 95% confidence interval [CI], 1.00-1.36) and fatal (RR, 1.31; 95% CI, 0.98-1.74) CRC in multivariate analyses. Incident CRC risks increased progressively by lengthening induction period (P trend=0.01), reaching a 30% increase (RR, 1.30; 95% CI, 1.04-1.63) after age 45 years. By anatomic subsite, ever smoked cigarettes and induction period were more strongly associated with incident proximal CRC (P = 0.03 and P trend = 0.03, respectively) than incident distal CRC (P=0.44 and P trend=0.10, respectively).

CONCLUSIONS

In this long-term cohort study of postmenopausal women, cigarette smoking was positively associated with CRC risk. Onset of smoking in the distant past appeared to confer the greatest risk, especially for incident proximal CRC. These data support a potential subsite-specific role for cigarette smoking in colorectal carcinogenesis, at least among women. Based on emerging data, an epigenetic pathway for smoking-induced CRC is proposed.

Authors+Show Affiliations

Divisions of Gastroenterology and Hepatology and Epidemiology, Mayo Clinic Cancer Center, Rochester, Minnesota, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15017492

Citation

Limburg, Paul J., et al. "Cigarette Smoking and Colorectal Cancer: Long-term, Subsite-specific Risks in a Cohort Study of Postmenopausal Women." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 1, no. 3, 2003, pp. 202-10.
Limburg PJ, Vierkant RA, Cerhan JR, et al. Cigarette smoking and colorectal cancer: long-term, subsite-specific risks in a cohort study of postmenopausal women. Clin Gastroenterol Hepatol. 2003;1(3):202-10.
Limburg, P. J., Vierkant, R. A., Cerhan, J. R., Yang, P., Lazovich, D., Potter, J. D., & Sellers, T. A. (2003). Cigarette smoking and colorectal cancer: long-term, subsite-specific risks in a cohort study of postmenopausal women. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 1(3), 202-10.
Limburg PJ, et al. Cigarette Smoking and Colorectal Cancer: Long-term, Subsite-specific Risks in a Cohort Study of Postmenopausal Women. Clin Gastroenterol Hepatol. 2003;1(3):202-10. PubMed PMID: 15017492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cigarette smoking and colorectal cancer: long-term, subsite-specific risks in a cohort study of postmenopausal women. AU - Limburg,Paul J, AU - Vierkant,Robert A, AU - Cerhan,James R, AU - Yang,Ping, AU - Lazovich,Deann, AU - Potter,John D, AU - Sellers,Thomas A, PY - 2004/3/16/pubmed PY - 2004/4/2/medline PY - 2004/3/16/entrez SP - 202 EP - 10 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 1 IS - 3 N2 - BACKGROUND & AIMS: Cigarette smoking is a putative risk factor for colorectal cancer (CRC). However, long-term CRC risk estimates among female smokers remain limited and inconsistent. The goal of this prospective study was to assess cigarette smoking and CRC risk, overall and by anatomic subsite, among postmenopausal women. METHODS: Data were drawn from a large population-based cohort (n = 41836) of randomly selected women, age 55-69 years at baseline (Iowa Women's Health Study). Cigarette smoking and other CRC risk factors were characterized at baseline (1986). Incident (n = 869) and fatal (n = 249) CRC cases were identified through December 31, 1999. CRC risks were estimated using Cox proportional hazards regression models. RESULTS: Compared with never smokers, ever smokers had slightly increased risks for both incident (relative risk [RR], 1.17; 95% confidence interval [CI], 1.00-1.36) and fatal (RR, 1.31; 95% CI, 0.98-1.74) CRC in multivariate analyses. Incident CRC risks increased progressively by lengthening induction period (P trend=0.01), reaching a 30% increase (RR, 1.30; 95% CI, 1.04-1.63) after age 45 years. By anatomic subsite, ever smoked cigarettes and induction period were more strongly associated with incident proximal CRC (P = 0.03 and P trend = 0.03, respectively) than incident distal CRC (P=0.44 and P trend=0.10, respectively). CONCLUSIONS: In this long-term cohort study of postmenopausal women, cigarette smoking was positively associated with CRC risk. Onset of smoking in the distant past appeared to confer the greatest risk, especially for incident proximal CRC. These data support a potential subsite-specific role for cigarette smoking in colorectal carcinogenesis, at least among women. Based on emerging data, an epigenetic pathway for smoking-induced CRC is proposed. SN - 1542-3565 UR - https://www.unboundmedicine.com/medline/citation/15017492/Cigarette_smoking_and_colorectal_cancer:_long_term_subsite_specific_risks_in_a_cohort_study_of_postmenopausal_women_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542356503700378 DB - PRIME DP - Unbound Medicine ER -