Longnecker M P, Chen M J, Probst-Hensch N M, Harper J M, Lee E R, Frankl H D, Haile R W
Department of Epidemiology, UCLA School of Public Health, USA.
Epidemiology. 1996 May;7(3):275-80. doi: 10.1097/00001648-199605000-00010.
Cigarette smoking has been associated with adenomatous polyps of the large bowel but not with increased risk of colorectal cancer. Giovannucci et al recently proposed a hypothesis to explain this inconsistency. A key testable aspect of the hypothesis is that smoking in the distant past increases the risk of large polyps. Questions also remain about the association between colorectal polyps and consumption of alcohol. To address these issues, we examined data from 488 cases with adenomatous polyps and 488 controls. Subjects were members of a prepaid health plan in Los Angeles who had a sigmoidoscopy in 1991-1993. As expected, the adjusted odds of polyps in current smokers compared with never-smokers was increased [odds ratio = 2.43; 95% confidence interval (CI) = 1.56-3.79]. For those who had smoked in the distant past (for example, 30 or more pack-years before 20 years ago), the adjusted odds of an adenoma > or = 1 cm, relative to nonsmokers, was 0.88 (95% CI = 0.23-3.42). The adjusted odds of polyps in those consuming > or = 46 gm per day of alcohol compared with nondrinkers was 1.50 (95% CI = 0.72-3.13). Although imprecise, these data do not support the hypothesis that past smoking increases the risk of large polyps, but our results indicate a weak association between alcohol use and risk of adenomatous polyps.
吸烟与大肠腺瘤性息肉有关，但与结直肠癌风险增加无关。乔瓦努奇等人最近提出了一个假说来解释这种不一致性。该假说的一个关键可检验方面是，过去长期吸烟会增加患大息肉的风险。关于结直肠息肉与酒精消费之间的关联也存在疑问。为了解决这些问题，我们研究了488例腺瘤性息肉患者和488例对照的数据。研究对象是洛杉矶一个预付健康计划的成员，他们在1991年至1993年期间接受了乙状结肠镜检查。正如预期的那样，与从不吸烟者相比，当前吸烟者患息肉的校正比值增加了[比值比 = 2.43；95%置信区间(CI) = 1.56 - 3.79]。对于那些过去长期吸烟的人(例如，20年前之前吸烟量达到30包年或更多)，相对于不吸烟者，腺瘤≥1厘米的校正比值为0.88(95%CI = 0.23 - 3.42)。与不饮酒者相比，每天饮酒≥46克的人患息肉的校正比值为1.50(95%CI = 0.72 - 3.13)。尽管数据不太精确，但这些数据不支持过去吸烟会增加患大息肉风险的假说，但我们的结果表明饮酒与腺瘤性息肉风险之间存在弱关联。
