A pooled analysis of smoking and colorectal cancer

Timing of exposure and interactions with environmental factors

Jian Gong, Carolyn Hutter, John A. Baron, Sonja Berndt, Bette Caan, Peter T. Campbell, Graham Casey, Andrew T. Chan, Michelle Cotterchio, Charles S. Fuchs, Steven Gallinger, Edward Giovannucci, Tabitha Harrison, Richard Hayes, Li Hsu, Shuo Jiao, Yi Lin, Noralane M. Lindor, Polly Newcomb, Bethann Pflugeisen & 11 others Amanda I. Phipps, Thomas E. Rohan, Robert Schoen, Daniela Seminara, Martha L. Slattery, Deanna Stelling, Fridtjof Thomas, Greg Warnick, Emily White, John Potter, Ulrike Peters

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: Considerable evidence suggests that cigarette smoking is associated with a higher risk of colorectal cancer (CRC). What is unclear, however, is the impact of quitting smoking on risk attenuation and whether other risk factors for CRC modify this association. Methods: We conducted a pooled analysis of eight studies, including 6,796 CRC cases and 7,770 controls, to evaluate the association between cigarette smoking history and CRC risk and to investigate potential effect modification by other risk factors. Results: Current smokers [OR, 1.26; 95% confidence interval (CI), 1.11-1.43] and former smokers (OR, 1.18; 95% CI, 1.09-1.27), relative to never smokers, showed higher risks of CRC. Former smokers remained at higher CRC risk, relative to never smokers, for up to about 25 years after quitting. The impact of time since quitting varied by cancer subsite: The excess risk due to smoking decreased immediately after quitting for proximal colon and rectal cancer but not until about 20 years post-quitting for distal colon cancer. Furthermore, we observed borderline statistically significant additive interactions between smoking status and body mass index [BMI; relative excess risk due to interaction (RERI]), 0.15; 95% CI, -0.01 to 0.31; P = 0.06] and significant additive interaction between smoking status and fruit consumption (RERI, 0.16; 95% CI, 0.01-0.30; P = 0.04). Conclusion: CRC risk remained increased for about 25 years after quitting smoking, and the pattern of decline in risk varied by cancer subsite. BMI and fruit intake modified the risk associated with smoking. Impact: These results contribute to a better understanding of the mechanisms through which smoking impacts CRC etiology.

Original languageEnglish (US)
Pages (from-to)1974-1985
Number of pages12
JournalCancer Epidemiology Biomarkers and Prevention
Volume21
Issue number11
DOIs
StatePublished - Nov 2012

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Colorectal Neoplasms
Smoking
Confidence Intervals
Colonic Neoplasms
Fruit
Rectal Neoplasms
Neoplasms
Body Mass Index
History

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

A pooled analysis of smoking and colorectal cancer : Timing of exposure and interactions with environmental factors. / Gong, Jian; Hutter, Carolyn; Baron, John A.; Berndt, Sonja; Caan, Bette; Campbell, Peter T.; Casey, Graham; Chan, Andrew T.; Cotterchio, Michelle; Fuchs, Charles S.; Gallinger, Steven; Giovannucci, Edward; Harrison, Tabitha; Hayes, Richard; Hsu, Li; Jiao, Shuo; Lin, Yi; Lindor, Noralane M.; Newcomb, Polly; Pflugeisen, Bethann; Phipps, Amanda I.; Rohan, Thomas E.; Schoen, Robert; Seminara, Daniela; Slattery, Martha L.; Stelling, Deanna; Thomas, Fridtjof; Warnick, Greg; White, Emily; Potter, John; Peters, Ulrike.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 21, No. 11, 11.2012, p. 1974-1985.

