Cigarette smoking and risk of cancers of the colon and rectum: A case–control study from Italy Article DOI:
Cite this article as: Tavani, A., Gallus, S., Negri, E. et al. Eur J Epidemiol (1998) 14: 675. doi:10.1023/A:1007545607059 Abstract
The relationship between smoking habit and risk of colon and rectal cancers was considered in a case–control study conducted between 1991 and 1996 in six Italian centers. Cases were 1225 patients below age 75 with histologically confirmed cancer of the colon and 728 with cancer of the rectum.Controls were 4154 patients admitted to hospital for a wide spectrum of acute, non-neoplastic diseases. Compared to neversmokers, the odds ratios (OR) for current smokers of 25 or more cigarettes/day was 0.90 for patients with colon and 0.86 for those with rectal cancer and those for ex-smokers were 1.02 and 1.09 for colon and rectal cancer, respectively. No increase in risk was found with duration of the habit, the OR for 40 or more years being 0.79 for colon and 0.87 for rectal cancer. Furthermore, no relationship was apparent with time since starting (the OR for 40 or more years were 0.94 for colon and 1.01 for rectal cancer), or age at starting (the OR for < 18 years were 1.02 for colon and 1.00 for rectal cancer), or for pack-years smoked (the OR for 40 or more pack-years were 0.93 for colon and 0.91 for rectal cancer) or time since stopping among ex-smokers. No increase in risk was found in smokers of ≥ 15 cigarettes/day for 40 years or longer (OR: 0.93). No significant heterogeneity was found across strata of age at diagnosis, sex, education, physical activity at work, intake of alcohol, coffee, vegetables, total energy, and number of meals/day. Likewise, no significant association was apparent for various intestinal subsites. Thus, this study did not find cigarette smokers at higher risk for cancer of the bowel even after a long duration and a long period since starting.
Case–control study Colon Neoplasm Rectum Risk factors Smoking References
Giovannucci E, Martinez ME. Tobacco, colorectal cancer, and adenomas: A review of the evidence. J Natl Cancer Inst 1996; 88: 1717–1730.
Potter JD, Slattery ML, Bostick RM, Gapstur SM. Colon cancer: A review of the epidemiology. Epidemiol Rev 1993; 15: 499–545.
Carstensen JM, Pershagen G, Eklund G. Mortality in relation to cigarette and pipe smoking: 16 Years' observation of 25,000 Swedish men. J Epidemiol Community Health 1987; 41: 166–172.
Sandler RS, Sandler DP, Comstock GW, Helsing KJ, Shore DL. Cigarette smoking and the risk of colorectal cancer in women. J Natl Cancer Inst 1988; 80: 1329–1333.
Chute CG, Willett WC, Colditz GA, et al. A prospective study of body mass, height, and smoking on the risk of colorectal cancer in women. Cancer Causes Control 1991; 2: 117–124.
Choi SY, Kahyo H. Effect of cigarette smoking and alcohol consumption in the etiology of cancers of the digestive tract. Int J Cancer 1991; 49: 381–386.
Kune GA, Kune S, Vitetta L, Watson LF. Smoking and colorectal cancer risk: Data from the Melbourne Colorectal Cancer Study and brief review of literature. Int J Cancer 1992; 50: 369–372.
Olsen J, Kronborg O. Coffee, tobacco and alcohol as risk factors for cancer and adenoma of the large intestine. Int J Epidemiol 1993; 22: 398–402.
Bostick RM, Potter JD, Kushi LH, et al. Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women (United States). Cancer Causes Control 1994; 5: 38–52.
Baron JA, Gerhardsson de Verdier M, Ekbom A. Coffee, tea, tobacco, and cancer of the large bowel. Cancer Epidemiol Biomarkers Prev 1994; 3: 565–570.
Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 Years' observations on male British doctors. Br Med J 1994; 309: 901–911.
Siemiatycki J, Krewski D, Franco E, Kaiserman M. Associations between cigarette smoking and each of 21 types of cancer: A multi site case control study. Int J Epidemiol 1995; 24: 504–514.
