Cigarette smoking and colorectal cancer risk

描述（由申请人提供）结肠直肠癌目前不在由外科医生确定为由吸烟引起的疾病清单上。虽然研究文献表明，吸烟与非癌性结肠腺瘤性息肉有关，但与结直肠癌的关系并不确定。最近的文献，包括延长随访时间的研究揭示了吸烟和结直肠癌之间的联系，只有在这个漫长的潜伏期之后;然而，许多其他研究未能找到一个关联。本研究的目的是提供额外的数据来解决文献中关于吸烟与结直肠癌之间关系的争议。 鉴于每年估计有135，400例新的结直肠癌病例，并且结直肠癌在早期发现时是非常可治疗的，进一步了解吸烟在结直肠癌发展中的病因作用可能会使人群-广泛的影响，以确定谁可能是更好的候选人，结直肠癌筛查和针对吸烟的疾病的高风险的人为高危人群提供戒烟服务。 该提案概述了一项计划，以确定9，343名妇女的癌症发病率和死亡率状况。1957年至1965年间在罗斯威尔公园癌症研究所就诊的3，965名男性和5，738名女性，他们完成了一项详细的流行病学调查，其中包括有关他们一生烟草使用和其他生活方式因素的问题，包括他们的饮食和饮酒量，也被诊断为非癌症将通过与纽约州癌症登记处、纽约州生命统计局、社会保障死亡指数和国家死亡指数的联系获得癌症发病率和死亡率状况。在多变量考克斯比例风险模型分析中，将在控制潜在混杂因素的同时，比较不同终身吸烟水平的结直肠癌发病率和死亡率的风险比，以评估吸烟与结直肠癌之间的相关性。该数据集提供了一个独特的资源，可以很容易地解决这个问题，因为已经收集了大量人群的详细流行病学数据，并且存在直接的机制来确定该队列的癌症和死亡率状态。 检验的主要假设是，即使在控制了潜在的混杂因素后，终生吸烟量最大的人群，尤其是接触香烟超过35年的人群，结直肠癌的发病率和死亡率风险也最高。

DESCRIPTION (provided by applicant) Colorectal cancer is not currently on the list of diseases identified by the Surgeon General as being caused by cigarette smoking. Although the research literature has shown that cigarette smoking is associated with non-cancerous adenomenous polyps in the colon, the relationship to colorectal carcinoma is less definitive. Recent literature that includes studies with extended follow-up times reveal associations between smoking and colorectal cancer only after this long latent period; however, numerous other studies fail to find an association. The purpose of this study is to provide additional data to address the controversy in the literature about the relationship between cigarette smoking and colorectal cancer. Given that there are an estimated 135,400 new colorectal cancer cases each year and that colorectal cancer is very treatable when caught in an early stage, further knowledge about the etiologic role that cigarette smoking plays in the development of colorectal cancer may have population-wide implications for identifying persons at higher risk for disease who may be better candidates for colorectal cancer screening and for targeting smoking cessation services to high risk populations. This proposal outlines a plan for ascertaining the cancer incidence and mortality status of 9,343 (3,965 males and 5,738 females) persons who were seen at Roswell Park Cancer Institute between 1957 and 1965, who completed a detailed epidemiologic survey that included questions about their lifetime tobacco use and other lifestyle factors including their diet and their alcohol consumption, and who also received a non-cancer diagnosis. Cancer incidence and mortality status will be obtained by linkages with the New York State Cancer Registry, the New York State Vital Statistics Department, the Social Security Death Index, and the National Death Index. Hazard ratios for colorectal cancer incidence and mortality will be compared across varying levels of lifetime cigarette consumption to assess associations between cigarette consumption and colorectal cancer while controlling for potential confounders in multivariate Cox proportionate hazard model analyses. This dataset provides a unique resource to readily address this question since detailed epidemiologic data have already been collected on a large population and straightforward mechanisms exist to ascertain cancer and mortality status of this cohort. The primary hypothesis tested is that the risk for colorectal cancer incidence and mortality will be highest among persons with the largest lifetime consumption of cigarettes, particularly in those with more than 35 years of exposure, even after controlling for potential confounders.