Research output: Contribution to journalArticle

Gong, J, Hutter, C, Baron, JA, Berndt, S, Caan, B, Campbell, PT, Casey, G, Chan, AT, Cotterchio, M, Fuchs, CS, Gallinger, S, Giovannucci, E, Harrison, T, Hayes, R, Hsu, L, Jiao, S, Lin, Y, Lindor, NM, Newcomb, P, Pflugeisen, B, Phipps, AI, Rohan, TE, Schoen, R, Seminara, D, Slattery, ML, Stelling, D, Thomas, F, Warnick, G, White, E, Potter, J & Peters, U 2012, 'A pooled analysis of smoking and colorectal cancer: Timing of exposure and interactions with environmental factors', Cancer Epidemiology Biomarkers and Prevention, vol. 21, no. 11, pp. 1974-1985. https://doi.org/10.1158/1055-9965.EPI-12-0692
Gong, Jian ; Hutter, Carolyn ; Baron, John A. ; Berndt, Sonja ; Caan, Bette ; Campbell, Peter T. ; Casey, Graham ; Chan, Andrew T. ; Cotterchio, Michelle ; Fuchs, Charles S. ; Gallinger, Steven ; Giovannucci, Edward ; Harrison, Tabitha ; Hayes, Richard ; Hsu, Li ; Jiao, Shuo ; Lin, Yi ; Lindor, Noralane M. ; Newcomb, Polly ; Pflugeisen, Bethann ; Phipps, Amanda I. ; Rohan, Thomas E. ; Schoen, Robert ; Seminara, Daniela ; Slattery, Martha L. ; Stelling, Deanna ; Thomas, Fridtjof ; Warnick, Greg ; White, Emily ; Potter, John ; Peters, Ulrike. / A pooled analysis of smoking and colorectal cancer : Timing of exposure and interactions with environmental factors. In: Cancer Epidemiology Biomarkers and Prevention. 2012 ; Vol. 21, No. 11. pp. 1974-1985.
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abstract = "Background: Considerable evidence suggests that cigarette smoking is associated with a higher risk of colorectal cancer (CRC). What is unclear, however, is the impact of quitting smoking on risk attenuation and whether other risk factors for CRC modify this association. Methods: We conducted a pooled analysis of eight studies, including 6,796 CRC cases and 7,770 controls, to evaluate the association between cigarette smoking history and CRC risk and to investigate potential effect modification by other risk factors. Results: Current smokers [OR, 1.26; 95{\%} confidence interval (CI), 1.11-1.43] and former smokers (OR, 1.18; 95{\%} CI, 1.09-1.27), relative to never smokers, showed higher risks of CRC. Former smokers remained at higher CRC risk, relative to never smokers, for up to about 25 years after quitting. The impact of time since quitting varied by cancer subsite: The excess risk due to smoking decreased immediately after quitting for proximal colon and rectal cancer but not until about 20 years post-quitting for distal colon cancer. Furthermore, we observed borderline statistically significant additive interactions between smoking status and body mass index [BMI; relative excess risk due to interaction (RERI]), 0.15; 95{\%} CI, -0.01 to 0.31; P = 0.06] and significant additive interaction between smoking status and fruit consumption (RERI, 0.16; 95{\%} CI, 0.01-0.30; P = 0.04). Conclusion: CRC risk remained increased for about 25 years after quitting smoking, and the pattern of decline in risk varied by cancer subsite. BMI and fruit intake modified the risk associated with smoking. Impact: These results contribute to a better understanding of the mechanisms through which smoking impacts CRC etiology.",
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AU - Gong, Jian

AU - Hutter, Carolyn

AU - Baron, John A.

AU - Berndt, Sonja

AU - Caan, Bette

AU - Campbell, Peter T.

AU - Casey, Graham

AU - Chan, Andrew T.

AU - Cotterchio, Michelle

AU - Fuchs, Charles S.

AU - Gallinger, Steven

AU - Giovannucci, Edward

AU - Harrison, Tabitha

AU - Hayes, Richard

AU - Hsu, Li

AU - Jiao, Shuo

AU - Lin, Yi

AU - Lindor, Noralane M.

AU - Newcomb, Polly

AU - Pflugeisen, Bethann

AU - Phipps, Amanda I.

AU - Rohan, Thomas E.

AU - Schoen, Robert

AU - Seminara, Daniela

AU - Slattery, Martha L.

AU - Stelling, Deanna

AU - Thomas, Fridtjof

AU - Warnick, Greg

AU - White, Emily

AU - Potter, John

AU - Peters, Ulrike

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N2 - Background: Considerable evidence suggests that cigarette smoking is associated with a higher risk of colorectal cancer (CRC). What is unclear, however, is the impact of quitting smoking on risk attenuation and whether other risk factors for CRC modify this association. Methods: We conducted a pooled analysis of eight studies, including 6,796 CRC cases and 7,770 controls, to evaluate the association between cigarette smoking history and CRC risk and to investigate potential effect modification by other risk factors. Results: Current smokers [OR, 1.26; 95% confidence interval (CI), 1.11-1.43] and former smokers (OR, 1.18; 95% CI, 1.09-1.27), relative to never smokers, showed higher risks of CRC. Former smokers remained at higher CRC risk, relative to never smokers, for up to about 25 years after quitting. The impact of time since quitting varied by cancer subsite: The excess risk due to smoking decreased immediately after quitting for proximal colon and rectal cancer but not until about 20 years post-quitting for distal colon cancer. Furthermore, we observed borderline statistically significant additive interactions between smoking status and body mass index [BMI; relative excess risk due to interaction (RERI]), 0.15; 95% CI, -0.01 to 0.31; P = 0.06] and significant additive interaction between smoking status and fruit consumption (RERI, 0.16; 95% CI, 0.01-0.30; P = 0.04). Conclusion: CRC risk remained increased for about 25 years after quitting smoking, and the pattern of decline in risk varied by cancer subsite. BMI and fruit intake modified the risk associated with smoking. Impact: These results contribute to a better understanding of the mechanisms through which smoking impacts CRC etiology.

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