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Smoking and the Association of Advanced Colorectal Neoplasia in an Asymptomatic Average Risk Population: Analysis of Exposure and Anatomical Location in Men and Women

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Abstract

Background

Identifying risk factors for advanced colorectal adenomas may aid in colorectal cancer (CRC) screening, especially in light of the American College of Gastroenterology’s recent guidelines, emphasizing cancer prevention through identification and removal of advanced adenomas. Smoking is an important risk factor for advanced adenomas but there is little data regarding levels of exposure for genders.

Methods

The aim of this study was to use an existing database to examine the genders separately with respect to exposure level and anatomic location of advanced adenomas. Our database was designed to study smoking in an asymptomatic, screening population. Data included demographics, family history of CRC, smoking exposure (pack-years and years smoked), alcohol, diabetes, medications, exercise and dietary history. We excluded patients with a first degree relative with CRC.

Results

Compared to non-smokers, female smokers had an increased risk for advanced adenomas with an exposure of 10–30 pack-years (adjusted odds ratio [AOR] = 4.11; 95% confidence interval [CI], 1.88–9.01) as well as for ≥30 pack-years (AOR = 2.54; 95% CI, 1.08–5.96) while men had an increased risk with smoking ≥30 pack-years (AOR = 3.10; 95% CI, 1.71–5.65). An increased association with smoking was observed for proximal advanced adenomas (AOR = 4.06; 95% CI, 1.62–10.19) and large hyperplastic polyps in women.

Conclusions

Women smokers had an increased risk for advanced adenomas at a lower exposure level and had a greater risk for proximal lesions. These findings may have an impact on CRC screening for women.

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Authors and Affiliations

  1. Division of Gastroenterology and the Carole and Ray Neag Cancer Center, Department of Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030-1845, USA

    Joseph C. Anderson

  2. Division of Gastroenterology, Department of Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030-1845, USA

    Koorosh Moezardalan

  3. Department of Preventive Medicine, Stony Brook University, Stony Brook, NY, USA

    Catherine R. Messina

  4. Department of Medicine, Columbia University, New York, NY, USA

    Michael Latreille

  5. Department of Medicine, Stony Brook University, Stony Brook, NY, USA

    Robert D. Shaw

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  1. Joseph C. Anderson
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Correspondence to Joseph C. Anderson.

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Anderson, J.C., Moezardalan, K., Messina, C.R. et al. Smoking and the Association of Advanced Colorectal Neoplasia in an Asymptomatic Average Risk Population: Analysis of Exposure and Anatomical Location in Men and Women. Dig Dis Sci 56, 3616–3623 (2011). https://doi.org/10.1007/s10620-011-1814-8

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  • DOI: https://doi.org/10.1007/s10620-011-1814-8

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