Tobacco smoking: A factor of early onset of colorectal cancer
Tobacco smoking: A factor of early onset of colorectal cancer
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DOI：
10.1007/s10350-006-0704-1
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发表时间：
2006-12-01
影响因子：
3.9
通讯作者：
Slim, Karem
中科院分区：
文献类型：
--
作者：
Buc, Emmanuel;Kwiatkowski, Fabrice;Slim, Karem
目的：吸烟与结直肠癌的高风险相关。本研究旨在评估吸烟在结直肠病理早期发病中的作用。方法：这是一项对997例结直肠癌患者的前瞻性横断面研究。在两组患者中研究了结肠直肠癌诊断的年龄，即，吸烟者（> 10包年）和不吸烟者。混杂因素，如饮酒，肥胖和性别，也进行了研究，采用相关分析和多因素Logistic回归分析。结果：在997例患者中，852例有足够的数据进行分析并被纳入。基线分析显示，排除的患者具有相似的人口统计学特征。吸烟者（n = 108）报告结直肠癌相关症状的平均年龄（64.1（标准差，11.7）岁）早于非吸烟者（69.6（标准差，12.6）岁;平均差异，5.5（标准差，1.2岁）; P < 0.001）。根据所涉及的肠段，吸烟对慢传输段（横结肠和乙状结肠和直肠）的影响是显著的。多因素分析显示，吸烟是大肠癌早发的唯一独立危险因素。结论：吸烟可能是结直肠癌早期发病的一个因素，特别是对于慢传输肠段。如果这些发现在更大规模的研究中得到证实，结直肠癌的筛查不应该包括简单的乙状结肠镜检查，而应该包括吸烟者横结肠的探查。
PURPOSE: Tobacco smoking is associated with a higher risk of developing colorectal cancer. This study was designed to assess the role of smoking in early onset of colorectal pathology. METHODS: This was a prospective cross-sectional study of 997 patients with colorectal cancer. Age of colorectal cancer diagnosis was studied in two groups of patients, i.e., smokers (> 10 pack-years) and nonsmokers. Confounding factors, such as alcohol drinking, obesity, and gender, also were studied using a correlation analysis and multivariate logistic regression analysis. RESULTS: Of the 997 patients, 852 had sufficient data for analysis and were included. Baseline analysis showed that excluded patients had similar demographic characteristics. Smokers (n = 108) reported symptoms related to colorectal cancer at an earlier mean age (64.1 (standard deviation, 11.7) years) than nonsmokers (69.6 (standard deviation, 12.6) years; mean difference, 5.5 (standard deviation, 1.2 years); P < 0.001). Impact of smoking according to the bowel segment involved was significant for slow-transit segments (transverse and sigmoid colon and rectum). Multivariate analysis revealed that tobacco smoking was the only independent risk factor of early onset of colorectal cancers. CONCLUSIONS: Tobacco smoking could be a factor of early onset of colorectal cancers especially for slow-transit bowel segments. If these findings are confirmed in larger studies, screening for colorectal cancer should not involve a simple sigmoidoscopy but also an exploration of transverse colon in smokers.