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Cigarette smoking and adenomatous polyps: a meta-analysis
Edoardo Botteri1, Simona Iodice, Sara Raimondi
1Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. edoardo.botteri@ieo.it
Gastroenterology
|February 5, 2008
Summary
Cigarette smoking significantly increases the risk of developing colorectal adenomatous polyps, precursors to cancer. This risk is elevated for current smokers and for high-risk polyps, underscoring smoking
Area of Science:
- Gastroenterology
- Oncology
- Epidemiology
Background:
- Cigarette smoking is consistently linked to colorectal adenomatous polyps.
- Adenomatous polyps are precursor lesions for colorectal cancer.
- Previous research indicates a strong association between smoking and polyp development.
Purpose of the Study:
- To conduct a meta-analysis quantifying the association between cigarette smoking and colorectal adenomatous polyps.
- To assess how study characteristics and polyp features influence this association.
Main Methods:
- A comprehensive literature search identified 42 independent observational studies.
- Random effects models were used to calculate pooled relative risks.
- Dose-response, heterogeneity, publication bias, and sensitivity analyses were performed.
Main Results:
- Current smokers had a 2.14-fold increased risk (95% CI, 1.86-2.46) compared to never smokers.
- Former and ever smokers also showed significantly increased risks (1.47 and 1.82, respectively).
- The association was stronger for high-risk adenomas and in studies with full colonoscopy.
Conclusions:
- This meta-analysis confirms a detrimental effect of cigarette smoking on adenomatous polyp development.
- Smoking influences both the formation and aggressiveness of colorectal adenomas.
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