Smoking and colorectal cancer:: Different effects by type of cigarettes?
Smoking and colorectal cancer:: Different effects by type of cigarettes?
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DOI：
10.1158/1055-9965.epi-06-0519
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发表时间：
2007-07-01
影响因子：
3.8
通讯作者：
Le Marchand, Loiec
中科院分区：
文献类型：
--
作者：
Luchtenborg, Margreet;White, Kami K. L.;Le Marchand, Loiec
虽然吸烟被认为是结直肠癌的一个危险因素，但迄今为止的证据是相互矛盾的，可能会混淆。此外，烟草烟雾的影响可能会因时间而异，因为开始，烟草产品的类型，解剖亚部位，和种族群体。数据来源于在夏威夷的高加索人、日本人、夏威夷土著人、菲律宾人和中国人中进行的两项连续的基于人群的病例对照研究，包括1，959个种族、性别和年龄匹配的病例对照对。通过面对面访谈获得不同烟草产品的终生吸烟史和其他风险因素的信息。采用条件logistic回归模型估计比值比（OR）和相应的95%置信区间（95% CD），并对潜在混杂因素进行调整。与从不吸烟的受试者相比，曾经吸烟的受试者患结直肠癌的风险增加（男性OR，1.23; 95% CI，0.99-1.52;女性OR，1.27; 95% CI，1.01-1.59）。所有烟草产品包年数的增加在男性中显示出明显的剂量依赖性相关性[对于最高四分位数，Q4（> 40包年）与从不吸烟者：OR，1.48; 95%CI，1.12-1.96; P趋势= 0.002]。剂量反应趋势也存在于女性[对于最高四分位数，Q4（> 30包-年）与从不吸烟者：OR，1.38; 95% CI，0.91-1.95; P趋势= 0.04]和每个种族组。有证据表明，烟草产品的类型对风险有影响。非过滤嘴香烟增加了结肠癌和直肠癌的风险[Q4与从不吸烟者相比：OR，1.59; 95%CI，1.15-2.21; P趋势= 0.001和OR，1.84; 95%CI，1.18-2.86; P-趋势= 0.02，分别]，而过滤嘴香烟似乎增加直肠癌的风险，但不是结肠癌（OR，1.37; 95% CI，0.88-2.13; P趋势= 0.06和OR，1.05; 95% CI，0.79-1.39; P趋势= 0.98）。吸烟的影响并不局限于遥远的过去，累积的吸烟包年数似乎比吸烟发生的时间更重要。这项大型研究的数据证实了先前关于吸烟与结直肠癌之间正相关的报道，并表明这种关联可能因香烟类型而异。
Although smoking is suggested to be a risk factor for colorectal cancer, the evidence to date is conflicting and may be confounded. Moreover, the effect of tobacco smoke may vary by time since initiation, type of tobacco product, anatomic subsites, and among ethnic groups. Data were derived from two consecutive population-based case-control studies conducted among Caucasians, Japanese, Native Hawaiians, Filipinos, and Chinese in Hawaii, including 1,959 ethnicity-, sex-, and age-matched case-control pairs. A lifetime history of smoking for different tobacco products and information on other risk factors were obtained by in-person interviews. Odds ratios (OR) and corresponding 95% confidence intervals (95% CD were estimated using conditional logistic regression models with adjustment for potential confounders. Subjects who ever smoked were at an increased risk of colorectal cancer compared with never smokers (OR, 1.23; 95% CI, 0.99-1.52 for men and OR, 1.27; 95% Cl, 1.01-1.59 for women). Increasing quartiles of pack-years over all tobacco products showed a clear dose-dependent association in men [for the highest quartile, Q4 (> 40 pack-years) versus never smokers: OR, 1.48; 95% CI, 1.12-1.96; P-trend = 0.002]. The dose-response trend was also present in women [for the highest quartile, Q4 (> 30 pack-years) versus never smokers: OR, 1.38; 95% CI, 0.91-1.95; P-trend = 0.04] and each ethnic group. There was a suggestion of a difference in risk with type of tobacco product. Non-filtered cigarettes increased risk of both colon and rectal cancer [for Q4 versus never smokers: OR, 1.59; 95% CI, 1.15-2.21; P-trend = 0.001 and OR, 1.84; 95% CI, 1.18-2.86; P-trend = 0.02, respectively], whereas filtered cigarettes seemed to increase risk of rectal but not colon cancer (OR, 1.37; 95% CI, 0.88-2.13; P-trend = 0.06 and OR, 1.05; 95% Cl, 0.79-1.39; P-trend = 0.98, respectively). The effect of smoking was not limited to the distant past, and accumulated pack-years of smoking seemed to be more important than the time in which smoking occurred. The data from this large study corroborate previous reports of a positive association between smoking and colorectal cancer and suggest that the association may vary by type of cigarette.