D'Avanzo B, La Vecchia C, Franceschi S, Gallotti L, Talamini R. Cigarette smoking and colorectal cancer: A study of 1584 cases and 2879 controls. Prev Med 1995; 24: 571–579.
Boutron M-C, Faivre J, Dop M-C, Quiport V, Senesse P. Tobacco, alcohol, and colorectal tumors: A multistep process. Am J Epidemiol 1995; 141: 1038–1046.
Nyrén O, Bergström R, Nyström L, et al. Smoking and colorectal cancer: A 20–year follow-up study of Swedish construction workers. J Natl Cancer Inst 1996; 88: 1302–1307.
Giovannucci E, Rimm EB, Stampfer MJ, et al. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. men. J Natl Cancer Inst 1994; 86: 183–191.
Giovannucci E, Colditz GA, Stampfer MJ, et al. A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. women. J Natl Cancer Inst 1994; 86: 192–199.
Marcus PM, Newcomb PA, Young T, Storer BE. The association of reproductive and menstrual characteristics and colon and rectal risk in Wisconsin women. Ann Epidemiol 1995; 5: 303–309.
Heineman EF, Zahm SH, McLaughlin JK, Vaught JB. Increased risk of colorectal cancer among smokers: Results of a 26–year follow-up of US veterans and a review. Int J Cancer 1995; 59: 728–738.
Slattery ML, Potter JD, Friedman GD, Ma K-N, Edwards S. Tobacco use and colon cancer. Int J Cancer 1997; 70: 259–264.
Yamada K, Araki S, Tamura M, et al. Case-control study of colorectal carcinoma
and cancer relation to cigarette smoking and alcohol use (Japan). Cancer Causes Control 1997; 8: 780–785.
La Vecchia C, Lucchini F, Negri E, Boyle P, Maisonneuve P, Levi F. Trends of cancer mortality in Europe, 1955–1989: I. Digestive sites. Eur J Cancer 1992; 28: 132–235.
La Vecchia C, Negri E, Franceschi S, et al. Aspirin and colorectal cancer. Br J Cancer 1997; 76: 675–677.
Franceschi S, Negri E, Salvini S, et al. Reproducibility of an Italian food frequency questionnaire for cancer studies: Results for specific food items. Eur J Cancer 1993; 29A: 2298–2305.
Decarli A, Franceschi S, Ferraroni M, et al. Validation of a food frequency questionnaire to assess dietary intakes in cancer studies in Italy: Results for specific nutrients. Ann Epidemiol 1996; 6: 110–118.
Breslow NE, Day NE. Statistical methods in cancer research, Vol. 1. The analysis of case-control studies. Lyon: IARC Sci Publ., 1980; 32.
Linet MS, Brookmeyer R. Use of cancer controls in case-control cancer studies. Am J Epidemiol 1987; 125: 1–11.
Dales LG, Friedman GD, Ury HK, Grossman S, Williams SR. A case-control study of relationships of diet and other traits to colorectal cancer in American blacks. Am J Epidemiol 1979; 109: 132–144.
Jarebinski M, Adanja B, Vlajinac H. Case-control study of relationship of some biosocial correlates to rectal cancer patients in Belgrade, Yugoslavia. Neoplasma 1989; 36: 369–374.
Pagano R, La Vecchia C, Decarli A. Smoking in Italy, 1995. Tumori. (In press.)
La Vecchia C, Negri E, Franceschi S, Parazzini F, Decarli A. Differences in dietary intake with smoking, alcohol, and education. Nutr Cancer 1992; 17: 297–304.
D'Avanzo B, La Vecchia C, Braga C, Franceschi S, Negri E, Parpinel M. Nutrient intake according to education, smoking, and alcohol in Italian women. Nutr Cancer 1997; 28: 46–51.
Hill C. Trends in tobacco use in Europe. J Natl Cancer Inst Monogr 1992; 12: 21–24.
Google Scholar Copyright information
© Kluwer Academic Publishers 1998