Anton-Culver H
Department of Medicine, University of California, Irvine 92717.
Cancer Detect Prev. 1991;15(5):345-50.
The present study analyzes data on colon and rectum cancer cases from a population-based cancer registry to determine the effect of smoking, alcohol drinking, and family history of cancer on disease characteristics. A total of 771 cases of primary invasive cancer of the colon and 304 cancers of the rectum constitute the study sample. More advanced colon cancer was present in female smokers than in female nonsmokers, while in males there was no smoking effect on stage at diagnosis of colon cancer. For cancer of the rectum, male smokers had a higher frequency of advanced disease than did nonsmokers. Smoking men and women were found to have lower mean ages at diagnosis of both colon and rectum cancer than did nonsmokers (p less than 0.001 and p less than 0.004, respectively). Alcohol drinking remained consistently associated with lower age at diagnosis in both sexes for both colon and rectum cancer (p less than 0.001 and p less than 0.001, respectively). Those cases of rectum cancer having positive family history for colorectal cancer in their first degree relatives had younger age at diagnosis than those having negative family history (p less than 0.005). The age at diagnosis was progressively younger as the number of risk factors increased (p less than 0.001 for colon cancer and p less than 0.003 for cancer of the rectum). Our findings indicate an interaction between exposures to risk factors that are potentially carcinogenic or cocarcinogenic and manifestations of cancer of the colon and rectum.
本研究分析了基于人群的癌症登记处中结肠癌和直肠癌病例的数据，以确定吸烟、饮酒和癌症家族史对疾病特征的影响。共有771例原发性结肠癌浸润癌病例和304例直肠癌病例构成了研究样本。女性吸烟者中晚期结肠癌的比例高于女性非吸烟者，而在男性中，吸烟对结肠癌诊断时的分期没有影响。对于直肠癌，男性吸烟者晚期疾病的发生率高于非吸烟者。研究发现，吸烟的男性和女性在结肠癌和直肠癌诊断时的平均年龄均低于非吸烟者（分别为p<0.001和p<0.004）。饮酒与结肠癌和直肠癌患者两性的较低诊断年龄始终相关（分别为p<0.001和p<0.001）。那些一级亲属有结直肠癌家族史的直肠癌病例，其诊断年龄比家族史阴性的病例要小（p<0.005）。随着风险因素数量的增加，诊断年龄逐渐降低（结肠癌为p<0.001，直肠癌为p<0.003）。我们的研究结果表明，接触潜在致癌或促癌风险因素与结肠癌和直肠癌的表现之间存在相互作用。
