Cigarette smoking and the colorectal adenoma-carcinoma sequence : a hypothesis to explain the paradox. Commentary.
As recognized precursor lesions to colorectal cancer, colorectal adenomatous polyps have been studied to enhance knowledge of colorectal cancer etiology.
Although most of the known risk factors for colorectal cancer are also associated with the occurrence of colorectal adenomas, cigarette smoking has had a strong, consistent relationship with colorectal adenomas but is generally not associated with colorectal cancer.
The explanation for this paradox is unknown.
With data collected in 1986-1988 during a large case-control study based on colonoscopy results in New York City, New York, the authors investigated the possibility that the paradox may arise because subjects with colorectal adenomas were included in the control group of cancer case-control studies.
The authors found a statistically significant increased risk between heavy cigarette smoking (smokers with =40 pack-years of smoking) and risk of adenoma (odds ratio (OR)=1.61,95% confidence interval (CI) 1.06-2.44).
They saw no increased colorectal cancer risk from heavy cigarette smoking (OR=1.02,95% Cl 0.52-1.99) using a « manufactured » control group to simulate a typical unscreened, population-based control group. (...)
Mots-clés Pascal : Adénocarcinome, Côlon, Rectum, Tabagisme, Adénome, Polype, Epidémiologie, Facteur risque, Homme, Etats Unis, Amérique du Nord, Amérique, Etude cas témoin, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie, Tumeur bénigne
Mots-clés Pascal anglais : Adenocarcinoma, Colon, Rectum, Tobacco smoking, Adenoma, Polyp, Epidemiology, Risk factor, Human, United States, North America, America, Case control study, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease, Benign neoplasm
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0273194
Code Inist : 002B13B01. Création : 27/11/1998.