Akter Shamima, Islam Zobida, Mizoue Tetsuya, Sawada Norie, Ihira Hikaru, Tsugane Shoichiro, Koyanagi Yuriko N, Ito Hidemi, Wang Chaochen, Tamakoshi Akiko, Wada Keiko, Nagata Chisato, Tanaka Kenta, Kitamura Yuri, Utada Mai, Ozasa Kotaro, Sugawara Yumi, Tsuji Ichiro, Shimazu Taichi, Matsuo Keitaro, Naito Mariko, Tanaka Keitaro, Inoue Manami
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
Int J Cancer. 2021 Feb 1;148(3):654-664. doi: 10.1002/ijc.33248. Epub 2020 Aug 25.
Smoking has been consistently associated with the risk of colorectal cancer (CRC) in Western populations; however, evidence is limited and inconsistent in Asian people. To assess the association of smoking status, smoking intensity and smoking cessation with colorectal risk in the Japanese population, we performed a pooled analysis of 10 population-based cohort studies. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox's proportional hazards model and then pooled using a random-effects model. Among 363 409 participants followed up for 2 666 004 person-years, 9232 incident CRCs were identified. In men, compared with never smokers, ever smokers showed higher risk of CRC. The HRs (95% CI) were 1.19 (1.10-1.29) for CRC, 1.19 (1.09-1.30) for colon cancer, 1.28 (1.13-1.46) for distal colon cancer and 1.21 (1.07-1.36) for rectal cancer. Smoking was associated with risk of CRC in a dose-response manner. In women, compared with never smokers, ever smokers showed increased risk of distal colon cancer (1.47 [1.19-1.82]). There was no evidence of a significant gender difference in the association of smoking and CRC risk. Our results confirm that smoking is associated with an increased risk of CRC, both overall and subsites, in Japanese men and distal colon cancer in Japanese women.
在西方人群中，吸烟一直与结直肠癌（CRC）风险相关；然而，在亚洲人群中，相关证据有限且不一致。为了评估吸烟状况、吸烟强度和戒烟与日本人群结直肠癌风险的关联，我们对10项基于人群的队列研究进行了汇总分析。使用Cox比例风险模型估计各研究的风险比（HR）和95%置信区间（CI），然后采用随机效应模型进行汇总。在363409名参与者中，随访了2666004人年，共识别出9232例新发CRC病例。在男性中，与从不吸烟者相比，曾经吸烟者患CRC的风险更高。CRC的HR（95%CI）为1.19（1.10 - 1.29），结肠癌为1.19（1.09 - 1.30），远端结肠癌为1.28（1.13 - 1.46），直肠癌为1.21（1.07 - 1.36）。吸烟与CRC风险呈剂量反应关系。在女性中，与从不吸烟者相比，曾经吸烟者患远端结肠癌的风险增加（1.47 [1.19 - 1.82]）。吸烟与CRC风险的关联在性别上没有显著差异的证据。我们的结果证实，吸烟与日本男性整体及各亚部位CRC风险增加以及日本女性远端结肠癌风险增加相关。
