Prevalence of colorectal neoplasia in smokers.
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.
Anderson
Joseph C
JC
Department of Gastroenterology and Hepatology, Room 60, Health Science Center T-17, Stony Brook University, Stony Brook, NY 11794-8173, USA.
Attam
Rajeev
R
Alpern
Zvi
Z
Messina
Catherine R
CR
Hubbard
Patricia
P
Grimson
Roger
R
Ells
Peter F
PF
Brand
Douglas L
DL
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*