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The association between cigarette smoking and risk of colorectal cancer in a large prospective cohort from the United States.
Cancer Epidemiol Biomarkers Prev. 2009 Dec; 18(12):3362-7.CE

Abstract

BACKGROUND

Many studies have reported a 20% to 60% increase in risk of colorectal cancer associated with active smoking. However, neither the U.S. Surgeon General nor the IARC have classified the relationship as causal because of concern about residual confounding.

METHODS

In a prospective study of 184,187 people followed from 1992 to 2005, we used Cox proportional hazard models to examine the relationship of cigarette smoking to incident colorectal cancer, controlling for screening and multiple known and putative risk factors. Information on smoking and time-varying covariates was updated in 1997, 1999, 2001, and 2003.

RESULTS

The incidence of colorectal cancer was significantly higher in current [hazard ratios (HR), 1.27; 95% confidence intervals (CI), 1.06-1.52] and former smokers (HR, 1.23; 95% CI, 1.11-1.36) compared with lifelong nonsmokers in analyses that controlled for 13 covariates, including screening. The relative risk was greatest among current smokers with at least 50 years of smoking (HR, 1.38; 95% CI, 1.04-1.84). Among former smokers, risk of colorectal cancer decreased with greater time since cessation (P trend = 0.0003), and also decreased with earlier age at cessation (P trend = 0.0014). No association was seen among former smokers who had quit before age of 40 years or abstained for 31 years or more.

CONCLUSIONS

Long-term cigarette smoking is associated with colorectal cancer, even after controlling for screening and multiple other risk factors.

Authors+Show Affiliations

Department of Epidemiology, American Cancer Society, Atlanta, Georgia 30303-1002, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19959683

Citation

Hannan, Lindsay M., et al. "The Association Between Cigarette Smoking and Risk of Colorectal Cancer in a Large Prospective Cohort From the United States." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 18, no. 12, 2009, pp. 3362-7.
Hannan LM, Jacobs EJ, Thun MJ. The association between cigarette smoking and risk of colorectal cancer in a large prospective cohort from the United States. Cancer Epidemiol Biomarkers Prev. 2009;18(12):3362-7.
Hannan, L. M., Jacobs, E. J., & Thun, M. J. (2009). The association between cigarette smoking and risk of colorectal cancer in a large prospective cohort from the United States. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 18(12), 3362-7. https://doi.org/10.1158/1055-9965.EPI-09-0661
Hannan LM, Jacobs EJ, Thun MJ. The Association Between Cigarette Smoking and Risk of Colorectal Cancer in a Large Prospective Cohort From the United States. Cancer Epidemiol Biomarkers Prev. 2009;18(12):3362-7. PubMed PMID: 19959683.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between cigarette smoking and risk of colorectal cancer in a large prospective cohort from the United States. AU - Hannan,Lindsay M, AU - Jacobs,Eric J, AU - Thun,Michael J, PY - 2009/12/5/entrez PY - 2009/12/5/pubmed PY - 2010/2/24/medline SP - 3362 EP - 7 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 18 IS - 12 N2 - BACKGROUND: Many studies have reported a 20% to 60% increase in risk of colorectal cancer associated with active smoking. However, neither the U.S. Surgeon General nor the IARC have classified the relationship as causal because of concern about residual confounding. METHODS: In a prospective study of 184,187 people followed from 1992 to 2005, we used Cox proportional hazard models to examine the relationship of cigarette smoking to incident colorectal cancer, controlling for screening and multiple known and putative risk factors. Information on smoking and time-varying covariates was updated in 1997, 1999, 2001, and 2003. RESULTS: The incidence of colorectal cancer was significantly higher in current [hazard ratios (HR), 1.27; 95% confidence intervals (CI), 1.06-1.52] and former smokers (HR, 1.23; 95% CI, 1.11-1.36) compared with lifelong nonsmokers in analyses that controlled for 13 covariates, including screening. The relative risk was greatest among current smokers with at least 50 years of smoking (HR, 1.38; 95% CI, 1.04-1.84). Among former smokers, risk of colorectal cancer decreased with greater time since cessation (P trend = 0.0003), and also decreased with earlier age at cessation (P trend = 0.0014). No association was seen among former smokers who had quit before age of 40 years or abstained for 31 years or more. CONCLUSIONS: Long-term cigarette smoking is associated with colorectal cancer, even after controlling for screening and multiple other risk factors. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/19959683/The_association_between_cigarette_smoking_and_risk_of_colorectal_cancer_in_a_large_prospective_cohort_from_the_United_States_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=19959683 DB - PRIME DP - Unbound Medicine ER -