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Cigarette smoking and the risk of colorectal cancer: a meta-analysis of prospective cohort studies.
Clin Gastroenterol Hepatol. 2009 Jun; 7(6):682-688.e1-5.CG

Abstract

BACKGROUND & AIMS

Smoking has been implicated in many malignant diseases, but its association with colorectal cancer (CRC) is controversial. We quantitatively evaluated the relation between smoking and incidence of CRC in a meta-analysis of cohort studies.

METHODS

Full publications of prospective cohort studies were identified in MEDLINE and EMBASE from 1950 to 2008. Subjects were classified as current smokers, former smokers, or never smokers. The quantity of smoking was assessed by number of cigarettes per day, years of smoking, and pack-years. The reported relative risks of CRC were pooled by random-effects model. Sensitivity analysis was conducted, and publication bias was evaluated.

RESULTS

A total of 1,463,796 subjects were recruited in 28 prospective cohorts from America, Europe, and Asia, with median follow-up of 13 years (range, 4-30 years). Current smokers showed a modestly higher risk of CRC (relative risk [RR], 1.20; 95% confidence interval [CI], 1.10-1.30) than never smokers. The risk of CRC among male smokers (RR, 1.38; 95% CI, 1.22-1.56) was more significant than among female smokers (RR, 1.06; 95% CI, 0.95-1.19). Rectal cancer was more closely related to smoking (RR, 1.36; 95% CI, 1.15-1.61) than colonic cancer. Former smokers still carried a higher CRC risk than never smokers. The increased risk of CRC was related to cigarettes per day, longer years of smoking, or larger pack-years.

CONCLUSIONS

Smoking was associated with a significantly increased risk of CRC. The associated risk was higher for men and for rectal cancers. The association of tobacco consumption and CRC risk appeared to be dose-related.

Authors+Show Affiliations

Institute of Digestive Disease, the Chinese University of Hong Kong, Hong Kong, PRC.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

19245853

Citation

Tsoi, Kelvin K F., et al. "Cigarette Smoking and the Risk of Colorectal Cancer: a Meta-analysis of Prospective Cohort Studies." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 7, no. 6, 2009, pp. 682-688.e1-5.
Tsoi KK, Pau CY, Wu WK, et al. Cigarette smoking and the risk of colorectal cancer: a meta-analysis of prospective cohort studies. Clin Gastroenterol Hepatol. 2009;7(6):682-688.e1-5.
Tsoi, K. K., Pau, C. Y., Wu, W. K., Chan, F. K., Griffiths, S., & Sung, J. J. (2009). Cigarette smoking and the risk of colorectal cancer: a meta-analysis of prospective cohort studies. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 7(6), 682-e1-5. https://doi.org/10.1016/j.cgh.2009.02.016
Tsoi KK, et al. Cigarette Smoking and the Risk of Colorectal Cancer: a Meta-analysis of Prospective Cohort Studies. Clin Gastroenterol Hepatol. 2009;7(6):682-688.e1-5. PubMed PMID: 19245853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cigarette smoking and the risk of colorectal cancer: a meta-analysis of prospective cohort studies. AU - Tsoi,Kelvin K F, AU - Pau,Carol Y Y, AU - Wu,William K K, AU - Chan,Francis K L, AU - Griffiths,Sian, AU - Sung,Joseph J Y, Y1 - 2009/02/24/ PY - 2008/12/19/received PY - 2009/02/09/revised PY - 2009/02/11/accepted PY - 2009/2/28/entrez PY - 2009/2/28/pubmed PY - 2009/7/28/medline SP - 682-688.e1-5 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 7 IS - 6 N2 - BACKGROUND & AIMS: Smoking has been implicated in many malignant diseases, but its association with colorectal cancer (CRC) is controversial. We quantitatively evaluated the relation between smoking and incidence of CRC in a meta-analysis of cohort studies. METHODS: Full publications of prospective cohort studies were identified in MEDLINE and EMBASE from 1950 to 2008. Subjects were classified as current smokers, former smokers, or never smokers. The quantity of smoking was assessed by number of cigarettes per day, years of smoking, and pack-years. The reported relative risks of CRC were pooled by random-effects model. Sensitivity analysis was conducted, and publication bias was evaluated. RESULTS: A total of 1,463,796 subjects were recruited in 28 prospective cohorts from America, Europe, and Asia, with median follow-up of 13 years (range, 4-30 years). Current smokers showed a modestly higher risk of CRC (relative risk [RR], 1.20; 95% confidence interval [CI], 1.10-1.30) than never smokers. The risk of CRC among male smokers (RR, 1.38; 95% CI, 1.22-1.56) was more significant than among female smokers (RR, 1.06; 95% CI, 0.95-1.19). Rectal cancer was more closely related to smoking (RR, 1.36; 95% CI, 1.15-1.61) than colonic cancer. Former smokers still carried a higher CRC risk than never smokers. The increased risk of CRC was related to cigarettes per day, longer years of smoking, or larger pack-years. CONCLUSIONS: Smoking was associated with a significantly increased risk of CRC. The associated risk was higher for men and for rectal cancers. The association of tobacco consumption and CRC risk appeared to be dose-related. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/19245853/Cigarette_smoking_and_the_risk_of_colorectal_cancer:_a_meta_analysis_of_prospective_cohort_studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(09)00139-6 DB - PRIME DP - Unbound Medicine ER -