title: Cigarettes and alcohol in relation to colorectal cancer: the Singapore Chinese Health Study.
abstract: The relations were examined between colorectal cancer and cigarette smoking and alcohol consumption within the Singapore Chinese Health Study, a population-based, prospective cohort of 63 257 middle-aged and older Chinese men and women enrolled between 1993 and 1998, from whom baseline data on cigarette smoking and alcohol consumption were collected through in-person interviews. By 31 December 2004, 845 cohort participants had developed colorectal cancer (516 colon cancer, 329 rectal cancer). Compared with nondrinkers, subjects who drank seven or more alcoholic drinks per week had a statistically significant, 72% increase in risk of colorectal cancer hazard ratio (HR)=1.72; 95% confidence interval (CI)=1.33-2.22). Cigarette smoking was associated with an increased risk of rectal cancer only. Compared with nonsmokers, HRs (95% CIs) for rectal cancer were 1.43 (1.10-1.87) for light smokers and 2.64 (1.77-3.96) for heavy smokers. Our data indicate that cigarette smoking and alcohol use interact in the Chinese population in an additive manner in affecting risk of rectal cancer, thus suggesting that these two exposures may share a common etiologic pathway in rectal carcinogenesis.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
authors.forename: W H
authors.initials: WH
authors.lastname: Tsong
authors.forename: W-P
authors.initials: WP
authors.lastname: Koh
authors.forename: J-M
authors.initials: JM
authors.lastname: Yuan
authors.forename: R
authors.initials: R
authors.lastname: Wang
authors.forename: C-L
authors.initials: CL
authors.lastname: Sun
authors.forename: M C
authors.initials: MC
authors.lastname: Yu
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects*