Department of Surgery, Central Arkansas Veterans Healthcare System, 4300 W 7th Street, 112/LR, Little Rock, AR 72205, USA.
Am J Surg. 2012 Dec;204(6):963-7; discussion 967-8. doi: 10.1016/j.amjsurg.2012.07.026. Epub 2012 Oct 4.
Current guidelines for colorectal cancer (CRC) screening recommend initial screening at 50 years of age for normal-risk patients. Alcohol and tobacco use can be associated with an earlier onset of CRC and possibly polyps.
We reviewed all colonoscopies performed at our institution from January to December 2007. Patient data were collected on age, sex, tobacco and alcohol history, and the presence of colon lesions.
Our data included 663 patients (643 men and 20 women) with a mean age of 60.7 years (range 23-89 years); 68.5% were current/former tobacco users, 53.7% were current/former alcohol users, 37.6% had used both, and 21.7% had used neither. Colonoscopy findings were as follows 64% of patients had no lesions, 30.6% had tubular polyps, 3.5% had villous polyps, and 2% had cancer. The current use of tobacco, alcohol, or both was associated with the early development of colon pathology (ie, 66.9 years, 61.1 years, and 59.2 years [P < .05], respectively). In nonusers, the mean age was 67.7 years.
Our work confirms that the use of alcohol and tobacco is associated with an earlier onset of colon pathology. Consideration should be given to modifying screening guidelines to include these habits as "high-risk" factors.
目前，结直肠癌（CRC）筛查指南建议正常风险患者在 50 岁时进行初始筛查。饮酒和吸烟可能与 CRC 和息肉的早期发病有关。
我们回顾了 2007 年 1 月至 12 月期间在我院进行的所有结肠镜检查。收集了患者的年龄、性别、烟酒史以及结肠病变情况。
我们的数据包括 663 例患者（643 例男性和 20 例女性），平均年龄为 60.7 岁（范围 23-89 岁）；68.5%为当前/既往吸烟者，53.7%为当前/既往饮酒者，37.6%两者兼有，21.7%两者均无。结肠镜检查结果如下：64%的患者无病变，30.6%有管状息肉，3.5%有绒毛状息肉，2%有癌症。当前吸烟、饮酒或两者同时使用与结肠病变的早期发生有关（分别为 66.9 岁、61.1 岁和 59.2 岁，P<.05）。在非使用者中，平均年龄为 67.7 岁。
我们的工作证实，饮酒和吸烟与结肠病变的早期发生有关。应考虑修改筛查指南，将这些习惯作为“高危”因素纳入其中。
