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El tabaquismo y el cáncer colorrectal: un metanálisis
Edoardo Botteri1, Simona Iodice, Vincenzo Bagnardi
1Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141, Milano, Italy. edoardo.botteri@ieo.it
JAMA
|December 18, 2008
Resumen
Fumar cigarrillos aumenta significativamente el riesgo de incidencia y mortalidad por cáncer colorrectal. Este metanálisis confirma una relación dosis-respuesta, particularmente después de 30 años de fumar.
Área de la Ciencia:
- Oncología Oncología.
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
Sus antecedentes:
- El cáncer colorrectal es una de las principales causas de muerte por cáncer a nivel mundial.
- Estudios previos sobre el vínculo del tabaquismo con el cáncer colorrectal arrojaron resultados inconsistentes.
Objetivo del estudio:
- Para aclarar la asociación entre el tabaquismo y el cáncer colorrectal.
- Analizar los datos de incidencia y mortalidad a través de un metanálisis de estudios observacionales.
Principales métodos:
- Se realizó una búsqueda exhaustiva de la literatura en PubMed, Web of Science y EMBASE hasta mayo de 2008.
- La extracción de datos y la estimación de riesgos fueron realizadas de forma independiente por tres investigadores.
- En el metaanálisis se incluyeron 106 estudios sobre incidencia y 17 sobre mortalidad.
Principales resultados:
- Los fumadores tenían un aumento de 1,18 en el riesgo de incidencia de cáncer colorrectal (95% IC, 1,11-1,25) y un aumento de 1,25 en el riesgo de mortalidad (95% IC, 1,14-1,37).
- Se observó una relación dosis-respuesta significativa, con riesgos que aumentan con los años de paquete y el consumo diario de cigarrillos.
- La asociación fue estadísticamente significativa después de 30 años de fumar y más fuerte para el cáncer rectal que para el cáncer de colon.
Conclusiones:
- Fumar cigarrillos es un factor de riesgo significativo para el cáncer colorrectal.
- Los hallazgos destacan la importancia de dejar de fumar para reducir la carga del cáncer colorrectal.
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