Association of tobacco and alcohol use with earlier development of colorectal cancer: should we modify screening guidelines?

Acott, Alison; Theus, Sue A.; Marchant-Miros, Kathyrn; Mancino, Anne T.

doi:10.1016/j.amjsurg.2008.07.033

Cited by 19 publications

(16 citation statements)

References 24 publications

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“…familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC)) have yet been observed in Greenland [3], however, lifestyle and nutritional risk factors may also be implicated in the observed age difference. Smoking and regular alcohol consumption are known to be associated with younger ages at the onset of CRC [40,41]. Alcohol consumption in Greenland is lower than in Denmark [42], but smoking is markedly higher with 66% of the adult population smoking in 2004 [43].…”

Section: Discussionmentioning

confidence: 99%

Oncological treatment and outcome of colorectal cancer in Greenland

Odgaard

Lohse

Petersen

et al. 2018

International Journal of Circumpolar Health

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Oncological treatment of colorectal cancer (CRC) has been available in Greenland since 2004. Treatment is provided by Queen Ingrid´s Hospital (QIH), under supervision from the Department of Oncology, Rigshospitalet, Denmark. The study describes patient characteristics, oncological treatment and survival for the first 8 years of treatment. The study was a registry-based observational study of all patients in Greenland diagnosed with histologically verified CRC from August 2004 to August 2012. Analyses were stratified according to stage and discussed in relation to reported data from patients with CRC in Denmark. 180 patients were included. . Stage I, II, III, and IV comprised 15, 34, 23, and 23%, respectively. 5% presented with unknown stage. A total of 51% received oncological treatment. 79% of patients with Stage III disease received adjuvant chemotherapy, 61% of patients with metastatic CRC received palliative chemotherapy. Five-year survival was 48 and 53% for colon and rectum cancer, respectively. An insignificant trend towards higher survival in men than in women was seen; adjusted hazard ratio for death (women vs men) = 1.46 (95% CI = 0.97–2.19). In conclusion; Stage distribution, provision of oncological treatment and 5-year survival were comparable to patients diagnosed and treated in Denmark.

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Section: Discussionmentioning

confidence: 99%

Oncological treatment and outcome of colorectal cancer in Greenland

Odgaard

Lohse

Petersen

et al. 2018

International Journal of Circumpolar Health

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“…Modifications in the age of presentation by smoking status have been described for other cancers. For example, at least four independent studies have reported a decrease in the age of presentation for colon cancer among smokers (22–25). Data such as these can influence professional societies to tailor recommendations for cancer screening (26).…”

Section: Discussionmentioning

confidence: 99%

Alcohol and Tobacco Lower the Age of Presentation in Sporadic Pancreatic Cancer in a Dose-Dependent Manner: A Multicenter Study

Anderson

Zolotarevsky

Cooper

et al. 2012

American Journal of Gastroenterology

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OBJECTIVES The objective of this study was to examine the association between tobacco and alcohol dose and type and the age of onset of pancreatic adenocarcinoma (PancCa). METHODS Prospective data from the Pancreatic Cancer Collaborative Registry were used to examine the association between age of onset and variables of interest including: gender, race, birth country, educational status, family history of PancCa, diabetes status, and tobacco and alcohol use. Statistical analysis included logistic and linear regression, Cox proportional hazard regression, and time-to-event analysis. RESULTS The median age to diagnosis for PancCa was 66.3 years (95% confidence intervals (CIs), 64.5–68.0). Males were more likely than females to be smokers (77% vs. 69%, P = 0.0002) and heavy alcohol and beer consumers (19% vs. 6%, 34% vs. 19%, P < 0.0001). In univariate analysis for effects on PancCa presentation age, the following were significant: gender, alcohol and tobacco use (amount, status and type), family history of PancCa, and body mass index. Both alcohol and tobacco had dose-dependent effects. In multivariate analysis, alcohol status and dose were independently associated with increased risk for earlier PancCa onset with greatest risk occurring in heavy drinkers (HR 1.62, 95% CI 1.04–2.54). Smoking status had the highest risk for earlier onset pancreatic cancer with a HR of 2.69 (95% CI, 1.97–3.68) for active smokers and independent effects for dose (P = 0.019). The deleterious effects for alcohol and tobacco appear to resolve after 10 years of abstinence. CONCLUSIONS Alcohol and tobacco use are associated with a dose-related increased risk for earlier age of onset of PancCa. Although beer drinkers develop pancreatic cancer at an earlier age than nondrinkers, alcohol type did not have a significant effect after controlling for alcohol dose.

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“…According to a retrospective analysis, Acott et al 38 found that current tobacco use was associated with younger ages at the onset of colorectal cancer, and the authors suggested the modification of the screening guidelines to include smoking as a "high-risk" factor. Studies also found that age at diagnosis of colorectal cancer was 5 years earlier in patients with a smoking history than in patients who never smoked.…”

Section: Cigarette Smoking and Colorectal Cancersmentioning

confidence: 98%