Colorectal cancer occurs earlier in those exposed to tobacco smoke: implications for screening
Colorectal cancer occurs earlier in those exposed to tobacco smoke: implications for screening
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DOI：
10.1007/s00432-007-0332-8
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发表时间：
2008-07-01
影响因子：
3.6
通讯作者：
Hyland, Andrew
中科院分区：
文献类型：
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作者：
Peppone, Luke J.;Mahoney, Martin C.;Hyland, Andrew
背景 结直肠癌 (CRC) 是美国第三大常见癌症。虽然各种生活方式因素已被证明会改变结直肠癌的风险，但早期发现结直肠癌的建议仅基于年龄和家族史。方法这项仅病例研究检查了暴露于烟草烟雾的受试者诊断结直肠癌的年龄。受试者包括 1957 年至 1997 年间接受 RPCI、诊断患有结直肠癌并完成流行病学调查问卷的所有患者。针对各种吸烟暴露情况计算调整后的线性回归模型。 结果 在 3,540 例结直肠癌病例中，与从不吸烟者相比，当前吸烟者的结直肠癌发病年龄最年轻（从未吸烟者：64.2 对比当前：57.4，P < 0.001），其次是最近吸烟者。在从不吸烟者中，与未接触过二手烟的人相比，过去接触过二手烟的人被诊断出的年龄明显更年轻。 结论 这项研究发现，与终生从不吸烟的人相比，长期大量接触烟草烟雾的人在诊断结直肠癌时明显更年轻。这一发现意味着，对于有显着终生接触烟草烟雾史的人来说，建议平均风险人群从 50 岁开始进行结直肠癌筛查，而应提前 5-10 年开始筛查。
Background Colorectal cancer (CRC) is the third most common cancer in the USA. While various lifestyle factors have been shown to alter the risk for colorectal cancer, recommendations for the early detection of CRC are based only on age and family history.Methods This case-only study examined the age at diagnosis of colorectal cancer in subjects exposed to tobacco smoke. Subjects included all patients who attended RPCI between 1957 and 1997, diagnosed with colorectal cancer, and completed an epidemiologic questionnaire. Adjusted linear regression models were calculated for the various smoking exposures.Results Of the 3,540 cases of colorectal cancer, current smokers demonstrated the youngest age of CRC onset (never: 64.2 vs. current: 57.4, P < 0.001) compared to never smokers, followed by recent former smokers. Among never smokers, individuals with past second-hand smoke exposure were diagnosed at a significantly younger age compared to the unexposed.Conclusion This study found that individuals with heavy, long-term tobacco smoke exposure were significantly younger at the time of CRC diagnosis compared to lifelong never smokers. The implication of this finding is that screening for colorectal cancer, which is recommended to begin at age 50 years for persons at average risk should be initiated 5-10 years earlier for persons with a significant lifetime history of exposure to tobacco smoke.