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Smoking and colorectal adenomas: a case-control study.
K Almendingen1, B Hofstad, K Trygg
1Medical Department A, The National Hospital, University of Oslo, Norway.
Summary
Smoking is linked to a fourfold increase in colorectal adenoma frequency, particularly for current smokers or those with over 15 pack-years. This association persists even after accounting for dietary factors, suggesting tobacco
Area of Science:
- Gastroenterology
- Oncology
- Epidemiology
Background:
- A potential link between tobacco use and colorectal adenomas has been observed.
- Dietary habits, often associated with smoking, may also influence adenoma risk.
Purpose of the Study:
- To investigate the relationship between smoking, diet, and the risk of colorectal adenomas.
- To determine if smoking plays an initiating role in colorectal neoplasia.
Main Methods:
- A follow-up study comparing 87 adenoma cases with 70 age- and sex-matched controls (hospital and healthy).
- Smoking data collected via interview and questionnaire; adenomas removed after 3-year follow-up.
- Multivariate analysis adjusted for dietary variables.
Main Results:
- Current smokers or those with >15 pack-years had a fourfold increased frequency of adenomas (OR 3.6-5.9).
- Smoking was associated with adenoma prevalence, not size, multiplicity, growth, or recurrence.
- Dietary habits of smokers with adenomas suggested a potential independent association.
Conclusions:
- Tobacco smoking is significantly associated with colorectal adenoma prevalence.
- Findings support the hypothesis that tobacco smoke initiates neoplasia formation in the colon.
- The association between smoking and adenomas remained robust after adjusting for diet.