© 1996 by Oxford University Press
Journal of the National Cancer Institute, Vol. 88, No. 18, 1302-1307,
September 18, 1996
© 1996 Oxford University Press
Smoking and Colorectal Cancer: a 20-Year Follow-up Study of Swedish Construction Workers
Department of Cancer Epidemiology, University Hospital Uppsala, Sweden
Department of Cancer Epidemiology, University Hospital, and Department of Statistics, Uppsala University
Department of Epidemiology and Public Health, Umea University Sweden
National Board of Health and Welfare Stockholm, Sweden
Department of Cancer Epidemiology, University Hospital, Uppsala, and Harvard School of Public Health Boston, MA
Department of Occupational Medicine Umea
National Institute of Occupational Health Umea, Sweden
Olof Nyren, M.D., Ph.D., Department of Cancer Epidemiology, University Hospital. S-751 85 Uppsala, Sweden.
BACKGROUND: Although cigarette smoking has consistently been shown to be positively related to the risk of adenomatous polyp development (benign neoplastic growth of epithelial tissue in the colon), most studies of cigarette smoking and the risk of colorectal cancer have been negative. However, in two large prospective studies in women and men, a statistically significant association between cigarette smoking and an increased risk of colorectal cancer was found, but only after more than 35 years of smoking.
PURPOSE: To shed further light on the alleged relationship between long-term smoking and colorectal cancer risk, we performed a retrospective cohort study among Swedish construction workers, with many long-term smokers, complete long-term follow-up, and a large number of observed cases.
METHODS: We analyzed the association of smoking with colon cancer and with rectal cancer, using data on a cohort of approximately 135 000 male construction workers. High-quality exposure information was collected with the use of a comprehensive questionnaire filled out at the time of enrollment in the cohort, from 1971 through 1975. Complete follow-up was achieved through 1991 and the subjects were observed for an average of 17.6 years, thereby contributing approximately 2 375 000 person-years of follow-up. We calculated age-adjusted rate ratios (RRs) with the use of Poisson-based multiplicative multivariate models followed by further multivariate modeling that adjusted for other variables.
RESULTS: A total of 713 incident colon cancers and 505 rectal cancers were observed. There was no statistically significant association between current smoking status, number of cigarettes smoked or number of years smoking, and risk of colorectal cancer. The age-adjusted RRs were 0.98 (95% confidence interval [CI] = 0.82–1.17) and 1.16 (95% CI = 0.94–1.44) for colon and rectal cancers, respectively, among current smokers, and 1.07 (95% CI = 0.63–1.82) and 1.08 (95% CI = 0.58–2.03) among smokers of 25 or more cigarettes per day, relative to nonsmokers. Among smokers for more than 30 years at the start of follow-up, the age-adjusted RRs were 1.03 (95% CI = 0.85–1.25) and 1.21 (95% CI = 0.96–1.53) for colon and rectal cancers, respectively, relative to nonsmokers. Heavy smokers of cigars and pipes had a statistically nonsignificant tendency toward excess risk for colon cancer, but there was no clear dose-risk trend.
CONCLUSION: Our large cohort study did not indicate any excess risk of colon cancer in males who were long-term heavy smokers and provided only weak support for an association with rectal cancer. Our data are thus consistent with the majority of previous reports. The reasons for the discrepancies in comparison with recent U.S. data have yet to be identified. [J Natl Cancer Inst 1996; 88: 1302–7]
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E. Botteri, S. Iodice, V. Bagnardi, S. Raimondi, A. B. Lowenfels, and P. Maisonneuve Smoking and Colorectal Cancer: A Meta-analysis JAMA, December 17, 2008; 300(23): 2765 - 2778. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Fernberg, A. Odenbro, R. Bellocco, P. Boffetta, Y. Pawitan, K. Zendehdel, and J. Adami Tobacco Use, Body Mass Index, and the Risk of Leukemia and Multiple Myeloma: A Nationwide Cohort Study in Sweden Cancer Res., June 15, 2007; 67(12): 5983 - 5986. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. P Purdue, L. Gold, B. Jarvholm, M. C R Alavanja, M. H Ward, and R. Vermeulen Impaired lung function and lung cancer incidence in a cohort of Swedish construction workers Thorax, January 1, 2007; 62(1): 51 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. S. Samowitz, H. Albertsen, C. Sweeney, J. Herrick, B. J. Caan, K. E. Anderson, R. K. Wolff, and M. L. Slattery Association of Smoking, CpG Island Methylator Phenotype, and V600E BRAF Mutations in Colon Cancer J Natl Cancer Inst, December 6, 2006; 98(23): 1731 - 1738. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. S. Azodi, R. Bellocco, K. Eriksson, and J. Adami The impact of tobacco use and body mass index on the length of stay in hospital and the risk of post-operative complications among patients undergoing total hip replacement J Bone Joint Surg Br, October 1, 2006; 88-B(10): 1316 - 1320. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Luchtenborg, M. P. Weijenberg, E. Kampman, G. N. van Muijen, G. M. J. M. Roemen, M. P. A. Zeegers, R. A. Goldbohm, P. van 't Veer, A. F. P. M. de Goeij, and P. A. van den Brandt Cigarette Smoking and Colorectal Cancer: APC Mutations, hMLH1 Expression, and GSTM1 and GSTT1 Polymorphisms Am. J. Epidemiol., May 1, 2005; 161(9): 806 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Giovannucci An Updated Review of the Epidemiological Evidence that Cigarette Smoking Increases Risk of Colorectal Cancer Cancer Epidemiol. Biomarkers Prev., July 1, 2001; 10(7): 725 - 731. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Ang, E.-H. Tan, S.-S. Leong, L. Koh, P. Eng, T. Agasthian, and F. K. Cheah Primary Intrathoracic Malignant Effusion : A Descriptive Study Chest, July 1, 2001; 120(1): 50 - 54. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Chao, M. J. Thun, E. J. Jacobs, S. J. Henley, C. Rodriguez, and E. E. Calle Cigarette Smoking and Colorectal Cancer Mortality in the Cancer Prevention Study II J Natl Cancer Inst, December 6, 2000; 92(23): 1888 - 1896. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. I. Neugut and M. B. Terry Cigarette Smoking and Microsatellite Instability: Causal Pathway or Marker-Defined Subset of Colon Tumors? J Natl Cancer Inst, November 15, 2000; 92(22): 1791 - 1793. [Full Text] [PDF]
|
|
|
|
|
|
M. L. Slattery, K. Curtin, K. Anderson, K.-N. Ma, L. Ballard, S. Edwards, D. Schaffer, J. Potter, M. Leppert, and W. S. Samowitz Associations Between Cigarette Smoking, Lifestyle Factors, and Microsatellite Instability in Colon Tumors J Natl Cancer Inst, November 15, 2000; 92(22): 1831 - 1836. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Knutsson, L. Damber, and B. Järvholm Cancers in concrete workers: results of a cohort study of 33 668 workers Occup. Environ. Med., April 1, 2000; 57(4): 264 - 267. [Abstract] [Full Text]
|
|
|
|
|
|
M. Frisch, B. Glimelius, J. Wohlfahrt, H.-O. Adami, and M. Melbye Tobacco Smoking as a Risk Factor in Anal Carcinoma: an Antiestrogenic Mechanism? J Natl Cancer Inst, April 21, 1999; 91(8): 708 - 715. [Abstract] [Full Text] [PDF]
|
|