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Keywords:

  • colorectal carcinoma (CRC);
  • smoking;
  • mortality;
  • cohort study

Abstract

BACKGROUND

Evidence suggests that colorectal carcinoma (CRC) may be a tobacco-associated malignancy.

METHODS

In the current study, the authors examined the association between cigarette smoking and CRC mortality in the Chicago Heart Association Detection Project in Industry study, a cohort of 39,299 men and women with an average of 26 years of follow-up. To assess whether the association was stronger in participants with a potentially long history of smoking, the authors also stratified the analysis using a baseline age ≥ 50 years versus < 50 years.

RESULTS

Using multivariate Cox regression analysis, there was a marginally significant trend (P = 0.06) for men and women combined between smoking and CRC mortality. In the age-stratified analysis in the older participant group, there was no apparent association for men, women, or men and women combined. In the younger participant group, there appeared to be dose-response relations for women and for men and women combined (P value for trend = 0.008 and 0.03, respectively) between smoking and CRC mortality. The relative risk for women who smoked >20 cigarettes/day compared with never smokers was 2.49 (95% confidence interval [95% CI], 0.87–7.12), and was 1.87 for men and women combined (95% CI, 1.08–3.22).

CONCLUSIONS

The results of the current study support an association between cigarette smoking and CRC mortality, particularly in women age < 50 years. Cancer 2004;100:288–93. © 2003 American Cancer Society.