Toyomura Kengo, Yamaguchi Keizo, Kawamoto Hideki, Tabata Shinji, Shimizu Eiichi, Mineshita Masamichi, Ogawa Shinsaku, Lee Kyong-Yeon, Kono Suminori
Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan.
Cancer Sci. 2004 Jan;95(1):72-6. doi: 10.1111/j.1349-7006.2004.tb03173.x.
While smoking has consistently been shown to be related to increased risk of colorectal adenomas, few studies have addressed the association between smoking and site-specific colorectal adenomas. The reported association between alcohol use and colorectal adenomas has been inconsistent. We evaluated risks of adenomas at the proximal colon, distal colon, and rectum in relation to cigarette smoking and alcohol use, and their interaction. Subjects were 754 cases with histologically proven colorectal adenomas and 1547 controls with normal colonoscopy among male officials of the Self-Defense Forces (SDF) undergoing total colonoscopy at two SDF hospitals. Statistical adjustment was made for hospital, rank, body mass index, physical activity, and either smoking or alcohol drinking. Cigarette smoking was significantly associated with an increased risk of adenomas, regardless of the location of the adenomas, but the increased risk associated with smoking was more pronounced for rectal adenomas. Alcohol use was associated with moderately increased risks of distal colon and rectal adenomas, but not of proximal colon adenomas. Cigarette smoking, but not alcohol drinking, was associated with greater increases in the risk of large adenomas and of multiple adenomas across the colorectum. There was no measurable interaction of cigarette smoking and alcohol drinking on colorectal adenomas. The findings corroborate an increased risk of colorectal adenomas associated with smoking and a weak association between alcohol use and colorectal adenomas. Further studies are needed to confirm whether smoking is more strongly related to rectal adenomas, large adenomas, or multiple adenomas.
虽然吸烟一直被证明与结直肠腺瘤风险增加有关，但很少有研究探讨吸烟与特定部位结直肠腺瘤之间的关联。关于饮酒与结直肠腺瘤之间的关联报道并不一致。我们评估了近端结肠、远端结肠和直肠腺瘤与吸烟和饮酒及其相互作用的风险。研究对象为754例经组织学证实的结直肠腺瘤患者和1547例在两家自卫队医院接受全结肠镜检查且结肠镜检查正常的男性自卫队官员作为对照。对医院、军衔、体重指数、身体活动以及吸烟或饮酒进行了统计调整。吸烟与腺瘤风险增加显著相关，无论腺瘤位于何处，但吸烟相关的风险增加在直肠腺瘤中更为明显。饮酒与远端结肠和直肠腺瘤风险适度增加有关，但与近端结肠腺瘤无关。吸烟而非饮酒与整个结直肠大腺瘤和多发腺瘤风险的更大增加有关。吸烟和饮酒在结直肠腺瘤方面没有可测量的相互作用。这些发现证实了吸烟与结直肠腺瘤风险增加以及饮酒与结直肠腺瘤之间存在弱关联。需要进一步研究以确认吸烟是否与直肠腺瘤、大腺瘤或多发腺瘤的关系更为密切。
