title: Prevalence of colorectal neoplasia in smokers.
abstract: OBJECTIVE
  Smoking has been linked with colorectal neoplasia. Previous colonoscopy screening studies have omitted smoking and have examined only gender, age, and family history. Our aim was to use a screening population to measure the prevalence of neoplasia in smokers, the anatomic location of these lesions, and the strength of this association relative to other risk factors.
  
  
  METHODS
  Data collected from the charts of 1988 screening colonoscopy patients included colonic findings, histology, risk factors for colorectal neoplasia, and smoking pattern. Current smokers were defined as those who had smoked more than 10 pack-years and were currently smoking or who had quit within the past 10 yr. Our outcomes were any adenomatous lesion and significant colonic neoplasia, which included adenocarcinoma, high grade dysplasia, villous tissue, large (>1 cm) adenomas, and multiple (more than two) adenomas.
  
  
  RESULTS
  Multivariate analysis revealed that current smokers were more likely to have any adenomatous lesion (odds ratio [OR] = 1.89; 95% CI = 1.42-2.51; p < 0.001) as well as significant neoplasia (OR = 2.26; 95% CI = 1.56-3.27; p < 0.001) than those who had never smoked. The increased risk for smokers was predominantly for left-sided neoplasia. The risk for significant neoplasia was greater for smokers than for patients with a family history of colorectal cancer (OR = 1.20; 95% CI = 0.75-1.92; p > 0.05).
  
  
  CONCLUSIONS
  Smoking is a significant risk factor for colorectal neoplasia in a screening population, especially for significant left-sided lesions. In our sample population, smoking posed a greater risk than family history of colorectal cancer.
authors.affiliation: Department of Gastroenterology and Hepatology, Room 60, Health Science Center T-17, Stony Brook University, Stony Brook, NY 11794-8173, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Anderson
authors.forename: Rajeev
authors.initials: R
authors.lastname: Attam
authors.forename: Zvi
authors.initials: Z
authors.lastname: Alpern
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Messina
authors.forename: Patricia
authors.initials: P
authors.lastname: Hubbard
authors.forename: Roger
authors.initials: R
authors.lastname: Grimson
authors.forename: Peter F
authors.initials: PF
authors.lastname: Ells
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Brand
mesh_terms: D000236:Adenoma / Q000453:epidemiology*; D000368:Aged; D016009:Chi-Square Distribution; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*