Prevalence of colorectal neoplasia in smokers
Prevalence of colorectal neoplasia in smokers
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DOI：
10.1111/j.1572-0241.2003.08671.x
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发表时间：
2003-12-01
影响因子：
9.8
通讯作者：
Brand, DL
中科院分区：
文献类型：
--
作者：
Anderson, JC;Attam, R;Brand, DL
目的：吸烟与结直肠肿瘤有关。以前的结肠镜筛查研究忽略了吸烟，只检查了性别、年龄和家族史。我们的目的是使用筛查人群来测量吸烟者中肿瘤的患病率，这些病变的解剖位置，以及与其他危险因素相关的强度。方法：从1988年结肠镜筛查患者的图表中收集数据，包括结肠检查结果、组织学、结直肠肿瘤的危险因素和吸烟模式。当前吸烟者被定义为吸烟超过10包年，目前正在吸烟或在过去10年内戒烟的人。我们的结果是任何腺瘤病变和显著的结肠肿瘤，包括腺癌、高度不典型增生、绒毛组织、大（bbb1cm）腺瘤和多发性（超过2个）腺瘤。结果：多因素分析显示，与从不吸烟的人相比，当前吸烟者更容易出现任何腺瘤病变（比值比[OR] = 1.89; 95% CI = 1.42-2.51; p < 0.001）以及显著的瘤变（OR = 2.26; 95% CI = 1.56-3.27; p < 0.001）。吸烟者增加的风险主要是左侧肿瘤。有结直肠癌家族史的患者相比，吸烟者患显著性肿瘤的风险更高（OR = 1.20; 95% CI = 0.75-1.92; p < 0.05）。结论：在筛查人群中，吸烟是结直肠肿瘤的重要危险因素，尤其是对于显著的左侧病变。在我们的样本人群中，吸烟比有结直肠癌家族史的风险更大。
OBJECTIVES: Smoking has been linked with colorectal neoplasia. Previous colonoscopy screening studies have omitted smoking and have examined only gender, age, and family history. Our aim was to use a screening population to measure the prevalence of neoplasia in smokers, the anatomic location of these lesions, and the strength of this association relative to other risk factors.METHODS: Data collected from the charts of 1988 screening colonoscopy patients included colonic findings, histology, risk factors for colorectal neoplasia, and smoking pattern. Current smokers were defined as those who had smoked more than 10 pack-years and were currently smoking or who had quit within the past 10 yr. Our outcomes were any adenomatous lesion and significant colonic neoplasia, which included adenocarcinoma, high grade dysplasia, villous tissue, large (>1 cm) adenomas, and multiple (more than two) adenomas.RESULTS: Multivariate analysis revealed that current smokers were more likely to have any adenomatous lesion (odds ratio [OR] = 1.89; 95% CI = 1.42-2.51; p < 0.001) as well as significant neoplasia (OR = 2.26; 95% CI = 1.56-3.27; p < 0.001) than those who had never smoked. The increased risk for smokers was predominantly for left-sided neoplasia. The risk for significant neoplasia was greater for smokers than for patients with a family history of colorectal cancer (OR = 1.20; 95% CI = 0.75-1.92; p > 0.05).CONCLUSIONS: Smoking is a significant risk factor for colorectal neoplasia in a screening population, especially for significant left-sided lesions. In our sample population, smoking posed a greater risk than family history of colorectal cancer.