Buc Emmanuel, Kwiatkowski Fabrice, Alves Arnaud, Panis Yves, Mantion Georges, Slim Karem
Department of General and Digestive Surgery, Hôtel-Dieu, Boulevard Leon Malfreyt, F-63058, Clermont-Ferrand, France.
Dis Colon Rectum. 2006 Dec;49(12):1893-6. doi: 10.1007/s10350-006-0704-1.
Tobacco smoking is associated with a higher risk of developing colorectal cancer. This study was designed to assess the role of smoking in early onset of colorectal pathology.
This was a prospective cross-sectional study of 997 patients with colorectal cancer. Age of colorectal cancer diagnosis was studied in two groups of patients, i.e., smokers (>10 pack-years) and nonsmokers. Confounding factors, such as alcohol drinking, obesity, and gender, also were studied using a correlation analysis and multivariate logistic regression analysis.
Of the 997 patients, 852 had sufficient data for analysis and were included. Baseline analysis showed that excluded patients had similar demographic characteristics. Smokers (n=108) reported symptoms related to colorectal cancer at an earlier mean age (64.1 (standard deviation, 11.7) years) than nonsmokers (69.6 (standard deviation, 12.6) years; mean difference, 5.5 (standard deviation, 1.2 years); P<0.001). Impact of smoking according to the bowel segment involved was significant for slow-transit segments (transverse and sigmoid colon and rectum). Multivariate analysis revealed that tobacco smoking was the only independent risk factor of early onset of colorectal cancers.
Tobacco smoking could be a factor of early onset of colorectal cancers especially for slow-transit bowel segments. If these findings are confirmed in larger studies, screening for colorectal cancer should not involve a simple sigmoidoscopy but also an exploration of transverse colon in smokers.
吸烟与患结直肠癌的风险较高相关。本研究旨在评估吸烟在结直肠病理早期发病中的作用。
这是一项对997例结直肠癌患者进行的前瞻性横断面研究。在两组患者中研究结直肠癌诊断时的年龄，即吸烟者（>10包年）和不吸烟者。还使用相关分析和多因素逻辑回归分析研究了饮酒、肥胖和性别等混杂因素。
997例患者中，852例有足够的数据进行分析并被纳入。基线分析表明，排除的患者具有相似的人口统计学特征。吸烟者（n = 108）报告结直肠癌相关症状的平均年龄（64.1（标准差，11.7）岁）早于不吸烟者（69.6（标准差，12.6）岁；平均差异，5.5（标准差，1.2岁）；P<0.001）。根据受累肠段，吸烟对慢传输段（横结肠、乙状结肠和直肠）的影响显著。多因素分析显示，吸烟是结直肠癌早期发病的唯一独立危险因素。
吸烟可能是结直肠癌早期发病的一个因素，尤其是对于慢传输肠段。如果这些发现在更大规模的研究中得到证实，结直肠癌筛查不应仅包括简单的乙状结肠镜检查，还应包括对吸烟者横结肠的探查。
