A PROSPECTIVE-STUDY OF CIGARETTE-SMOKING AND RISK OF COLORECTAL ADENOMA AND COLORECTAL-CANCER IN UNITED-STATES WOMEN
A PROSPECTIVE-STUDY OF CIGARETTE-SMOKING AND RISK OF COLORECTAL ADENOMA AND COLORECTAL-CANCER IN UNITED-STATES WOMEN
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DOI：
10.1093/jnci/86.3.192
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发表时间：
1994-02-02
期刊：
影响因子：
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通讯作者：
SPEIZER, FE
中科院分区：
文献类型：
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作者：
GIOVANNUCCI, E;COLDITZ, GA;SPEIZER, FE
背景：吸烟与结直肠癌之间的正相关性已在男性中被报道，但在女性中则没有，女性在20世纪40年代末和50年代初开始大量吸烟。我们假设吸烟是结直肠肿瘤的始发者，并且由于癌症的始发和诊断之间的长时间间隔，女性被忽略了与癌症的关联。目的：我们的目的是评估吸烟与女性结直肠腺瘤和结直肠癌风险之间的关系，并估计从吸烟开始到癌症诊断之间的最短诱导期。方法：我们的数据来自正在进行的护士健康研究，在该研究中，当前和终身吸烟史和其他潜在的混杂因素通过问卷在基线和两年的间隔进行评估。我们记录了1976年至1990年118334名女性中的586例结直肠癌新病例，以及1980年至1990年间首次接受结肠镜或乙状结肠镜检查的12143名女性中的564例腺瘤。然后，我们根据吸烟年数评估了小腺瘤、大腺瘤(大于或等于1厘米)和结直肠癌的相对风险(RR)。结果：前20年吸烟量与小腺瘤患病率相关(多变量RR=1.45；95%可信区间[CI]=1.25~1.68；P
Background: A positive correlation between smoking and colorectal cancer has been reported for men, but not for women, who began smoking in substantial numbers in the late 1940s and early 1950s. We hypothesized that smoking acts as an initiator of colorectal neoplasia and that an association with cancer in women has been missed because of the long period between initiation and diagnosis of cancer. Purpose: Our purpose was to assess the association between smoking and risk of colorectal adenoma and colorectal cancer in women and to estimate the minimum induction period between the onset of smoking and cancer diagnosis. Methods: Our data came from the ongoing Nurses' Health Study, in which current and lifetime smoking histories and other potential confounding factors were assessed by questionnaire at baseline and at 2-year intervals. We documented 586 new cases of colorectal cancer from 1976 to 1990 from a group of 118334 women and 564 new cases of adenoma among 12143 women who had a first colonoscopy or sigmoidoscopy between 1980 and 1990. We then assessed the relative risk (RR) of small adenoma, large adenoma (greater-than-or-equal-to 1 cm), and colorectal cancer in terms of pack-years of smoking. Results: The amount smoked in the prior 20 years was related to the prevalence of small adenomas (multivariate RR = 1.45; 95% confidence interval [CI] = 1.25-1.68; P